What to expect at the tier 3 obesity clinic

Please read this information carefully before your first appointment

You have been referred to the tier 3 obesity service at Addenbrooke’s hospital. This service is designed to help patients who have difficulty in managing their weight and builds on interventions you may have received from your GP or the community weight management team (also known as tier 2 services).

Who are we?

The tier 3 obesity service is based at the Wolfson diabetes and endocrinology clinic (WDEC) at Addenbrooke’s Hospital although most of our clinics are now delivered remotely through either video or telephone calls.

The team have extensive experience in helping patients who struggle with managing their weight. Dr Adrian Park is the lead obesity consultant and other members of the team include specialist nurses, dietitians and a clinical psychologist. The team also has support from administration staff.

What do we do?

• Provide an initial comprehensive assessment to gain a thorough understanding of your current lifestyle, health, weight and dieting history and the difficulties your weight problems cause you; we will ask you to complete some questionnaires to support this process. This information is used to design a treatment plan which is specific to your needs
• Recommend further investigations and treatment of any medical causes of obesity and review any obesity-related conditions to improve your health prior to weight loss. We do not routinely offer genetic testing but have access to this should we feel it is necessary
• Offer a medically supervised intensive weight management programme (IWMP) based on a low energy liquid diet which aims to help you change some of your current behaviours. A solid version is also available.
• Offer pharmacological treatments for patients, as appropriate, as per NICE guidelines.
• Provide support via medical clinic
• Arrange psychology input to address some of the causes of overeating and strategies to deal with it

The treatment options are run either as one to one programmes or as groups.

Bariatric surgery

Referral for bariatric surgery (also called tier 4 obesity services) can be considered after a period of engagement with a tier 3 obesity service. This is in keeping with the NICE guidelines for obesity management. Bariatric surgery referral criteria and requirements can be discussed further at your assessment appointment.

What happens when I am seen?

Our clinics are mainly delivered remotely by video or telephone call. We also run some limited face to face clinics at Addenbrooke's hospital and at community locations within Cambridgeshire. If you are booked in for a video consultation, we will send you instructions on how to use Attend Anywhere (the NHS video appointment platform).

At your first visit you will see a member of the team for an assessment. Ahead of this appointment you will be asked to have some blood tests and other clinical measurements including weight, BMI and blood pressure performed. These can either be done at Addenbrooke's hospital or we will ask you to make an appointment for them to be conducted at your GP practice instead.

After your assessment appointment, the obesity team meet regularly to discuss all new patients and to decide how we can best help. We will make a follow up appointment for you after this meeting. In some cases, we may feel your treatment is best managed by your GP or the community team with our recommendations.

What we will expect of you

We know that the best results are achieved by those who are committed to working with us to achieve long-term changes to their lifestyle. As well as attending appointments we will ask you to complete “homework” activities throughout the programme, including self-monitoring diaries and reading resources. These activities are very important to help you develop new weight management skills and strategies. We ask you to complete these to the best of your ability and bring them with you to each subsequent visit.

To enable us to understand as much as we can about what has caused your weight difficulties, being honest with us at the assessment and all subsequent visits is very important. If you are struggling at any point during the programme, please speak to a member of the team.

Please arrive for your appointments promptly and inform us as soon as possible if you are unable to keep an appointment. We operate a ‘did not attend’ policy so any patient that does not attend an appointment without informing us will be discharged from the service. We will also consider discharge if you cancel either two appointments within a nine-month period or two consecutive appointments.

Contacts further information

If you require any additional information about the service, please contact a member of the obesity team on 01223 348124.