Jump to: Check your NHS eligibility | Which NHS programmes Second Nature delivers | Who’s eligible for NHS support | What if you’re not eligible | NHS vs Second Nature’s medicated programme | What to ask your GP | FAQs | Take home message
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 two free NHS weight-management programmes: the NHS Digital Weight Management Programme and the Healthier You: NHS Diabetes Prevention Programme1,2.
Whether you qualify for free access depends on your BMI, blood sugar level, and whether you have a related health condition, such as diabetes or high blood pressure.
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.
This guide explains which NHS programmes are available, who qualifies, what to do if you’re not eligible, and how the NHS programmes compare to private medicated support.
Important information: NHS eligibility criteria are set by NHS England and may change. The information in this article reflects published guidance at the time of writing. Always speak to your GP about your individual eligibility for any NHS programme.
Check your NHS eligibility in under a minute
The quickest way to find out which NHS weight-management programmes you may qualify for is to answer a few short questions about your age, BMI, and any existing diagnosis.
If the quiz suggests you’re eligible, your GP can refer you to the relevant NHS programme.
If you’re not eligible, the rest of this guide explains your private options and how NHS support compares with medicated weight-loss 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 UK7.
We deliver two of the largest national NHS weight-management programmes.
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.
NHS England’s evaluation of the digital arm of the NDPP, published in BMJ Open Diabetes Research and Care, found average weight loss of around 6.2 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 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.
NHS specialist weight-management services (sometimes called Tier 3) and the new NHS tirzepatide prescribing pathway are commissioned through local NHS services rather than through Second Nature4.
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.
Who is eligible for NHS weight-loss support?
NHS eligibility depends on your specific risk profile. Each programme has its own criteria.
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 involves replacing all meals with shakes and soups (around 800 to 900 kcal per day) for 12 weeks, followed by reintroduction of food and 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.
From 1 April 2026, GP practices in England can prescribe tirzepatide for weight management, but only for the highest-priority cohort: adults with a BMI of 40 or more plus at least 4 of 5 specified weight-related 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.
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 local Tier 3 specialist weight-management service
- 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 you’re approved by the clinical team after ereview. There’s no waiting list and no requirement to meet NHS prioritisation criteria6.
The trade-off is cost. Our medicated programme starts at ~£149 per month, which covers the GLP-1 medication, prescribing pharmacist and medical oversight, and the full behavioural support programme.
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 that our medication programme does (health coach support, access to our app, and a community support group), minus the use of weight-loss injections.
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) on top of the same kind of structured support, with the goal of supporting greater weight loss for people living with more established and complex obesity.
The most useful comparison is between Second Nature’s outcomes with and without medication, because the delivery model is otherwise similar.
| Feature |
NHS Diabetes Prevention Programme (delivered by Second Nature) |
NHS Digital Weight Management Programme (delivered by Second Nature) |
Second Nature medicated programme |
| Cost |
Free |
Free |
From £179/month |
| Length |
9 months |
12 weeks |
Open-ended (typically 12+ months) |
| Eligibility |
Adults at risk of type 2 diabetes (HbA1c 42-47.9) |
Adults with obesity plus diabetes or hypertension |
Adults with BMI 30+ (or 27+ with comorbidities) |
| Medication |
None |
None |
Mounjaro or Wegovy |
| Support |
Health coach + app + smart scales |
Levelled coaching (self-guided to one-to-one) |
Daily registered dietitian support + peer group + smart scales |
| Access route |
GP/self-referral |
GP/pharmacy referral |
Direct (online clinical assessment) |
| Time to start |
Weeks (depends on local provider) |
Weeks (depends on local provider) |
Same week |
| Published 12-month weight loss |
~6.2 kg average (digital arm of NDPP, NHS England evaluation)7 |
Outcomes vary by support level1 |
19.1% average for active subscribers (around 20 kg)6 |
NHS programmes are free and clinically effective for the prevention and early-stage weight management they’re designed to do.
Our medicated programme is paid, but adds GLP-1 medication to that same kind of 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.
For people who don’t qualify, or who face a multi-year wait for NHS GLP-1 access, private medicated programmes offer faster access without sacrificing the structured behavioural support that helps to 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?’
If you’re below current priority cohorts but still need clinical support for weight management, your GP can also discuss other locally commissioned options.
Frequently asked questions
Is the NHS Diabetes Prevention Programme really free?
Yes. There’s no cost to attend the programme or to 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.
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 losing weight.
We don’t require you 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. From 1 April 2026, NHS GP practices in England can prescribe tirzepatide for weight management, but only for adults with a BMI of 40 or more and at least 4 of 5 specified weight-related health conditions in year one4.
The eligible cohort widens over time. Wegovy is also available via NHS specialist weight-management services for eligible people.
Is Second Nature available everywhere on the NHS?
Second Nature delivers NHS programmes across 43 ICBs and Health Boards in England, Scotland, and Wales.
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.
Clinical eligibility is assessed through our online consultation, with prescribing decisions made by independent prescribing pharmacists.
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.
Take home message
You can get Second Nature for free on the NHS if you’re eligible for one of the NHS programmes we deliver: the Diabetes Prevention Programme or the Digital Weight Management Programme.
Eligibility depends on your blood sugar level, BMI, and any existing diagnosis of diabetes or hypertension.
NHS programmes are free and clinically effective for prevention and early-stage weight management, but they don’t include weight-loss medication.
NHS access to GLP-1 medication is being phased in slowly, and most eligible people face a multi-year wait.
If you’re not eligible for NHS support, or you’ve been told to wait, our private medicated programme provides faster access to GLP-1 medication alongside daily registered dietitian support, peer groups, and the structured habit-change programme that supports keeping weight off long term.
Whichever route fits your circumstances, the most useful next step is checking what you qualify for.
The eligibility quiz at the top of this page is the quickest way to start.
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.
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