1. 1 Sarah Sarah is overweight and feels out of breath easily. She would like to lose weight but feels she needs some extra support. What might happen now… Sarah decides to sign up to a diet club that meets every week. She attends for three months but finds it difficult to stick to the plan that she is given as she feels hungry most of the time. Sarah has not managed to lose much weight on her own and is starting to feel depressed about her situation, so visits her GP. Her GP refers her to the Dietetics Department at an acute hospital for some advice. Sarah has an appointment at the hospital two months later with a dietician. She finds the information she is given useful and makes some changes to her diet following the meeting. Sarah is able to lose some weight over the following year. NHS Yorkshire and the Humber: Staying healthy N.B. The names and images used in this scenario are completely fictitious and are for discussion purposes only

2. 2 Sarah Sarah is overweight and feels out of breath easily. She would like to lose weight but feels she needs some extra support. What might happen in the future… At a GP appointment for something else the GP recommends that Sarah loses some weight A trained worker gives her advice about ways to lose weight and offers treatment and support. Sarah chooses what will suit her best. Sarah decides to go to a local weight management service. She enrols on a long- term programme that covers both food and activity levels and sets Sarah specific goals. She also sees a behaviour change worker who advises her on breaking her habits about overeating. Sarah receives regular support and advice from her local weight management service. She stays on the programme until she has achieved a healthy weight loss and is exercising regularly. NHS Yorkshire and the Humber: Staying healthy N.B. The names and images used in this scenario are completely fictitious and are for discussion purposes only

3. 3 Proposed differences between the pathway now and in the future Weight management is recognised as a distinct health problem needing support Comprehensive screening and identification of obesity occurs throughout the NHS A range of options for weight management are developed in local areas e.g. weight management services, exercise prescriptions and surgery Behaviour change model is used (based on smoking cessation service) Ongoing information and support on weight management Wide range of NHS staff trained in helping people to lose weight and stay healthy NHS Yorkshire and the Humber: Staying Healthy