From Margins to Mainstream: Making Psychological Interventions for the Treatment of Obesity and Weight Management Core to NHS Primary Care.

Obesity continues to place an escalating burden on the NHS, both economically and socially. Despite the introduction of a tiered model of care, psychological support within Tier 2 services remains patchy and is often delivered by non-specialists, thereby limiting its effectiveness. This editorial argues that meaningful progress requires a stronger integration of evidence-based psychological interventions, such as Cognitive Behavioural Therapy, Motivational Interviewing, and Acceptance and Commitment Therapy, into routine primary care. Current provision is highly variable, with many patients facing long waits for higher-tier services and little access to structured mental health input at the community level. Digital tools show promise, but adoption remains inconsistent and inequitable. Primary care is uniquely positioned to address these shortcomings: upskilling GPs and allied staff, embedding psychologists within Primary Care Networks, and scaling digital support could provide earlier, more equitable intervention while reducing the burden on secondary care. If obesity is to be managed effectively and sustainably, Tier 2 services must evolve from their current fragmented state into a model where psychological care is recognised as central, not peripheral, to treatment.