Background
Despite National guidance recommending their use, there is uncertainty regarding the best way to deliver weight management services across the UK and worldwide.

Methods
To ascertain access, provision and interventions used in lifestyle Tier 2 and specialist Tier 3 weight management services in Scotland, a survey was distributed to all mainland health boards covering pathways for referral, eligibility criteria, intervention format and definitions of attendance completion and adherence.

Results
Nine Health boards provided information on their weight management services. The provision of services was low. Only four health boards offered services for those with a BMI 25–30 kg/m2. Lifestyle Tier 2 services were mainly weekly or fortnightly group sessions for 8–12 weeks delivered by dietitians or community workers. Specialist Tier 3 services were largely similar to lifestyle Tier 2 services. The provision of specialist interventions including pharmacotherapy, cognitive behavioural therapy sessions and low-calorie prescribed diets was low.

Conclusions
This national survey has illustrated large disparities in the provision of weight management across Scotland, a likely consequence of uncertainty regarding best practice. There is a clear requirement for the evaluation of existing services to identify those that lead to the largest improvements in health outcomes and are cost-effective.