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Evaluation of the experience of people referred under the NHS enhanced service incentive for obesity to the NHS digital weight management programme: a mixed method study

Lookup NU author(s): Dr Simon BarrettORCiD, Dr Lorraine McSweeneyORCiD, Dr Charlotte RothwellORCiD, Dr Mackenzie FongORCiD, Professor Ashley AdamsonORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Abstract

© The Author(s) 2026.Background: Internationally, guidelines recommend clinicians identify patients living with obesity and offer referral to weight management programmes, especially patients with related co-morbidities. In 2021, NHS England introduced the NHS Digital Weight Management Programme for people living with obesity and a diagnosis of hypertension or diabetes or both. The programme is offered at three levels of intensity with people triaged to the appropriate level determined through age, sex, ethnicity, and deprivation. The aim of this study was to assess the experiences of people referred to the programme. Methods: A mixed methods evaluation, involving questionnaires and semi-structured interviews with patients. Questionnaires were sent to everyone who registered and chose a preferred service Provider between March 2022 and June 2023, and responses are reported as proportions. Differences in health status, demographic characteristics and experience on the programme were assessed using ordinal logistic regression. A sample of patients were interviewed, and data were analysed using a framework. Results: 17,553 questionnaires were distributed, with 3885 (22.1%) completed. We interviewed 24 patients (27 to 79 years of age; 15 females, 9 males), who had various levels of support and rates of completion. The programme was reported to be easy to use, and around half of survey respondents felt the programme helped them change their diet or activity or improved their wellbeing, regardless of the level of support received. Participants from minority ethnic groups were less likely to describe the programme or the coaching as helpful in terms of changing behaviour. Interview participants valued weight tracking, goal setting, and meal planning, but some felt the service was too generic for their individual needs. Some participants reported they did not receive sufficient in-person or group support, and that online forums were not a suitable alternative. Around half of participants found coaching helpful, but some described the coaches as unresponsive or scripted. Conclusion: The NHS Digital Weight Management Programme was moderately well received by most participants, and facilitated weight loss, behaviour change, and continued engagement. It was less helpful for people from minority ethnic groups, and some participants wanted more frequent contact and greater personalization in interactions with health coaches.


Publication metadata

Author(s): Barrett S, Haffner SJP, McSweeney L, Rothwell C, Fong M, Jebb SA, Indulkar T, Taylor K, Adamson AJ, Heath L, Aveyard P

Publication type: Article

Publication status: Published

Journal: BMC Public Health

Year: 2026

Volume: 26

Issue: 1

Print publication date: 17/02/2026

Online publication date: 23/01/2026

Acceptance date: 05/01/2026

Date deposited: 03/03/2026

ISSN (electronic): 1471-2458

Publisher: BioMed Central Ltd

URL: https://doi.org/10.1186/s12889-026-26203-z

DOI: 10.1186/s12889-026-26203-z

Data Access Statement: The quantitative data that support the findings of this study are available from NHS England but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of NHS England. The qualitative dataset used and analysed during the current study is available from the corresponding author upon reasonable request

PubMed id: 41578273


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Funding

Funder referenceFunder name
Applied Research Collaboration (ARC)
National Institute for Health and Care Research (NIHR)
NIHR Oxford and Thames Valley Applied Research Collaboration (ARC)
NIHR Oxford Biomedical Research Centre
NIHR Oxford Health Biomedical Research Centre

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