1. The patient has a BMI of 40kgs/m2 or more, or a BMI of 35-40kgs/m2 plus other significant disease that could be improved with weight loss. (Commissioning Policy currently under review)
2. Non surgical measures must have been attempted for at least 6 months but have failed to achieve or maintain clinically beneficial weight loss.
The phrase of “significant disease that could be improved with weight loss” could encompass:
• Type 2 Diabetes
• Osteoarthritis of Weight Bearing Joints
We are aware that NICE has recently approved the use of semaglutide as part of a tier 3 and 4 weight management programme. The current RMS guidelines will be updated as soon as the product is licensed and the team have capacity to provide a service. This is likely to take until winter 2022. There is an advice and guidance service available for any questions, please do not refer purely for semaglutide at this point.
In Cornwall all patients are seen by Dr T Dugal or Dr S Creely at RCHT in the Obesity Clinic prior to referral for Bariatric Surgery.
Date Reviewed 07/08/2019
Date Next Review 07/08/2020
Author Dr B Wesson ( RMS GP Endocrinology lead)