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Specialist weight management services in south west Essex

How to access Tier 3 specialist weight management services, eligibility and exclusion criteria, and guidance on tirzepatide.

Weight management support in Essex is available to help you improve your health and wellbeing. Maintaining a healthy weight can reduce your risk of heart disease, type 2 diabetes, stroke, and other serious conditions.

Tier 3 services provide specialist clinical support for people with more complex needs.

For south west Essex, Second Nature delivers Tier 3 specialist weight management services.

Access is by GP referral only. You will usually need to have completed a Tier 2 programme within the past 12 months, unless your GP advises otherwise.

Eligibility criteria

  • Residents aged 18+ with a BMI ≥40.0 AND meet at least one of the following criteria:
    • Have obstructive sleep apnoea, severe asthma, cor pulmonale, obesity hypoventilation syndrome, or receive CPAP (Continuous Positive Airway Pressure) 
    • Have ischaemic heart disease, heart failure, or a *QRISK score >20% 
    • Have a diagnosis of type 2 diabetes mellitus 
    • Have subfertility 
    • Have oesophagitis, severe gastro-oesophageal reflux disease, or Barrett’s oesophagus.  

*QRISK is a clinical scoring tool used to assess risk factors associated with cardiovascular disease.

Exclusion criteria

  • Aged 17 years or under 
  • Pregnant or breastfeeding 
  • Active eating disorders 
  • Have undergone bariatric surgery in the past 12 months 
  • Pre-diabetes more appropriate for the NHS diabetes prevention programme 
  • Previously attended a Tier 3 weight management programme in the last two years from date of discharge 
  • Referrals can be made once the following conditions are stable:
    • Alcohol or drug use 
    • Hypothyroidism 
    • Cushing’s syndrome 
    • Mental illness  

Tirzepatide (Mounjaro®) for weight management

It was announced on 23 June 2025 that people living with obesity will begin accessing tirzepatide (Mounjaro®) for weight loss purposes in primary care settings.

Weight management services are locally commissioned and funded at an Integrated Care Board (ICB) level, which means services will differ across each ICB. In south west Essex, the specialist weight management provider Second Nature is providing access to tirzepatide (Mounjaro®) through an outreach service. GP practices can refer patients to this service.

Patients who wish to access Mounjaro through the specialist weight management service must meet the eligibility criteria for Mounjaro. Patients who currently pay for Mounjaro outside of the NHS (privately) and would like to request an NHS prescription will need to meet the eligibility criteria at the time of their NHS referral to the Tier 3 specialist weight management service.

Please note that acceptance onto Tier 3 specialist weight management services does not guarantee access to Mounjaro. Access to this medication is prioritised for those facing the most significant health risks related to their weight: people living with obesity, in poor health with multiple obesity-related conditions.

Tirzepatide FAQs for south west Essex residents

The full qualifying clinical criteria is a BMI (Body Mass Index) of 40 or more, plus four or more of the following diagnosed health conditions:

  • type 2 diabetes
  • high blood pressure
  • heart disease
  • obstructive sleep apnoea
  • abnormal blood fats (dyslipidaemia)

Drug access must be accompanied by wraparound care, which includes support for people to make dietary changes and to increase physical activity. Services will not prescribe tirzepatide as a standalone treatment. Patients must fully participate with the wraparound support programme.

Tirzepatide (Mounjaro®) might not be considered clinically suitable for everyone, and not everyone who meets the eligibility criteria will want to use it to support their weight loss. Therefore, there are alternative weight management services available in south west Essex.

Patients can continue taking tirzepatide (Mounjaro®) if the NHS has prescribed it to manage their diabetes. If you have any questions, speak to a healthcare professional.

If patients are using tirzepatide (Mounjaro®) bought privately, they may be able to access the medication through an NHS prescription if they meet the NHS qualifying criteria. However, patients should not gain advantage over other patients waiting for NHS care and would join the end of any existing waiting list.

It is important to tell your GP if you are taking tirzepatide (Mounjaro®) if the NHS hasn’t prescribed it, as it may impact your health and other treatments you are having or may need.

In south west Essex, the specialist weight management provider Second Nature is providing access to tirzepatide (Mounjaro®) through an outreach service. GP practices can refer patients to this service.

There are currently no plans to make tirzepatide available on the NHS through pharmacies in south west Essex.