Weight loss

Commissioners of lifestyle weight management services (such as public health teams within local authorities or other health and social care commissioners) should commission or recommend lifestyle weight management programmes that:

• Are multi-component that is, they address dietary intake, physical activity levels and behaviour change.

• Are developed by a multidisciplinary team. This includes input from a registered dietitian, registered practitioner psychologist and a qualified physical activity instructor.

• Ensure staff are trained to deliver them and they receive regular professional development sessions.​

• Focus on life-long lifestyle change and the prevention of future weight gain.​

• Last at least 3 months, and that sessions are offered at least weekly or fortnightly and include a 'weigh-in' at each session.​

• Ensure achievable goals for weight loss are agreed for different stages – including within the first few weeks, for the end of the programme or referral period (as appropriate) and for 1 year (see improve adherence and outcomes in this pathway).​

• Ensure specific dietary targets are agreed (for example, for a clear energy [calorie] intake or for a specific reduction in energy intake) tailored to individual needs and goals. Note: it is preferable not to 'ban' specific foods or food groups – and the price of any recommended dietary approaches should not be prohibitive. Individual advice from a registered dietitian may be beneficial, but is not essential.​

• Ensure discussions take place about how to reduce sedentary behaviour and the type of physical activities that can easily be integrated into everyday life and maintained in the long term (for example, walking).​

• Ensure any supervised physical activity sessions are led by an appropriately qualified physical activity instructor and take into account any medical conditions people may have. Instructors should be on the Register of Exercise Professionals (or equivalent) at level 3 or above.​

• Use a variety of behaviour-change methods. These should address: problem solving; goal setting; how to carry out a particular task or activity; planning to provide social support or make changes to the social environment; self-monitoring of weight and behaviours that can affect weight; and feedback on performance.​

• Tailor programmes to support the needs of different groups. For example, programmes should provide men- or women-only sessions as necessary; provide sessions at a range of times and in venues with good transport links or used by a particular community; and consider providing childcare for attendees.​

• Monitor weight, indicators of behaviour change and participants' personal goals throughout the programme.​

• Adopt a respectful, non-judgemental approach (see minimise harm in this pathway).

Maintain weight loss

Providers of lifestyle weight management programmes should ensure programmes are based on the core components to prevent weight regain(see bullet list below).

Commissioners of lifestyle weight management programmes (such as public health teams within local authorities or other health and social care commissioners) should commission or recommend lifestyle weight management programmes that address the prevention of weight regain by:​

• Fostering independence and self-management (including self-monitoring).​

• Discussing opportunities for ongoing support once the programme or referral period has ended. Sources of ongoing support may include the programme itself, online resources or support groups, other local services or activities, and family or friends.​

• Stressing the importance of maintaining new dietary habits and increased physical activity levels in the long term to prevent weight re gain and discussing strategies to overcome any difficulties in maintaining the new behaviours.​

• Encouraging dietary habits that will support weight maintenance and are sustainable in the long term. For example, programmes should emphasise how following national advice on healthy eating can support weight management. (For example, see NHS Choices.)​

• Promoting ways of being more physically active and less sedentary that are sustainable in the long term (for example, walking). The wider benefits of physical activity should also be emphasised.