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Tier 3 Weight Management
Our 12 month+ intervention provides tailored, intensive support from our team of dietitians, psychologists, physicians, pharmacists, and exercise specialists. Initial assessments triage a patient to clinical pathways based on their clinical complexity, improving engagement, outcomes, and user satisfaction. Our innovative service has demonstrated 11.8% weight reduction at 2-years.
Triage
Personalised clinical pathways based on a patient's clinical complexity to ensure optimal care and safety
Support
Intensive support from a broad MDT of dietitians, psychologists, physicians, pharmacists, and exercise specialists
Learn
Modules that dynamically adapt to patient needs, improving their relationship with food and reducing disordered eating behaviours
How it works

1

Referral
Specialist weight management teams can refer patients to Second Nature with an online form

2

Initial Assessment
Conducted by an MDT to determine the unique package of support required

3

Plan Customised
Support is customised and tailored to patient need, depending on complexity

4

Clinical Support
From dietitians, psychologists, physicians, and exercise specialists
Weight-loss results
⬇️ 11.8% mean reduction in body weight by month 24
1: Richards R, Wren G, Whitman M. The Potential of a Digital Weight Management Program to Support Specialist Weight Management Services in the UK National Health Service: Retrospective Analysis JMIR Diabetes 2024;9:e52987 URL: https://diabetes.jmir.org/2024/1/e52987 DOI: 10.2196/52987
2: Second Nature Tier 3 Weight Management data on file

Recent Second Nature Tier 3 Weight Management data awaiting publication shows mean weight change of 4.8%, a 66% improvement in psychological distress, and 83% improvement in anxiety & depression
Inclusion Criteria ✅
  • Over 18 years old
  • BMI >35 in the presence of diabetes and/or other significant co-morbid conditions (note we may also accept patients for assessment with a BMI >30 if screened and referred specifically by their NHS tier 3 service lead)
  • Or BMI of >40 without (reduced by 2.5 kg/m2 of BMI in Black African, African Caribbean and Asian groups)
  • The underlying causes of overweight or obesity need to be assessed
  • The person has complex disease states or needs that cannot be managed adequately in tier 2 (for example, the additional support needs of people with learning disabilities)
  • Conventional treatment has been unsuccessful
  • Drug treatment is being considered for a person with a BMI of more than 50 kg/m2
  • Specialist interventions (such as a very-low-calorie diet) may be needed
  • Surgery is being considered.
Exclusion Criteria ❌
  • Current or planned pregnancy
  • An unstable condition that does not warrant weight management at present.
  • Recent complicated myocardial infarction or stroke and/or awaiting further investigation
  • Blood pressure at rest above 180mg Systolic, 120mg Diastolic
  • Alcohol or drug misuse
  • Diagnosed or suspected eating disorder (e.g. binge eating disorder), or presenting with active purging behaviours e.g. laxative misuse, self-induced vomiting in the absence of a diagnosed eating disorder (referral to mental health/eating disorder services for specialist assessment should be considered)
  • Undergoing active cancer treatment
  • Acute infection
  • Unstable major psychiatric illness
  • Recent bariatric surgery (within the last 2 years)
  • Within 2 years of surgery, people are often still losing weight and should still be under the care of their tier 4 team.
Carla, 27, London
"Sometimes when you’re having those negative thoughts you can really feel like you’re the only one in the world experiencing them. It’s a hard mentality to break and with the help of Second Nature, as well as doing my own mental health journey, I’ve realised that all wellness health is life long."
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