Can you get Second Nature for free on the NHS?

Jump to: Check your tier 3 eligibility | Which NHS programmes Second Nature delivers | Second Nature free through NHS tier 3 | Who’s eligible for NHS support | What if you’re not eligible | NHS vs Second Nature’s medicated programme | What to ask your GP | Take home message | FAQs

You can join Second Nature for free on the NHS if we offer a service in your local area and you meet the local or national NHS eligibility criteria.

Second Nature delivers 3 free NHS weight-management services: the NHS Digital Weight Management Programme, the Healthier You: NHS Diabetes Prevention Programme^1,2, and a tier 3 specialist weight-management service that can include Wegovy (semaglutide) where it’s suitable.

Tier 3 is for adults living with more complex obesity. In England, you can ask your GP to refer you to our tier 3 service under Right to Choose, which lets you choose your provider when your GP refers you, as long as that provider holds an NHS contract for the service⁸.

Whether you qualify for free access depends on your BMI, blood sugar levels, and any related health conditions, such as diabetes or high blood pressure. For tier 3, each local NHS area sets its own criteria.

If you’re not eligible for an NHS programme, or you’ve been told to wait, our private medicated weight-loss programme is available without a GP referral, with same-week start times and outcomes published in peer-reviewed research⁶.

Check if you could get our NHS tier 3 service for free

Our eligibility checker compares your NHS area, age, height, weight and health conditions with your area’s criteria for our tier 3 service, and takes about 2 minutes.

Your GP checks your eligibility against your medical record and decides whether to refer you.

If the checker says you’re likely to qualify, the next step is asking your GP to refer you, which is explained in the tier 3 section below.

If you don’t meet the tier 3 criteria, the rest of this guide covers the other NHS programmes we deliver, with a checker for those programmes, and your private options.

Which NHS weight-loss programmes does Second Nature deliver?

Second Nature has worked with the NHS since 2017 and is currently commissioned across 43 Integrated Care Boards and Health Boards in the UK.

We deliver two of the largest national NHS weight-management programmes, as well as our own tier 3 specialist service.

Healthier You: NHS Diabetes Prevention Programme

A free 9-month behavioural programme for adults at risk of type 2 diabetes.

Our delivery combines daily health coach support, smart scales, and educational content through the Second Nature app².

An evaluation of the NHS digital diabetes prevention pilot, published in BMJ Open Diabetes Research and Care, found an average weight loss of 3.1 kg at 12 months across digital providers⁷.

NHS Digital Weight Management Programme

A free 12-week online programme for adults living with obesity who also have diabetes, high blood pressure, or both¹.

Three levels of support are available, ranging from self-guided plans to one-to-one health coaching.

Local NHS contracts

Beyond the two national programmes, we also deliver local NHS contracts for type 2 diabetes management in areas including NHS Tayside and NHS Fife.

NHS Tier 3 specialist weight management

We also deliver an NHS tier 3 specialist weight-management service for adults living with more complex obesity.

The programme is free, it can include Wegovy, and patients in England can ask their GP to refer them to us under Right to Choose.

Eligibility is set locally and varies by area. The tier 3 section below explains who qualifies and how referrals work.

Our article on NHS digital weight-management research reports the outcomes from Second Nature’s NHS programme.

NHS programmes that Second Nature doesn’t deliver

The NHS Type 2 Diabetes Path to Remission Programme is delivered by other NHS-approved providers (such as Counterweight, Oviva, Liva, and Momenta)³.

The NHS tirzepatide prescribing pathway through GP practices is commissioned through local NHS services rather than through Second Nature⁴.

However, Second Nature does provide behaviour change support for patients who’ve received their tirzepatide prescription via this pathway. This is known as ‘wraparound support’.

If you live somewhere where we’re not the local provider, your GP can still refer you to the provider commissioned in your area.

National NHS programmes are available across England, Scotland, and Wales, regardless of which provider delivers them locally.

How to get Second Nature free through NHS tier 3 weight management

Tier 3 is the NHS’s specialist level of weight-management care for adults living with more complex obesity. It’s delivered by a team that includes doctors, dietitians and psychologists, and NICE recommends prescribing Wegovy for weight management within a specialist service like this⁹.

Our tier 3 service is funded by the NHS, so it costs you nothing, and GPs can refer you to it from 28 NHS areas (integrated care boards) in England.

What is Right to Choose?

Right to Choose is your legal right in England to choose which NHS-approved provider you’re referred to when your GP refers you for certain services⁸.

It means you can ask your GP to refer you to Second Nature’s tier 3 service, as long as we take referrals in your area and your GP agrees the referral is clinically appropriate.

Who is eligible for our tier 3 service?

Each NHS area sets its own criteria, so the BMI threshold and the health conditions that count depend on where you live.

In some areas, the threshold is a BMI of 35 or more with one weight-related condition, such as sleep apnoea or heart disease.

Areas that use the national criteria ask for a BMI of 40 or more, recorded in the past 12 months, and at least four of these five conditions: type 2 diabetes, high blood pressure, abnormal cholesterol or blood fat levels (dyslipidaemia), obstructive sleep apnoea, and heart or circulatory disease caused by narrowed arteries.

For people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean backgrounds, the BMI thresholds are 2.5 lower, so 37.5 instead of 40.

The national criteria also require you to have already taken part in a tier 2 service, which is a structured lifestyle weight-management programme, or something equivalent.

Reasons you can’t be referred include being under 18, being pregnant or breastfeeding, having had weight-loss surgery in the past two years, and living with an active or suspected eating disorder.

The eligibility checker at the top of this page compares your answers with the criteria for your area.

How to get referred

1. Use the eligibility checker to see whether we take referrals in your area and whether you’re likely to meet its criteria.
2. Download our referral guide, which explains the service and what to say to your GP, and book a GP appointment.
3. Ask your GP to refer you to Second Nature for specialist weight management under Right to Choose. Your GP checks your medical record against your area’s criteria and sends the referral.
4. Once we receive the referral, we’ll contact you to book your first video appointment.

What’s included

After an assessment with our clinical team, you’ll be offered one of two pathways:

• Medicated: if Wegovy (semaglutide) injections suit you, we prescribe them and deliver them to your home each month, with support from our dietitians and psychologists for up to 24 months.
• Non-medicated: a personalised plan covering your diet, eating behaviour and physical activity, with regular check-ins from your care team for 12 months.

Your care team includes consultant doctors, specialist dietitians, psychologists, pharmacists and exercise specialists, and appointments take place by video.

Guided activity sessions take place every two weeks, and the Second Nature app lets you track your weight, steps and sleep.

Who is eligible for NHS weight-loss support?

NHS eligibility depends on your specific risk profile, and each programme has its own criteria.

This checker covers the NHS programmes on this page, including the Diabetes Prevention Programme and the Digital Weight Management Programme, and shows which ones you may qualify for.

NHS Diabetes Prevention Programme

You may be eligible if you²:

• Are aged 18 to 79
• Have an HbA1c of 42 to 47.9 mmol/mol (6.0 to 6.4%) or a fasting plasma glucose of 5.5 to 6.9 mmol/L
• Or have a history of gestational diabetes
• Don’t have an existing type 2 diabetes diagnosis
• Aren’t currently pregnant

You can self-refer through the Diabetes UK Know Your Risk tool, or your GP can refer you.

NHS Digital Weight Management Programme

You may be eligible if you¹:

• Are aged 18 or over
• Have a BMI of 30 or more (or 27.5 or more if you’re from a Black, Asian, or other ethnic minority background)
• Have a diagnosis of type 1 diabetes, type 2 diabetes, hypertension, or both diabetes and hypertension

Your GP or local pharmacist can refer you. The programme is 12 weeks long and is accessed online.

NHS Type 2 Diabetes Path to Remission

You may be eligible if you³:

• Are aged 18 to 65
• Were diagnosed with type 2 diabetes within the last 6 years
• Have a BMI of 27 or above (or 25 or above if you’re from a Black, Asian, or other ethnic minority background)
• Have an HbA1c within the specified clinical ranges
• Aren’t on insulin
• Aren’t pregnant or planning pregnancy in the next 6 months

This 12-month programme replaces all meals with shakes and soups (around 800 to 900 kcal per day) for 12 weeks, then reintroduces food and provides weight-maintenance support.

NHS specialist weight management services and tirzepatide (Mounjaro)

NICE recommends tirzepatide for adults who have a BMI of 35 or more along with at least one weight-related health condition, such as type 2 diabetes, hypertension, sleep apnoea, cardiovascular disease, or non-alcoholic fatty liver disease⁵.

The BMI threshold is reduced by 2.5 kg/m² for people from Black, Asian, and other ethnic minority backgrounds.

NHS access is being rolled out gradually because around 3.4 million people in England are estimated to be eligible⁴.

GP practices in England have been able to prescribe tirzepatide for weight management since 23 June 2025, starting with adults who have a BMI of 40 or more and at least 4 of 5 specified weight-related conditions⁴.

Since June 2026, this has widened to include adults with a BMI of 35 to 39.9 who also have at least 4 of those conditions⁴.

Lower BMIs and fewer comorbidities become eligible in later cohorts of the planned 12-year rollout.

Until your local GP service is set up to prescribe, NHS access to tirzepatide is through a local specialist weight-management service following GP referral.

Second Nature’s own tier 3 service prescribes Wegovy rather than tirzepatide, and you can ask your GP to refer you to it under Right to Choose.

Our guide to weight-loss injections on the NHS explains the national criteria and how access varies by local service.

What if you’re not eligible for any NHS programme?

A common scenario: people meet NICE’s clinical criteria but face long waiting lists, narrow priority cohorts, or local services that aren’t yet prescribing. If you’re in this position, you have three practical options.

Option 1: Ask your GP to refer you anyway

Even if you’re below the current priority cohort for NHS tirzepatide, your GP can still consider:

• A referral to a tier 3 specialist weight-management service, including Second Nature’s tier 3 service if we take referrals in your area
• The NHS Digital Weight Management Programme, if you have diabetes or hypertension
• The Diabetes Prevention Programme if you’re at risk of type 2 diabetes
• The Path to Remission programme if you’ve been diagnosed with type 2 diabetes in the last 6 years

Option 2: Consider private weight-loss medication with structured support

You can start a private programme like Second Nature’s medicated weight-loss programme within a few days of signing, if the clinical team approves you after review. There’s no waiting list and no requirement to meet NHS prioritisation criteria⁶.

However, these private programmes are expensive.

Second Nature’s medicated programme starts at ~£149 per month (with £50 off your first month) and includes GLP-1 medication, a prescribing pharmacist, medical oversight, and the full behavioural support programme, supported by a registered dietitian or nutritionist.

Option 3: Use Second Nature’s non-medication programme

If you’d prefer to start without medication, our behaviour-change programme costs £33 per month and includes everything our medication programme does (health coach support, access to our app, and a community support group), without the support of weight-loss injections.

Our guides to Mounjaro on the NHS and Wegovy on the NHS explain each medication’s eligibility rules.

NHS programmes vs Second Nature’s medicated programme

NHS behavioural programmes (NDPP, DWMP) and our private medicated programme both support weight loss, but they’re designed for different goals.

NHS behavioural programmes focus on diet, lifestyle, and habit change without medication.

They’re free, evidence-based, and effective for prevention and early-stage weight management.

Our medicated programme adds GLP-1 medication (Mounjaro or Wegovy) alongside the same kind of structured support, with the goal of supporting greater weight loss for people living with more established and complex obesity.

Our NHS tier 3 service is free and can include Wegovy, where it’s suitable, alongside specialist support, but it’s only open to people who meet their local NHS area’s criteria.

The most useful comparison is between Second Nature’s outcomes with and without medication, because the programme is otherwise delivered similarly.

NHS programmes are free and clinically effective for prevention and early-stage weight management.

Our medicated programme is paid, but adds GLP-1 medication alongside the structured support, and the published average weight loss reflects that.

For people who qualify for NHS support, starting with a free programme is a good option, and people who meet their area’s tier 3 criteria can get specialist support through our NHS service at no cost, including Wegovy where it’s suitable.

For people who don’t qualify or face a multi-year wait for NHS GLP-1 access, private medicated programmes offer faster access without sacrificing the structured behavioural support that helps achieve significant weight loss.

What to ask your GP

If you’d like to be referred to an NHS weight-management programme, useful phrases include:

• ‘Could I be referred to the Healthier You: NHS Diabetes Prevention Programme? I’d like to check my HbA1c first.’
• ‘Could I be referred to the NHS Digital Weight Management Programme? I have [diabetes/hypertension/both] and a BMI of [X].’
• ‘Am I eligible for the NHS Type 2 Diabetes Path to Remission Programme? I was diagnosed within the last 6 years.’
• ‘Am I in the priority cohort for NHS tirzepatide prescribing? If not, can I be referred to a specialist weight-management service?’
• ‘I’d like to be referred for specialist weight management. Could you refer me to Second Nature’s tier 3 service under Right to Choose?’

If you’re below current priority cohorts but still need clinical support for weight management, your GP can also discuss other locally commissioned options.

Take home message

You can get Second Nature for free on the NHS if you’re eligible for one of the three NHS services we deliver: the Diabetes Prevention Programme, the Digital Weight Management Programme, or our tier 3 specialist weight-management service.

Eligibility for the first two programmes depends on your blood sugar level, BMI, and any existing diagnosis of diabetes or hypertension. Eligibility for the tier 3 programme depends on the criteria in your local NHS area.

The behavioural programmes don’t include weight-loss medication, but our tier 3 service can include Wegovy for people who meet their area’s criteria, and you can ask your GP to refer you to it under Right to Choose.

NHS access to GLP-1 medication through GP practices is being phased in over several years, so many people who meet NICE’s criteria aren’t yet eligible.

If you’re not eligible for NHS support, or you’ve been told to wait, our private medicated programme offers faster access to GLP-1 medication, plus daily registered dietitian support, peer groups, and a structured habit-change programme to help keep weight off long term.

In our 12-month evaluation, published in JMIR Formative Research, members of our private programme who kept an active subscription for 12 months lost an average of 19.1% of their starting weight, and 77.7% of members with 12-month data lost at least 10%⁶.

If you think you might meet the tier 3 criteria, the eligibility checker at the top of this page compares your answers with your area’s criteria.

Second Nature's Mounjaro and Wegovy programmes

Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.

Why choose Second Nature over other medication providers, assuming you're eligible?

Because peace of mind matters.

We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.

Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.

At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.

With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.

We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.

Frequently asked questions

Is the NHS Diabetes Prevention Programme really free?

Yes. You don’t pay to attend the programme or receive the included equipment (such as Bluetooth scales for digital delivery).

It’s funded by NHS England and delivered by approved providers, including Second Nature².

Can my GP refer me to Second Nature?

Yes. Your GP can refer you to the NHS Diabetes Prevention Programme or the NHS Digital Weight Management Programme, which we deliver.

In England, your GP can also refer you to our tier 3 specialist weight-management service under Right to Choose, if you meet your area’s criteria and we take referrals there. Our referral guide explains what to say to your GP.

What is tier 3 weight management?

Tier 3 is the NHS’s specialist weight-management service for adults living with more complex obesity, delivered by a team that includes doctors, dietitians and psychologists.

NICE recommends prescribing Wegovy for weight management within a specialist service like this⁹. Second Nature’s tier 3 service lasts up to 24 months and is delivered via video sessions and our app.

What is Right to Choose?

Right to Choose is your legal right in England to choose which NHS-approved provider your GP refers you to for certain services, including specialist weight management⁸.

Your GP still decides whether a referral is clinically appropriate, and the provider you choose must accept referrals from your area.

Can you get Mounjaro on tier 3 weight management?

It depends on the service. NICE recommends tirzepatide (Mounjaro) for adults with a BMI of 35 or more and at least one weight-related condition⁵, and some specialist services prescribe it.

Second Nature’s tier 3 service prescribes Wegovy (semaglutide) rather than Mounjaro, where it’s suitable.

How long is the wait for NHS weight-management support?

Wait times vary by region and programme. Behavioural programmes (NDPP, DWMP) typically start within a few weeks of referral.

NHS Tier 3 specialist weight-management services often have waits of several months, sometimes over a year.

NHS tirzepatide access depends on your priority cohort and whether your local ICB has set up prescribing⁴.

Can I do an NHS programme, then switch to Second Nature?

Yes. Many people start with an NHS behavioural programme to build foundational habits, then move to private medicated support if they need additional help with weight loss.

You don’t need to have completed any other programme to join ours.

What if I’m not eligible for any NHS programme?

You can still access weight-loss support privately. Second Nature offers a non-medication programme from £33 per month and a medicated programme from ~£149 per month.

Both include daily access to a registered dietitian and a structured behaviour-change programme.

Can I get Mounjaro or Wegovy on the NHS?

Yes, but access is currently limited.

GP practices in England can prescribe tirzepatide for weight management to adults with a BMI of 35 or more and at least 4 of 5 specified weight-related health conditions, and the eligible group widens over time⁴.

You can get Wegovy through NHS specialist weight-management services, including Second Nature’s tier 3 service, which you can ask your GP to refer you to under Right to Choose.

Is Second Nature available everywhere on the NHS?

Second Nature delivers NHS programmes across 43 ICBs and Health Boards in England, Scotland, and Wales.

For our tier 3 service, we take referrals from GP practices in 28 NHS areas in England.

If your area has a different commissioned provider, your GP can still refer you to your local NHS programme.

The national NHS programmes (NDPP, DWMP) are available everywhere in England.

Do I need a GP referral for Second Nature’s private programme?

No. You can join our private medicated or non-medicated programmes directly.

We assess clinical eligibility through our online consultation, and independent prescribing pharmacists make prescribing decisions.

What if I’m under 18 or over 80?

NHS programmes are generally available to adults aged 18 and over, with upper age limits varying by programme (NDPP: 79; T2DR: 65; DWMP: no upper age limit, but additional checks apply over 80).

Second Nature’s private medicated programme is available to adults aged 18 to 75.

Can I join Second Nature if I’m already getting Mounjaro on the NHS?

You could join Second Nature’s non-medication programme if you’re already on GLP-1 medications.

The health coaching support and guided programme can help you build and maintain the habits you need to keep the weight off in the long term.

References

• 1. NHS England. The NHS Digital Weight Management Programme.
  2. NHS England. Healthier You: NHS Diabetes Prevention Programme.
  3. NHS England. NHS Type 2 Diabetes Path to Remission Programme.
  4. NHS England (2025). Interim commissioning guidance: implementation of the NICE technology appraisal TA1026 and the NICE funding variation for tirzepatide (Mounjaro) for the management of obesity.
  5. National Institute for Health and Care Excellence (2024). Tirzepatide for managing overweight and obesity (TA1026).
  6. Richards, R., Whitman, M., Wren, G., et al. (2025). A Remotely Delivered GLP-1RA-Supported Specialist Weight Management Program in Adults Living With Obesity: Retrospective Service Evaluation. JMIR Formative Research, 9(1), e72577.
  7. Ross, J.A.D., et al. (2022). Uptake and impact of the English National Health Service digital diabetes prevention programme. BMJ Open Diabetes Research & Care, 10(3), e002736.
  8. NHS England. Patient choice guidance.
  9. National Institute for Health and Care Excellence (2023). Semaglutide for managing overweight and obesity (TA875).