Obesity Care Pathway

Background

The level of obesity and the incidence of obesity-related morbidities and associated hospital admissions^1,2 have risen over recent years with the UK experiencing one of the highest rates of obesity in the world². This has a negative impact on the health of the UK population and increases costs for the NHS which are estimated to grow to £9.7bn annually by 2050². There are significant inequalities in the rates of obesity, factors that influence this rate include deprivation and ethnicity³.

There is an acceptance by both clinicians and service managers that current service models do not demonstrate consistent successful treatment outcomes for those seeking support with their weight⁴. However, there is a lack of understanding of the clinical pathway, including whether there are different pathways for co-morbid conditions associated with obesity such as fatty liver disease or Type 2 Diabetes.

Understanding and Reimagining Obesity Care and Management Across Greater Manchester

Through a Collaborative Working Agreement (CWA), “Implementing a New Model of Obesity care in Greater Manchester Integrated Care System”, Health Innovation Manchester and Eli Lilly and Company (Lilly) are working together to optimise the existing obesity care pathways and service models. Through a previous CWA, “Reimagining Obesity Care Pathways in Greater Manchester Integrated Care System” in 2024, it was demonstrated that there is an inconsistent approach across Greater Manchester (GM) and that steps need to be taken to optimise current resources and introduce new ways of working that will improve obesity services⁴.

The aim of the project was to design a more efficient and effective tech enabled, primary care-led model of care, to increase equity of access to all therapies and wrap around support for eligible cohorts in line with National Institute for Health and Care Excellence (NICE) recommendations⁵. Together we are building a case for implementation of a reimagined obesity pathway, scalability and sustainability into GM and nationally.

Outputs into a reimagined obesity pathway include:

• Service co-design: Developing a GM-standard model of care and pathways for weight management and obesity, underpinned by user-centred design with staff and patients. This involved working in close partnership with primary care (general practice and community pharmacy), as well as input from secondary care specialists, third sector partners and industry providers.
• Community Research and Pathway Design: Understanding patients’ needs, priorities, and ideal approach to weight management is essential to ensure a balance of clinical and community perspectives and removal of any potential healthcare bias in recommending a new obesity care model. Through working with the hardest-to-reach patients, as well as those from marginalised and vulnerable communities, the aim was to design for the most acute needs to ensure universal access to obesity services.
• Development of a Digital Support Service Specification: Understanding how obesity services can be transformed using digital and tech to support primary care to deliver more efficient and equitable care for individuals living with obesity. Novel digital weight management services were explored to help understand which could enable patients to have access to support at any time. The support could include the ability to track weight loss progress and receive expert support via a digital device, tailored nutrition, exercise, and behavioural strategies.
• Cost benefit analysis: Cost benefit analysis assessing the long-term impact of obesity treatment, delivered as part of a commissioned weight management pathway for eligible populations in Greater Manchester. The analysis estimates 20-year costs and potential system level savings, including changes in healthcare utilisation, social care demand, and economic inactivity, under NICE, Greater Manchester Medicines Management Group (GMMMG) guidance⁶ and local eligibility criteria.

What Happened Next

These insights further helped to inform a user journey map and mindset framework to guide future design. They shaped the planning of three co-design workshops where community members heard the research findings to help focus their ideas. This methodology ensures any future pathway design is grounded in real experience and driven by the people it’s meant to serve.

Access the Patient and HCP Survey Outcomes Report here.

Reports

• Patient and HCP Survey Outcomes Report (2025)
• Reimagining Obesity Care Pathways in Greater Manchester Integrated Care System (2024)
• Understanding Obesity Care Pathways in GM ICS (2024)
• Cost of Obesity in Greater Manchester (2024)
• Obesity PPIE Report (2024)

References

1. https://www.england.nhs.uk/ourwork/prevention/obesity/
2. Tackling Obesities: Future Choices – Project Report
3. Fair Society Healthy Lives full report (parliament.uk)
4. https://healthinnovationmanchester.com/wp-content/uploads/2026/10/UK_Obesity_ManchesterReimaginingLandscapeFinalReport_August26_PP-MG-GB-0569.pdf
5. https://www.nice.org.uk/guidance/ng246
6. https://gmmmg.nhs.uk/guidance/clinical-guidance-and-pathways/