Reducing Obesity and Closing the Health Gap

Residents and partners told us that early support, focusing on prevention for children and families offers the greatest long-term impact.  This is in recognition of the fact thar habits form early and benefits can compound across the life course and across generations. Childhood obesity rates rise sharply between Reception and Year 6, with families often struggling to find practical help, free from stigma. This makes early years, primary school and the wider family environment critical points for intervention.  

There are key opportunities to:  

• Strengthen a more joined-up family approach across schools, child health hubs, children’s centres, family services and community organisations.  

• Improve how families are identified and supported earlier. 
• Reduce stigma in how support is framed, and make support more practical for families facing poverty, time pressure, digital exclusion or cultural barriers.  
• Build on existing assets such as family-based programmes, schools and community organisations, while filling gaps for underserved groups, including secondary school-age children and families with complex needs. 

By focusing here, the mission can support a shift from fragmented, reactive support to earlier, more universal and family-centred prevention.  

Both residents and partners across the system identified a major gap between the support that exists and people’s ability to find, access and stay engaged with it. Residents described NHS weight management services as low-profile, fragmented and difficult to navigate, with GP gatekeeping, inconsistent referrals, long waits and postcode variation all acting as barriers.  

Partners working across health and care services echoed this, pointing to patchy Tier 2 and Tier 3 provision, oversubscription, and a lack of clarity across boroughs and services. 

There are key opportunities to: 

• Not just expand activity but make existing pathways easier to access, more equitable and more engaging for people who need them most.  

• Include clearer referral routes, self-referral or digital front door models 

• Create more culturally and linguistically tailored support. 
• Strengthen continuity through coaching, community outreach and better exit routes after time-limited programmes.  

Residents saw this as a practical ‘quick win’, because services often work when people are able to engage with them, but too many people never reach the right support or drop out before they benefit. 

Focusing on access and engagement also helps turn ambition into real system change. By making services easier to use and access and improving the experience for underserved communities, NW London can help more people benefit from the support already available. Increasing the reach and effectiveness of current services can lead to more people achieving sustainable weight loss and maintain a healthy weight, while ensuring efforts are focused where need and inequality are greatest.

GLP-1s are one of the most significant recent developments in obesity care, but access is restricted, uneven and often disconnected from wider support needed for long-term success. Partners highlighted the potential of GLP-1s to prevent longer-term conditions and improve outcomes for people at highest risk, while residents recognised their effectiveness but were clear that medicines alone are not enough. Across both groups, the consistent message was that any expansion in access must be paired with education, behavioural support and a clear pathway before, during and after treatment. 

There are key opportunities to:  

• Develop a more equitable and clinically meaningful model of access that goes beyond the current narrow rollout and links medicines to wider system goals.  

• Target people with obesity who are at highest risk of long-term conditions and improve how services identify and support these groups. 

• Develop stronger wraparound support so people are less likely to regain weight, struggle with nutrition or experience fragmented care. 

• Respond to rapid market change, including growth of private prescribing, testing more joined-up approaches to improve safety, understanding and continuity of care. 

This area has not been chosen as a stand-alone solution, but as one part of the wider portfolio. The mission’s role is to ensure GLP-1s are used where they add genuine value, without crowding out prevention or reinforcing inequality. Done well, this priority could help NW London prepare for the future of obesity treatment while demonstrating how innovation can be linked to better outcomes, better experience and more equitable access.