Objective To comprehensively assess the establishment and service provision of weight management clinics in healthcare institutions in Shenzhen city, Guangdong province, thus providing robust evidence to support the standardized and scientific development of weight management services in China.

Methods In June 2025, a census survey was conducted among 62 secondary- and tertiary-level medical institutions (STLMIs) and 734 community health service organizations (CHSOs) in Shenzhen. A structured questionnaire was employed to investigate the weight management clinics in terms of establishment, service capacity, equipment configuration, extended services, participation in professional skills training, and existing problems.

Results The establishment rates of weight management clinics were 83.87% in STLMIs and 11.58% in CHSOs, being higher in STLMIs than in CHSOs (χ² = 209.68, P < 0.001). In terms of service capacity, STLMIs demonstrated generally strong capabilities in weight management clinics, except for bariatric and metabolic surgery. CHSOs exhibited satisfactory basic service capacity but limited specialized intervention capabilities, with significantly weaker overall capacity than STLMIs. For services targeting children and adolescents as well as pregnant and postpartum women, the proportion of CHSOs with corresponding service capacity was lower than that of STLMIs (all P < 0.01). Regarding equipment configuration, both STLMIs and CHSOs reported over 80% availability of basic examination and assessment equipment (excluding body fat scales and body composition analyzers), with no statistically significant differences (P > 0.05). However, STLMIs showed higher availability of body fat scales, body composition analyzers, and metabolic assessment equipment than CHSOs (all P < 0.01). In terms of extended services, the proportions of STLMIs conducting weight management-related skills training and providing school-based health education and free medical consultations were 50.00% and 40.38%, respectively, both higher than those of CHSOs (17.65% and 21.18%, respectively; both P < 0.05). With respect to professional skills training, the proportions of STLMIs receiving training in endocrine and metabolic diseases, nutrition guidance, exercise guidance, and psychological and behavioral interventions were 80.77%, 76.92%, 78.85%, and 59.62%, respectively, all higher than those of CHSOs (51.76%, 48.24%, 52.94%, and 32.94%, respectively; all P < 0.01). The major problems reported by STLMIs included information systems failing to meet work demands, insufficient publicity coupled with low outpatient volume, and lack of effective incentive mechanisms. CHSOs mainly reported inadequate equipment and facilities, information systems failing to meet work demands, and limited professional skills among healthcare staff.

Conclusions The overall establishment of weight management clinics in healthcare institutions in Shenzhen is relatively satisfactory, while substantial room for improvement remains in CHSOs.