Weight Management Support (Gender Affirmation Surgery)

This leaflet provides guidance for individuals whose current weight may delay their surgical journey. It outlines how reducing weight can improve surgical outcomes and minimise complications.

If your current weight is preventing you from having surgery, reducing your weight can lower the risk of post-surgical complications and improve outcomes. 

Below are free NHS services and community resources to help you start your weight-loss journey.

How to access NHS weight management services

  • Speak to your GP – they can provide advice and refer you to local weight management programmes.
  • Self-refer – check with your GP surgery or local Integrated Care Board (ICB): Find your ICB
  • Explore online resources:

Please note: Waiting time for these services will vary locally.

Find local services across the UK

  • Local authority services – many councils offer free or subsidised weight management programmes. Search for “weight management” on your council’s website.
  • Community groups – join local weight loss groups or fitness programmes for extra support.
  • NHS website search – use the NHS site to find services near you.

Tier 3 and Tier 4 services

Your GP can refer you if you meet the eligibility criteria:

Tier 3—specialist, non-surgical weight management

  • For people who have not succeeded with diet, exercise, or behavioural support
  • Delivered by a multidisciplinary team of doctors, dietitians, psychologists and activity specialists

Eligibility:

  • BMI ≥ 40, or
  • BMI ≥ 35 with health conditions such as type 2 diabetes or sleep apnoea

Tier 4—surgical weight management

  • Focuses on weight-loss surgery with pre- and post-operative support (dietary advice, psychological support, and physical activity coaching)

Eligibility:

  • Completion of a Tier 3 programme, and
  • BMI ≥ 40, or
  • BMI ≥ 35 with associated health conditions

Trans and non-binary fitness and wellbeing resources

  • Misfits – fitness classes for trans and non-binary people in London, Manchester, Bristol, Brighton, Edinburgh, Sheffield, Cardiff, Belfast and Warrington
  • Trans-fitness – connects people to inclusive personal trainers, coaching and sports clubs.
  • Spectra London – advocacy and signposting for trans and non-binary people facing barriers to healthcare, including weight management
  • Gendered Intelligence – support line for those affected by waiting times for gender-affirming care, including surgery delays linked to weight management
  • GIRES TranzWiki – directory of non-commercial groups and organisations supporting trans and gender diverse people