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Several things. Being pregnant, breastfeeding or planning a pregnancy. A BMI below the threshold with no linked health condition. Certain medical histories, including some conditions and some medicines that interact. And sometimes, simply that treatment is not the right answer for what you are trying to achieve.
A good assessment is designed to find these, not to get around them.
BMI below the threshold
The usual starting point is a BMI of 30, or 27.5 with a weight-related condition — and 2.5 points lower if your family background is South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean.
Below that, treatment is not usually appropriate. Below a BMI of 25 it very rarely is. A service willing to treat someone at a healthy weight is not following UK guidance, and that is worth knowing about any clinic you are considering.
Pregnancy, breastfeeding, or planning a pregnancy
Weight management treatment is not appropriate during pregnancy or while breastfeeding, and it is not appropriate if you are actively trying to conceive. If any of those apply, the answer is no for now rather than no permanently.
Your medical history
Some conditions make treatment unsuitable. Others do not rule it out but change how closely you would need to be monitored, or which option is appropriate.
This is why the questions about your history are long and why they matter. A clinician is not collecting them for the file — they are the assessment.
What you are already taking
Some medicines interact. Some need their dose reviewed if your weight changes. Some conditions become easier to manage as weight falls and need monitoring for that reason rather than because anything is wrong.
Tell us everything you take, including anything bought without a prescription.
A history of an eating disorder
This is not an automatic no, but it is a conversation rather than a checkbox. A clinician will want to understand your history and may involve or contact other professionals already supporting you. If this applies to you, say so during your assessment — it changes what safe care looks like, and it is far better raised at the start.
When treatment simply is not the right answer
Sometimes everything is within range and treatment still is not the best route. If what you want is achievable another way, or if the thing driving your weight is better addressed elsewhere, a clinician should say so.
This is the part patients least expect from an online service, and it is the part that distinguishes a clinic from a shop.
What happens if the answer is no
You are told why, in plain terms, by the clinician who reviewed it. Where something else would help more, we say what. Where it is a no for now rather than a no permanently, we say when to come back.
You are not charged for treatment you are not prescribed.
Frequently asked questions
Can I be refused weight management treatment? Yes. A clinician can decline if treatment is not clinically appropriate. Common reasons are a BMI below the threshold, pregnancy or breastfeeding, or a medical history that makes it unsuitable.
What disqualifies you from weight management treatment? Pregnancy, breastfeeding or planning a pregnancy. A BMI below the relevant threshold with no linked condition. Certain medical conditions and some medicine interactions. A clinician assesses these together rather than one at a time.
Do I get charged if I'm declined? You are not charged for treatment you are not prescribed.
Can I reapply if something changes? Yes. Where a no is temporary — pregnancy, or a condition being treated elsewhere — a clinician will usually say when it is worth coming back.
Will you contact my GP? With your consent, yes. Keeping your GP informed is part of safe care, and in some cases a clinician will want their input before proceeding.
References
National Institute for Health and Care Excellence (2025) Overweight and obesity management. NICE guideline NG246. London: NICE.
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