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NICE Guidelines

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 or gastric sleeve, they provide the guidelines that apply to fertility treatment and new cancer treatments.

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 – check your BMI here
  • 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 ruins for a minimum of 6 months and requires people to attend regularly and keep to 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 completion of the weight loss programme 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, the NHS Trusts also have to apply more stringent selection criteria than those provided by NICE. It is for this reason we’ll often see a minimum BMI of 50 is applied in some locations. There have also been Trusts where smokers have been denied weight loss surgery. These financial limitations are likely to continue in the future. 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 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 are published to guide commissioners in the NHS. 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 clinical benefits alone. For this reason private weight loss surgery can be performed from a BMI of 30 and upwards as there is a very significant body of data to show it is safe and effective from this level upwards. 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.

Length of cover depends on the warranty package chosen. 2 year surgical warranty provided as standard; extended warranty package includes 5 year surgical warranty and insolvency cover.

For prices & finance options, get a quote online or call 0121 693 4488

*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.