NICE NG246 (England and Wales-facing national guidance)

Front

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📘 GuidelineCh 11 · Bariatric & Metabolic Surgery

NICE NG246 (England and Wales-facing national guidance)

In one breath

NICE guideline NG246 on overweight and obesity: specialist multidisciplinary assessment first, bariatric surgery considered inside the defined NHS pathway after appropriate assessment and prior weight-management approaches, with lower BMI thresholds for several ethnic groups.

EditionNG246 — 2025 (updated 2026)

Issued byNational Institute for Health and Care Excellence (NICE)

Place of issueEngland and Wales

⏳ Pending verification

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 1

2 of 3 · Back 1

Back colours mark the reading sections — the chapter colour is the band and chip.

§1 · What it covers

This guideline covers adults and children with overweight/obesity; the surgery section addresses referral to specialist overweight/obesity services and bariatric surgery pathways. NICE embeds informed/shared decision-making and specialist multidisciplinary assessment. It should be read alongside legacy CG189 material where the current page retains or cross-references relevant surgery pathways.

Applies to: adults and children with overweight/obesity; the surgery section addresses referral to specialist overweight/obesity services and bariatric surgery pathways. NICE embeds informed/shared decision-making and specialist multidisciplinary assessment. It should be read alongside legacy CG189 material where the current page retains or cross-references relevant surgery pathways.

§2 · Key recommendations

use specialist services and multidisciplinary assessment.
consider surgery within the defined NHS pathway after appropriate assessment and prior weight-management approaches.
apply lower BMI thresholds for several ethnic groups because of earlier metabolic risk.
The current page is also important for medication-versus-surgery context, including semaglutide/tirzepatide pathways, and states that pregnancy contraindicates several anti-obesity medicines.
NICE uses its own wording to communicate recommendation certainty rather than the ASMBS/IFSO or GRADE format.

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 2

3 of 3 · Back 2

Back colours mark the reading sections — the chapter colour is the band and chip.

§3 · Evidence & grading

NICE recommendations are evidence-to-decision outputs from its guideline committee and evidence reviews, but the surgery page does not present a single bariatric-specific GRADE table in the accessible HTML. Certainty is therefore best read from the linked evidence/rationale documents rather than inferred from the page alone.

§4 · What changed in this edition

Not yet established — pending verification.

§5 · Source & working link

National Institute for Health and Care Excellence. NG246 — Overweight and obesity (record title: 'NICE NG246 (England and Wales-facing national guidance)'). NICE, 2025; updated 2026. Publisher URL and DOI/PMID: Not yet established — pending verification.

No working link established yet — see the link check below.

Link check 2026-11-11: the record carries no original_url and no DOI/PMID, and no canonical URL or identifier could be established from a named source at build time — no link rows are printed. Not yet established — pending verification.

Source: Tamer-supplied guideline index, intake 2026-11-10 (record #97, Domain 09) · Card built 2026-11-11 (Wave D) from the record itself; the §5.2 verification pass (UpToDate + Medscape → Perplexity → Tamer decision) has not yet run on this card. Completed in verification: issuedBy — The record's own title and topic text (NICE NG246; 'NICE embeds informed/shared decision-making…'), 2026-11-11. ⚑ Conflict flag on the source record — documented cross-society disagreement (intake DOCX Table 2): Bariatric eligibility — ASMBS/IFSO 2022 vs NICE NG246 2025/2026. Unresolved — pending the verification pass (UpToDate + Medscape → Perplexity → Tamer decision).

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

gl-div11-nice-ng246-overweight-obesity-2025GS.code · Guidelines

More in Division 11 · Bariatric & Metabolic Surgery

📘 GuidelineCh 11 · Bariatric & Metabolic Surgery⏳ Pending verification

2022 ASMBS and IFSO Indications for Metabolic and Bariatric Surgery

The 2022 ASMBS/IFSO indications for metabolic and bariatric surgery: recommended at BMI above 35 kg/m² regardless of comorbidity, to be considered at BMI 30–34.9 kg/m² with metabolic disease, with lower thresholds for Asian populations.

2022 · American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)

📘 GuidelineCh 11 · Bariatric & Metabolic Surgery⏳ Pending verification

2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery

The 2022 ASMBS/IFSO indications statement (Domain 09 filing of the same guideline as the Domain 02 record): metabolic and bariatric surgery recommended at BMI above 35 kg/m², to be considered at BMI 30–34.9 kg/m² with metabolic disease, with adjusted Asian thresholds.

2022 · American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)

📘 GuidelineCh 11 · Bariatric & Metabolic Surgery⏳ Pending verification

Scientific Evidence for the Updated Guidelines on Indications for Metabolic and Bariatric Surgery (IFSO/ASMBS)

The 2024 evidence update behind the ASMBS/IFSO indications: a systematic report on 13 criteria — BMI thresholds, Asian populations, diabetes, age, adolescents, safety and long-term outcomes — finding the evidence for expanded eligibility strengthened, though several questions rest on observational data.

2024 Evidence Update · International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and ASMBS