Time to act? Is the new era of gut hormone-based pharmacotherapy an opportunity to rethink the tier-based UK obesity care model?

Obesity, like type 2 diabetes, is a complex, often life limiting disease influenced by genetics and modern environment. However, unlike diabetes, the provision of integrated, holistic care for people with obesity in the UK remains underdeveloped, despite the growing prevalence of obesity and increasing availability of effective treatments for weight loss. The current tier-based approach to obesity management, although based around a multidisciplinary model, can be fragmented with significant geographical variations in care. The recent approval of new pharmacotherapies by the National Institute for Health and Care Excellence offers an opportunity to rethink and reshape the approach to obesity management. This article provides a review of the current tier-based system for obesity care in UK and proposes alternative models aimed at improving efficiency, promoting equity, and enhancing person-centred outcomes.