Northern Ireland’s New Obesity Management Service: Who Qualifies and How Will It Work?
Northern Ireland’s New Obesity Management Service: Who Qualifies and How Will It Work?
Northern Ireland is introducing its first Regional Obesity Management Service, known as ROMS.
The Department of Health announced the first detailed eligibility criteria on 29 June 2026 and said implementation is expected to begin in autumn 2026.
Phase one will focus on adults with the highest clinical need.
Under the published criteria, a person must:
• Be aged 18 or over
• Have a BMI above 45
• Have at least one of five specified health conditions
A separate programme called the Obesity Pathway Innovation Programme, or OPIP, is also being introduced.
It will use a neighbourhood based model and may support some people with a BMI from 30 to 39.9.
The Department says OPIP will include self referral and community based support.
The two programmes are related, but they are not the same service.
This article explains what has been confirmed, what has not yet been announced and what people in Northern Ireland can do while they wait for full access information.
The short answer
• ROMS is Northern Ireland’s first regional specialist obesity management service
• The Department of Health said implementation would begin in autumn 2026
• Phase one is for adults aged 18 or over with a BMI above 45 and at least one listed health condition
• The listed conditions are cardiovascular disease, high blood pressure requiring medicine, raised cholesterol or triglycerides, confirmed obstructive sleep apnoea, or type 2 diabetes
• Meeting the basic criteria does not guarantee a particular treatment. A clinical assessment will still be required
• Treatment may include lifestyle support and weight management medicine when clinically appropriate and consistent with NICE guidance
• OPIP is a separate neighbourhood programme which may support people with a BMI from 30 to 39.9
• The Department says OPIP will allow self referral, but it has not yet confirmed that ROMS will use the same route
• The published announcement does not explain the initial pathway for people with a BMI from 40 to 45
• Full referral routes, contact details, waiting times and local delivery arrangements were still to be announced when this article was updated
What is the Regional Obesity Management Service?
ROMS is a new Health and Social Care service intended to provide structured obesity care across Northern Ireland.
Until now, Northern Ireland has not had the same specialist regional weight management provision available in some other parts of the UK.
The Department of Health first confirmed plans for the service in May 2025, following a public consultation that received almost 19,000 responses.
The service is expected to provide:
• Clinical assessment
• Lifestyle and behaviour support
• Help with nutrition and physical activity
• Access to weight management medicine when clinically appropriate
• Monitoring and follow up care
• Connections with wider health services when needed
The Department has described the first phase as community based.
It has also said that treatment will follow current NICE guidance and that patient numbers will build gradually.
ROMS should not be understood as a medicine only service.
Modern obesity management considers:
• Physical health
• Mental wellbeing
• Eating patterns
• Activity
• Sleep
• Medicines
• Previous weight management attempts
• Health complications associated with weight
Why is the service being introduced?
Obesity is a major public health issue in Northern Ireland.
The Health Survey Northern Ireland for 2024 and 2025 reported that 67 per cent of adults were living with overweight or obesity.
The proportion classified as living with obesity had increased from 23 per cent in 2010 and 2011 to 30 per cent in 2024 and 2025.
Weight is influenced by many factors.
These can include:
• Genetics
• Health conditions
• Medicines
• Sleep
• Mental health
• Income
• Food access
• Work
• Caring responsibilities
• The environment in which someone lives
Living with obesity can increase the risk of:
• Type 2 diabetes
• High blood pressure
• Heart disease
• Stroke
• Obstructive sleep apnoea
• Joint and mobility problems
• Some cancers
• Complications during pregnancy
• Poorer mental wellbeing
This does not mean that every person with a higher weight will develop these conditions.
It explains why the first phase is prioritising people whose weight is already linked with a higher level of clinical risk.
The service also sits within Northern Ireland’s wider Healthy Futures strategy.
That strategy aims to address both individual health needs and the wider social and environmental conditions that affect food, activity and health.
Who qualifies for phase one of ROMS?
The Department of Health has published two main requirements.
The person must:
• Be aged 18 or over
• Have a BMI above 45 and at least one of the specified health conditions
Both parts are required under the phase one announcement.
Atherosclerotic cardiovascular disease
The Department’s examples include:
• Ischaemic heart disease
• Stroke
• Peripheral vascular disease
• Heart failure
These are serious conditions affecting the heart or blood vessels.
A past diagnosis should be documented in the person’s medical record and will need to be considered during clinical assessment.
High blood pressure requiring medicine
The published criterion specifies hypertension that requires medication.
A single raised reading or high blood pressure that has not been clinically diagnosed may not meet this wording.
Anyone concerned about their blood pressure should seek appropriate assessment rather than trying to determine eligibility from a home reading alone.
Dyslipidaemia
Dyslipidaemia means unhealthy levels of fats in the blood.
The Department describes this as raised cholesterol or triglycerides.
Eligibility is likely to depend on a documented diagnosis and the person’s overall clinical risk, rather than an isolated result interpreted without medical context.
Obstructive sleep apnoea confirmed by a sleep study
The announcement specifically requires obstructive sleep apnoea confirmed by a sleep study.
Snoring, tiredness or suspected sleep apnoea alone does not match the published criterion.
If you have symptoms such as:
• Loud snoring
• Pauses in breathing during sleep
• Waking gasping
• Severe daytime sleepiness
speak to your GP.
Do not drive if sleepiness makes it unsafe.
Type 2 diabetes
Adults with diagnosed type 2 diabetes may meet the health condition part of the criteria.
They would still need to meet the age and BMI requirements for phase one.
Weight management in someone with diabetes must be coordinated carefully because changes in food intake, body weight or treatment can affect blood glucose and existing medicine requirements.
Does a BMI above 45 guarantee access?
No.
The published criteria describe who phase one is intended to prioritise.
They do not guarantee:
• Acceptance
• Medicine
• Any particular result
A clinical team may need to confirm:
• Current height and weight
• The relevant health diagnosis
• Current medicines and allergies
• Previous treatment and weight history
• Whether specialist weight management is safe and appropriate
• Whether another service is more suitable
• The person’s ability to take part in monitoring and support
Capacity may also affect how quickly eligible people are assessed because the Department has said patient numbers will increase gradually.
How is BMI calculated?
BMI is calculated by dividing weight in kilograms by height in metres squared.
For example, someone who weighs 130 kilograms and is 1.68 metres tall has a BMI of about 46.
BMI is a practical screening measure, not a complete diagnosis.
It does not directly measure body fat or show where fat is stored.
It can be less accurate for people with high muscle mass and should be interpreted alongside health history and other clinical information.
Do not change a height or weight measurement to try to fit an eligibility boundary.
Accurate information helps the clinical team make a safe decision.
What happens if your BMI is between 40 and 45?
The June 2026 announcement does not explain this clearly.
The published ranges are:
• BMI above 45 for ROMS phase one, together with a listed health condition
• BMI from 30 to 39.9 for possible OPIP eligibility
This leaves an unanswered question about the initial route for people with a BMI from 40 to 45.
It would be wrong to invent an explanation or assume that everyone in this range is permanently excluded.
Further phases of ROMS are planned, and the Department has said more delivery information will be provided.
If you fall within this range, speak to your GP about your current health needs and monitor official Department of Health and Public Health Agency updates.
What is OPIP?
OPIP stands for the Obesity Pathway Innovation Programme.
It is a UK programme funding new ways of making obesity care easier to access.
Northern Ireland has received a share of the programme funding for a neighbourhood based service.
The Department of Health said OPIP delivery would commence in August 2026.
At the time this article was updated, detailed public instructions explaining exactly where and how every person could register had not yet been published.
The announced Northern Ireland model is expected to include:
• Self referral
• More than one route into support
• Work with an HSC clinician to agree personal goals
• Nutrition and physical activity advice through digital tools
• Community and voluntary sector support
• Social prescribing
• Easier access to weight management medicine when clinically appropriate
Social prescribing can connect people with practical community support, such as:
• Local activity
• Wellbeing programmes
• Social programmes
It is not the same as prescribing medicine.
Who may qualify for OPIP?
The Department says that people with a BMI from 30 to 39.9 may be eligible.
The words “may be eligible” are important.
The announcement does not say that BMI alone guarantees entry or treatment.
A clinician may still need to consider:
• Health conditions
• Current risk
• Previous support
• Safety
• Which part of the pathway best fits the person
The full Northern Ireland entry criteria, exclusions, local contact points and assessment steps should be checked when the programme publishes its access information.
How are ROMS and OPIP different?
Main purpose
ROMS phase one: Regional specialist obesity management.
OPIP: Testing a neighbourhood based route into weight support.
Published BMI range
ROMS phase one: BMI above 45.
OPIP: BMI from 30 to 39.9 for possible eligibility.
Additional criteria
ROMS phase one: At least one listed health condition.
OPIP: Full entry criteria still to be published.
Access route
ROMS phase one: Not fully confirmed.
OPIP: Self referral and other routes have been announced.
Support
ROMS phase one: Clinical assessment, lifestyle support and medicine where appropriate.
OPIP: Personal goals, digital and community support, social prescribing and medicine where appropriate.
Planned timing
ROMS phase one: Implementation from autumn 2026.
OPIP: Delivery planned to commence in August 2026.
The programmes may work alongside each other, but patients should not assume they are interchangeable.
How will ROMS probably work?
Some parts of the pathway are clear, while others remain unconfirmed.
Step 1: Entry or referral
The Department has not yet published the complete ROMS referral process.
It has not confirmed whether every patient will need a GP referral or whether another regional entry route will be available.
Do not use OPIP’s announced self referral route as proof that ROMS will operate in exactly the same way.
Step 2: Eligibility check
The service will need to confirm:
• Age
• BMI
• The relevant health condition
It may use information from:
• GP records
• Hospital records
• Current measurements
• Clinical assessment
Step 3: Comprehensive assessment
A safe assessment should look beyond the number on the scale.
It may cover:
• Medical and family history
• Current medicines
• Weight history
• Eating patterns
• Physical activity and mobility
• Sleep
• Mental health and emotional eating
• Alcohol and smoking
• Pregnancy or plans for pregnancy where relevant
• Previous weight management treatment
• Practical barriers to care
Step 4: Individual care plan
The plan may combine:
• Nutrition support
• Physical activity
• Behaviour support
• Management of related health conditions
• Medicine when clinically appropriate
Not everyone will need or be suitable for medicine.
If it is considered, the choice must be made by an appropriately qualified clinician after assessing:
• Benefits
• Risks
• Contraindications
• Monitoring needs
Step 5: Monitoring and review
Effective care requires follow up.
The team may monitor:
• Weight
• Side effects
• Nutrition
• Blood pressure
• Blood tests
• Related conditions
• Whether treatment is meeting agreed goals
Treatment may need to change if it is:
• Ineffective
• Poorly tolerated
• No longer suitable
Patients should not alter prescribed treatment without discussing it with the responsible clinician.
Will everyone receive weight management medicine?
No.
The Department says medicine will be available if clinically appropriate and in line with NICE guidance.
This means:
• Eligibility for assessment is not a promise of a prescription
• The clinician must assess individual benefits and risks
• Lifestyle and behaviour support remain part of care
• Monitoring is required
• Treatment may not be suitable for everyone
• Access may be phased as the service builds capacity
Avoid buying prescription weight management products through:
• Social media
• Informal sellers
• Websites that do not require a proper clinical assessment
Prescription medicine should come through a lawful prescriber and regulated supply route.
What does lifestyle support mean?
Lifestyle support should not mean simply telling someone to eat less and move more.
A useful programme can help a person understand:
• Meal structure and portion awareness
• Protein, fibre and overall nutritional quality
• Hunger, fullness and food triggers
• Movement that suits their health and mobility
• Sleep and stress
• Emotional eating
• Realistic goals
• Relapse prevention and weight maintenance
The plan should be respectful and adapted to the person’s circumstances.
Obesity is a complex chronic condition, not a failure of willpower.
Will bariatric surgery be included?
The Department stated in May 2025 that later phases of ROMS may develop other interventions, including bariatric surgery, subject to funding.
The June 2026 phase one announcement focused on:
• People with the highest clinical need
• Lifestyle support
• Access to medicine where appropriate
It did not publish a new bariatric surgery referral route or confirm that surgery would be immediately available to everyone meeting the phase one criteria.
Anyone seeking information about surgery should use current HSC referral guidance rather than assume ROMS automatically provides access.
When will the service start?
The latest Department of Health announcement said:
• OPIP delivery would commence in August 2026
• ROMS implementation would begin in autumn 2026
These are rollout periods, not a guarantee that every area, referral route or treatment will be available on one launch date.
At the time of writing, the Department had not published:
• A single ROMS patient contact page
• Complete referral instructions
• Waiting time targets
• The number of places available in phase one
• Detailed arrangements for each HSC Trust area
• The initial pathway for people with a BMI from 40 to 45
This article should be updated as soon as those details appear.
What can you do now?
Check your measurements accurately
Use a reliable scale and a recent height measurement.
Treat an online BMI result as an estimate rather than confirmation of eligibility.
Gather relevant health information
It may help to know:
• Your current medicines
• Diagnosed health conditions
• Recent blood pressure results
• Recent cholesterol or diabetes results
• Whether sleep apnoea was confirmed by a sleep study
• Previous weight management support or treatment
Do not send confidential medical information to an unverified website or social media account.
Keep your GP record current
If a diagnosis was made outside your GP practice, check that your GP has received the relevant letter or result.
This may make future eligibility checks easier.
Watch official sources
Use the:
• Northern Ireland Department of Health
• Public Health Agency
• HSC websites
for referral announcements.
News reports and social media posts may omit important eligibility details.
Seek help for current health concerns
Do not wait for ROMS if you have symptoms or a condition that needs attention now.
Speak to your GP about:
• High blood pressure
• Diabetes symptoms
• Chest pain
• Severe daytime sleepiness
• Other health concerns
What if you do not qualify for phase one?
Not qualifying for phase one does not mean that your health concerns are unimportant or that no support is available.
Possible routes can include:
• GP assessment
• Community pharmacy advice
• HSC dietetic services where referral criteria are met
• Diabetes or cardiovascular services
• Sleep services
• Local physical activity and wellbeing programmes
• OPIP when the access route is published
• Regulated private weight management care
Each service has its own criteria.
Private treatment should not be presented as a guaranteed alternative to public care, and a payment should never guarantee a prescription.
How private weight management differs
ROMS and OPIP are publicly funded Northern Ireland initiatives.
A private online clinic is separate from these programmes and does not control public eligibility, referrals or waiting times.
A safe private service should include:
• Identity verification
• A genuine clinical assessment
• Review of health conditions and current medicines
• An appropriately qualified prescriber
• Clear information about benefits and risks
• Regulated pharmacy supply when medicine is prescribed
• Monitoring and follow up
• A route for reporting side effects or concerns
• Clear advice about urgent care
Be cautious if a website:
• Promises approval
• Offers prescription treatment without meaningful health questions
• Will not identify the responsible healthcare professionals and pharmacy
How Keltoi fits into the picture
Keltoi provides a separate doctor led online weight management service.
It is not part of ROMS or OPIP and cannot fast track access to either public programme.
Keltoi’s online questions provide Dr Waqar Ahmed, Clinical Lead, with a snapshot of the person’s health, weight history and circumstances.
The website does not:
• Diagnose obesity
• Decide that treatment is suitable
• Make a prescribing decision
All individual clinical and prescribing decisions within Keltoi’s weight management service are made by Dr Ahmed after appropriate review.
Completing the online process or making a payment does not guarantee treatment.
People can still discuss public services with their GP or follow official ROMS and OPIP access instructions when they are published.
Private care should not prevent anyone from seeking appropriate HSC support.
Frequently asked questions
What does ROMS stand for?
ROMS stands for Regional Obesity Management Service.
It is Northern Ireland’s new regional specialist service for obesity care.
When does ROMS start in Northern Ireland?
The Department of Health said implementation would begin in autumn 2026.
This describes a phased rollout rather than one guaranteed appointment date for every eligible person.
What BMI qualifies for ROMS?
Phase one is intended for adults aged 18 or over with a BMI above 45 and at least one specified health condition.
Which health conditions count for phase one?
The listed conditions are:
• Atherosclerotic cardiovascular disease
• High blood pressure requiring medicine
• Dyslipidaemia
• Obstructive sleep apnoea confirmed by a sleep study
• Type 2 diabetes
Can I refer myself to ROMS?
The complete ROMS referral process has not yet been published.
Self referral has been announced for OPIP, which is a separate programme.
Do not assume that the same route automatically applies to ROMS.
What is OPIP in Northern Ireland?
OPIP is the Obesity Pathway Innovation Programme.
Northern Ireland’s project will test a neighbourhood based model offering:
• Self referral
• Support from HSC clinicians
• Digital advice
• Social prescribing
• Access to medicine where clinically appropriate
Who may qualify for OPIP?
The Department says people with a BMI from 30 to 39.9 may be eligible.
Full entry criteria and public access instructions still need to be confirmed.
What if my BMI is between 40 and 45?
The June 2026 announcement does not explain the initial pathway for this range.
Speak to your GP about current health needs and monitor official updates rather than assuming that you are permanently excluded.
Will ROMS provide weight loss injections?
The Department says the service will provide access to weight management medicine when clinically appropriate and in line with NICE guidance.
It has not promised a particular medicine for every eligible patient.
Will treatment be free?
ROMS and OPIP have been announced as Health and Social Care initiatives.
Detailed patient access and service arrangements should be confirmed through the official rollout information rather than assumed from early announcements.
Do I need a confirmed diagnosis of sleep apnoea?
For the sleep apnoea phase one criterion, the Department specifies obstructive sleep apnoea confirmed by a sleep study.
Can Keltoi refer me into ROMS?
Keltoi is separate from ROMS and OPIP and cannot promise or fast track public service access.
Follow the official referral route when it is published or speak to your GP.
The bottom line
Northern Ireland’s first Regional Obesity Management Service is an important development, but phase one will be tightly focused.
The published criteria require a person to:
• Be aged 18 or over
• Have a BMI above 45
• Have at least one specified condition
The specified conditions are:
• Cardiovascular disease
• High blood pressure requiring medicine
• Raised cholesterol or triglycerides
• Confirmed obstructive sleep apnoea
• Type 2 diabetes
OPIP is a separate programme for possible eligibility from BMI 30 to 39.9.
It is expected to provide:
• Self referral
• Community support
• Work with HSC clinicians
Important details remain unanswered, including:
• The full ROMS referral route
• Waiting times
• Local contacts
• The initial pathway for people with a BMI from 40 to 45
Until those are published, use official sources and avoid anyone claiming to guarantee NHS access or prescription treatment.
Sources and further reading
• Department of Health NI: First phase of Northern Ireland’s Obesity Management Service
• Department of Health NI: Northern Ireland to get its first Obesity Management Service
• GOV.UK: Obesity Pathway Innovation Programme projects
• Department of Health NI: Health Survey Northern Ireland 2024 and 2025
• Department of Health NI: Healthy Futures obesity strategic framework
• NICE: Overweight and obesity management
• NICE: Quality standard for overweight and obesity management
Last updated: 19 August 2026
Medical disclaimer: This article provides general information and does not confirm eligibility for ROMS, OPIP, medicine or any other treatment. Official criteria and access arrangements can change. Speak to an appropriate healthcare professional about your circumstances and use Department of Health and HSC information for the latest public service guidance.