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NICE Guidelines


NICE stands for the National Institute for Health and Clinical Excellence

It’s a government body that sets the eligibility criteria for drugs and medical procedures in the UK. In addition to setting criteria for surgical procedures such as gastric bypass and gastric sleeve, they provide the guidance that applies to all treatments, including fertility and new cancer treatments as examples.

Although they only provide guidelines, rather than hard and fast rules, it is unusual for the NHS, or commissioning groups, to operate outside of their guidelines. In fact, where weight loss surgery is concerned it is more likely that local hospital Trusts and Commissioning groups will apply much more stringent criteria. This is because there are insufficient resources to treat all of the patients who are eligible. 

For weight loss surgery, the NICE guidelines are that the following people are eligible for NHS surgery:

  • A body mass index (BMI) above 40 –  BMI Checker
  • A BMI above 35 when accompanied by a serious weight related co-morbidity (illness or disease) such as Type 2 Diabetes

If you have a question about the NICE guidelines and whether a private or NHS procedure would be a possibility for you, please call our team on 0800 313 4618 or use our enquiry form.

The criteria above only apply when it is demonstrated that other weight loss methods have been tried and failed. In practice, that means that all people hoping to have weight loss surgery in the NHS will first need to complete an NHS weight loss programme that is run through their local NHS Hospital Trust. It usually runs for a minimum of 6 months and requires people to attend regularly and keep appointments. 

In order to get onto this programme you will need the support of your GP as a referral from your GP will be required.

Once the course is completed, potential patients will be referred to a surgeon. There will usually be a long waiting list before being seen by the surgeon. There is also a requirement for your case to be reviewed by a multi-disciplinary team including dietitians, psychologists and anaesthetists. From the time you complete the weight loss programme (known as Tier 3), it can take 18 months or more before surgery will be scheduled.

*Weight loss surgery results and benefits differ for each individual. Results cannot be guaranteed

Given their limited resources, NHS Trusts often apply more stringent selection criteria than those provided by NICE. It is for this reason we’ll may see a minimum BMI of 50 is applied in some locations. There are also Trusts where smokers have been denied weight loss surgery. These financial limitations are likely to continue in the future. Already, resources are so stretched that only 5,000 NHS weight loss procedures are done in the whole of the UK each year. See our recent blog on this.

Many of the patients we treat have tried to access surgery through the NHS only to find that they are ineligible or that they face an uncertain wait for several years.

It is for this reason that most patients in the UK elect to have their weight loss surgery done privately. If you have a question about the NICE criteria or you are interested in exploring  a private weight loss procedure, call us on 0800 313 4618 or enquire here.

NICE guidelines balance the financial cost of treatment and the public health benefit. As such these guidelines balance the financial cost with the public health benefit. The same restrictions do not apply to privately funded surgery where a decision on the benefit of surgery can be based on the health benefits alone. For this reason, private weight loss surgery can be performed from a BMI of 30 and upwards (gastric sleeve and bypass from BMI 35) as there is a very significant body of data to show it is safe and effective from this level – see scientific reference below.’ Then delete the remainder of the para ‘Indeed there….BMI of 30 or above. Indeed there are some patient groups where surgery will be considered for patients with even lower BMI dependent upon their individual circumstances. One such group would be diabetics. The criteria we apply is based on the NCEPOD (National Confidential Enquiry into Patient Outcome and Death) review from 2012, ‘Too Lean a Service’. This report recommends surgery for patients with a BMI of 30 or above.

If you are ready to consider a privately funded weight loss procedure or you have questions about your eligibility, please call us on 0800 313 4618 or make an online enquiry using the form here.

Scientific reference:JAMA. 2012 Jan 4;307(1):56-65. doi: 10.1001/jama.2011.1914. Bariatric surgery and long-term cardiovascular events

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*Weight loss surgery results and benefits differ for each individual. Results cannot be guaranteed

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*Weight loss surgery results and benefits vary and are different for each individual. As such, Healthier Weight cannot guarantee specific weight loss goals.