About four million people in the UK are classified as “tier three” in terms of obesity, just one step below the level at which the NHS begins considering surgical interventions. While tier 3 patients are eligible for lifestyle and medical support, the NHS can only accommodate 35,000 to 45,000 people annually—just 1% of those who could benefit.
Now, a patient and a doctor from the NHS’s own weight-loss service are seeking to change that with an entirely digital approach. Instead of attending hospital appointments with dieticians and consultants, patients can access treatment entirely online.
Richard Green, a retired businessman, admits he enjoyed retirement a little too much, gaining weight while also giving up smoking. Following a conversation with his GP, he entered University Hospitals Coventry and Warwickshire for a unique 24-hour stay.
The stay wasn’t ordinary—it took place inside a calorimeter, overseen by Dr Petra Hanson from the University of Warwick. The sealed chamber includes a bed, internet, television, and even a toilet, allowing scientists to track precisely what a patient eats and the energy their body expends. This creates an extremely accurate measurement of metabolism, providing vital data for research.
Dr Hanson’s work with Green was part of a broader University of Warwick study on weight-loss patients, running alongside his treatment. During days and nights in the chamber, they discussed not only his progress but also how NHS weight-loss services could be improved.
For instance, Green noted that he was asked to keep a food diary three months into his treatment. “Wouldn’t it make more sense to be told that at the start?” he thought, reflecting on how simple adjustments could streamline the process. His business experience allowed him to see opportunities for improving patient care and efficiency.
Meanwhile, Dr Hanson was concerned about the mismatch between the demand for services and NHS capacity. The idea of reaching more patients in a cost-effective way began to take shape.
Seven years later, Green and Dr Hanson have collaborated with experts to create a digital alternative to traditional NHS weight-loss pathways. The platform, called W8Buddy, provides everything previously available in hospital visits—exercise classes, video consultations with dieticians and consultants, and even integration with smartwatches to track activity and steps.
Currently being trialled at four NHS sites, patients can choose between traditional in-person services or the digital program. Over the next two years, their outcomes will be monitored to assess effectiveness. While the trial is still in its early stages with only a small number of participants, the aim is to remove bottlenecks and make weight-loss support accessible to far more people.
As for Richard Green, he lost 3.5 stone (22kg) through the traditional NHS tier 3 program. But he believes the digital platform he helped develop could allow thousands more to achieve similar health improvements.
