Second Nature will be the new weight loss service locally, accepting patients from 1st April 2025.

Those previously under Oviva (not via right to choose) will be transitioned across.

Any patients who have been referred into the RIGHT TO CHOOSE Oviva Tier 3 service which is part of the patient choice framework will remain in that service as this is not commissioned by Mid and South Essex Integrated Care Board.

Inclusion Criteria:

Service Users 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
• 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.

Confirmation that a Tier 2 weight management programme has been completed within 12 months of the date of referral, unless Tier 2 is not suitable or appropriate for the individual.

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 2 years from date of discharge
•  Only refer once stable: Alcohol or drug use, Hypothyroidism, Cushing’s syndrome & Mental illness