There is a growing demand for specialist weight management services across Australia, yet publicly funded weight management services are lacking, with limited data on the effectiveness of these services.To evaluate the effectiveness of a regional specialist weight management service on weight loss and weight loss maintenance, and to determine attrition rates of this service.A prospective evaluation of adults who attended the publicly funded Top End Weight Management Service, with their first appointment between August 2021 and August 2023 and follow-up period of at least 12 months. Wilcoxon signed rank test was used to analyse changes in absolute and percent body weight between the initial visit and at 3, 6 and 12 months.Of the 81 patients, 40% identified as Aboriginal and/or Torres Strait Islander, 59 (73%) were still attending the service at 3 months, 48 (59%) at 6 months and 39 (48%) at 12 months. Median weight change at 3 months was -6.0 kg and -4.7%. Median weight change at 6 months was -7.9 kg and -5.6%, and at 12 months was -11.3 kg and -8.5% for participants in the weight management service. At 12 months, 62% achieved at least 5% weight loss and 44% achieved at least 10% weight loss.This study demonstrated that clinically meaningful weight loss and associated weight loss maintenance were achievable for a select population through a weight management service.