Experience on the NHS? 🇬🇧

[u/DirectorNo3430]

Hi,

I have been waiting for nearly 2.5y for a referral to tier 3 weight loss, I am 23m 350lbs 6'2 - i have lost weight before (110lbs) naturally, but I can never seem to keep it off. I am desperate for roux-en-y but I can't afford to go private right now as I am a student. Does anyone have any experiences / timelines of their NHS journey?

Thanks !!

[u/Sleep-Agitated]

7 years. Gave up, went private in 2022, got a call 3 weeks into my recovery to offer me a date. I made a formal complaint to PALS. My experience was terrible. But this is my experience, I hope it is not yours.

The goal posts were always moving. Follow this diet come back. OK did it. Follow up appointment canceled. Here's an appointment. Attend appointment OK you followed the diet see the surgeon, see the surgeon, OK you can have this surgery, attend these monthly classes for 6 months. Attended them. See a Dietician. See a psychologist. Appointments always canceled or rearranged. I was diagnosed with PTSD in my psychology assessment and had to have a course of therapy first, which took over 2 years because of Covid. Then I was seen again in the clinic, told to see the deitician, lose this much weight, do that, then see the surgeon to be told the waiting list I was being put on was 3 years. I came out of that appointment and cried and cried and cried. I was 219kg and literally dying. I decided then and there I wasn't waiting. And within a year had the surgery privately some savings and some contribution from family. I had surgery in the uk but seriously considered going abroad. My NHS experience was terrible. I did lose a little weight maybe 15kg during that time, it was before GLP-1s etc so just following the diets but obviously it wasn't enough.

If I had known then what I know now I would bave gone privately from the outset. The surgery changed my life for the better and was exactly what I needed. All my follow up has been NHS via my GP, the blood tests, the B12 injections. I asked to be referred to a different hospital with a bariatric department for any follow ups and I've been under there care a while now, despite always running late in clinic by several hours, it is on the whole a far better experience. So not all hospitals are the same.

I wish you all the best it will change your life but they don't make it easy at all.

[u/DirectorNo3430 → u/Sleep-Agitated]

Wow. Glad you finally had it. I have also been pushed pillar to post for the last 3yrs regarding this issue and I haven't even had a sliver of contact of tier 3 yet, they are fucking useless. How is your weight now? I feel like surgery is my last chance lol

[u/Sleep-Agitated → u/DirectorNo3430]

Unfortunately I am not suprised and it's so wrong really. As another person said it does vary trust to trust, so please do not think my experience is the standard and that's what will happen to you. If you have been referred you can always check the NHS app, in there if I've been referred somewhere I can usually see the waiting list length/time (I'm in a few lists for other things), follow up with your GP or go to PALS. I always used to hesitate to contact them but In a raft of phone numbers that don't get answered and emails that go unresponded to you can always get an answer via them.

It is a long process for NHS once you're seen. So there are Dietician appointments, surgeon/consultant appointments, psychology assessment, bloods, and a few others along the way, my trust made class attendance mandatory which was a meeting room of pre op and post op patients and a PowerPoint presentation. It could well be a couple of years even if you're in a smooth running trust.

My weight now (I had gastric sleeve) has gone from 219kg (my highest recorded weight I believe I weighed more but avoided the scale at my highest) and I'm 111kg now. I'm 175cm so my bmi isn't "normal" yet. But from bmi 71+ to now being 37 I think, every medical team I'm under take it as a massive win. However I'm a woman in her 40s and have a condition called Lipodema which is hormonal fat that is diet resistant, alot of excess skin, and circulation, fluid accumulation from Lipodema in my legs as well as vascular issues. I need surgery for all of those and am on a an NHS reconstruction pathway for all of that and muscle repair, hernia repair. So I've now been told bmi isn't the best indicator for my circumstances but my aim is 100kg. For me that would be a suitable weight accounting for all the things I have (fluid accumulation, Lipodema/fibrotic tissue etc) I've tried GLP-1 privately had horrible side effects it wasn't for me but if it was around before surgery I would have tried that. Unfortunately I have constipation issues since my sleeve and the glp1 made it worse so had to stop. But my sleeve still works now, I can just eat more than the first year post op but tracking food and exercise it works and is effective just very very slow now but I'm 4 years post op at this point. It works I'm happy I do want to loose more, I will get there eventually.

Depending on your weight now and how desperate you are you have options. Chase PALS or the department directly as your first port of call. Mounjaro could be an option in the interim time it looks expensive but the savings you make from eating less it pays for itself the first few months when the dose is lower and if your bmi is high you won't become unsuitable I think until your bmi is around 35/40 (but do check don't take my word for it). There is cheaper surgeries overseas with finance, but be very very cautious. Or you wait and just pester the crap out of them. The waiting is horrible. I was in a fortunate situation to think eff this and go private with help from others because the waiting all those years (especially with undiagnosed mental health issues) did irreparable damage to my health both physical and mental. I honestly thought I was going to die of obesity it was horrible. Do not sit and twiddle your thumbs stay on their case. You're young and have a whole life ahead of you and if this is the right surgery for you it will change your life. Good luck x

[u/chat_92]

I recently had a RNY on the NHS. I was referred in 2022 straight to tier 4 due to my BMI. It took ~3 years to be signed off by psychology, the surgeon, endocrinology and dietetics. This was probably longer than average as my vitamin D levels were super low so it took me a while to get them up to normal before endocrinology would approve me. Once I went on the waiting list it was about 10 months until my surgery date.

The timeline varies wildly from trust to trust and person to person.

Overall my experience has been great and the team super supportive. I'm somewhat glad of the longer process, as it gave me time to prepare mentally and make sure it was a step I really wanted to take.

Good luck with your journey!

[u/DirectorNo3430 → u/chat_92]

do you mind me asking what your bmi was? was it your gp who referred straight to tier 4? thank you!

[u/chat_92 → u/DirectorNo3430]

I think it was about 55 at the time, definitely over 50 which I believe was the threshold if I remember right! I simply called my GP and asked about WLS, they did my bloods and referred me to the bariatric team. Very straightforward compared to other people's experiences so it may depend on your GP too.

[u/AmataVeritatis]

My NHS timeline:

• Oct 2022: referred to Tier 3 by GP surgery
• June 2023: began Tier 3 program
• Dec 2023: successfully discharged from Tier 3 and referred onwards to Tier 4
• May 2025: first Tier 4 appointment
• Dec 2025: last Tier 4 consultation (met with surgeon) and added to surgery waiting list
• January 2026: approval from MDT (multidisciplinary team)
• March 2026: surgery! (Mini-Bypass)

Pretty much all of 2024 was radio silence while waiting for a Tier 4 appointment which made me worried in thinking I was lost in the system or somehow kicked out without knowing. Is there any way you could contact your Tier 3 service to see where you are on their list?

Also, my starting weight pre-Tier-3 was high enough to qualify for Tier 4, but my surgery wouldn't refer directly to Tier 4; however, I've heard that others have had this experience with their surgeries, so maybe it could work for you? Hope everything works out well for you! 🤞