Case study: Tier 3 Weight Management in Cambridgeshire & Peterborough

Oviva Tier 3 Weight Management in Cambridgeshire & Peterborough

Obesity is a growing health issue in the UK and associated with significant comorbidities and costs. Elective waiting lists have reached an all-time high, with a record 7.22 million people waiting for treatment. Meanwhile, weight management services are facing their own set of challenges. Limited funding and increasing demand for other services have left people with obesity untreated, further adding to NHS pressures.

Tier 3 weight management programmes are aimed at people living with obesity and complex physical and/or psychological needs.

There are currently gaps in the provision of Tier 3 Weight Management services across the UK which cause multiple barriers for people living with obesity to get the care that they need. Such barriers include:

  • People being unable to commit to months of face-to face appointments
  • Lack of one-to-one care options for patients who do not wish to attend groups
  • Appointment timings and travel costs
  • Lack of provision in patients’ first languages

The health and care needs of those eligible for Tier 3 weight management services are complex. A service which tackles health inequalities and personalises the patient pathway based on their individual needs and preferences makes care more accessible for the population, greatly enhancing the effectiveness of the intervention and increasing participant engagement and adherence.

The solution

Making use of digital or remote pathways supports improved access to care, and supporting people to get online and use digital health resources can be
crucial to achieving both national and local priorities.

In October 2020 Oviva was commissioned to provide a fully remote Tier 3 weight management service in the Cambridgeshire and Peterborough area to
people living with obesity.

About Oviva Tier 3 Weight Management

Oviva Tier 3 Weight Management is a programme structured to provide knowledge and tools that empowers participants to improve their overall health.

The service provides personalised support from a multidisciplinary team of healthcare professionals, including psychological support if needed. The programme is delivered either one-to-one or in groups via intensive app coaching or phone calls, and supported by an online learning platform.

The pathway

Eligible participants were offered a choice of delivery method and dietary approach to provide a fully personalised treatment pathway.

Participants were guided through a core educational curriculum, supported by one-to-one or group personalised coaching in the form of frequent app coaching or phone calls over three stages of the 12 month programme.


Initial Consultation to offer choice of triage and set goals to provide a personalised health care plan.


Participants were offered the choice of app or telephone coaching, and a dietary approach of either Total Diet Replacement (TDR) or a Healthy Eating Approach (HEA).


Six months of intensive coaching by a specialist dietitian, with additional
health coach check ins at 12 and 18 months. Optional psychological
support depending on individual need.

Participants achieving 5 or 10% weight loss at 6 months


73% of referrals (n=333) attended their initial assessment and 60% of referrals attended their initial dietitian consultation.

31 Healthy Eating Approach (HEA)-participants and 29 Total Diet Replacement (TDR)-participants had completed the service at the point the data was reviewed.

Mean weight loss at 6 months

Total Diet Replacement as a dietary approach within an intensive and supportive Tier 3 service can achieve excellent weight loss outcomes compared to traditional dietary approaches.

Therefore, Total Diet Replacement can be seen as a viable dietary approach in Tier 3 weight management as part of a menu of options to suit the individual.


Adopting a remote digital approach in Tier 3 weight management services has the potential to increase uptake and overcome barriers to access, achieving significant weight loss outcomes, thereby reducing the need for surgical interventions.

Within this framework, Total Diet Replacement emerges as a highly effective dietary approach, delivering excellent weight loss outcomes when compared to traditional methods.

It should be considered as a viable option in the range of interventions offered by Tier 3 services, recognising that there is no one-size-fits-all approach that suits every individual.

At Oviva, we acknowledge the diverse needs of the local population and the complex health and care requirements of those eligible for Tier 3 weight management services. We take pride in offering flexibility and choice to personalise our services, emphasising the importance of prioritising the development and expansion of such programmes.

By doing so, we can contribute to more efficient healthcare delivery and enhance the overall patient experience.

Ashlee’s story

After multiple attempts to lose weight Ashlee started considering bariatric surgery. After discussion with her GP, she was referred to Oviva Tier 3 Weight Management, and shortly after began a 12 week low calorie diet using Total Diet Replacement under the supervision of a specialist dietitian.

Initially Ashlee found the first ten days challenging, but her Oviva dietitian recommended various tips to help her stay on track, including adding additional seasonings to the meal replacement soups for palatability, and adding linseeds for fibre. Ashlee looked forward to check-ins with her dietitian throughout the programme, and as she progressed on her journey she found she had more energy to be active with her children.

I feel like a new person, a different person. I feel different, look different, act different. I have found myself and I have turned a corner in terms of weight. I would rather give up my house than not complete this programme!”

Read Ashlee’s story

If you’d like to learn more about how Oviva could support your patients and practice, get in touch today.

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