Obesity is a leading cause of preventable illness and premature death in the UK. According to the latest Government figures, almost two-thirds of adults are overweight or obese, with obesity-related illnesses costing the NHS £6 billion a year.  

The pandemic has influenced obesity rates over the last two years. The Zoe Covid Symptom Study found that overall reported weight gain among participants averaged out at 0.8kg, while another 2021 NHS study revealed that people who sought help with losing weight were 2.3kg heavier on average in 2021 than they had been three years before. In addition, under 40s who enrolled on the NHS diabetes prevention programme were found to be around 8lbs heavier on average when they started than those who enrolled before the pandemic, according to the study, which was published in The Lancet Diabetes & Endocrinology.

The NHS launched its own Digital Weight Management programme in July 2021. Initially available only through GP referral, the programme has now been opened to community pharmacy referrals. Pharmacy teams can refer people through www.pharmacy.wmp.nhs.uk/ (a pharmacy ODS code is required for access). Referrals are only accepted online via the website. 

Public Health Minister Jo Churchill commented earlier this year: “By expanding virtual and face-to-face weight management support across the country, we’re bringing improved health and wellbeing closer to home.”

The NHS is certainly pushing its digital weight management offerings, although there is a feeling that more clarity may be needed around where and when to refer people to different services. The decision about how much focus is given to different (Tier 2) lifestyle weight management services currently seems to vary at local commissioning level. 

According to the King’s Fund, the fragmented approach to tackling obesity taken by recent governments has ‘fallen short of the cross-cutting approach needed’. A 2021 report argued that the NHS needs to do more to support people in making healthier choices. The Office for Health Improvement and Disparities (OHID) was launched in October to sit alongside integrated care systems (ICSs), with the aim of tackling national health inequalities, including obesity prevention and reduction, but it is unclear how these new structures and accountabilities will trickle down, and how they will affect community pharmacy.

Jonathon Holmes, policy adviser at the King’s Fund, believes pharmacy will have an important role to play. “Community pharmacy is very visible – it’s a shop front to the NHS,” he says. “To help address health inequalities such as obesity rates, pharmacy staff need to be aware of what kind of support services are available locally and offer a ‘light touch’ approach – referrals, even things like leaflets for weight loss classes or diabetes support groups.”

Community pharmacy might consider feeding into these soft, ‘light touch’ referrals by promoting behavioural change support, weight loss groups and physical activity groups such as walking groups. While evidence suggests this type of social prescribing could offer significant benefits in terms of wellbeing, the direct benefits have yet to be proven. 

Mitesh Desai, CEO of Landy’s Chemist in London, suggests pharmacy staff should feel empowered in supporting customers to make healthier choices and can do simple things like helping people set realistic goals, encouraging small steps, and suggesting they focus on one aspect of their weight loss at a time. “Pharmacy staff are often the first members to engage with customers and can have a major impact on what the customer chooses to do. By being attentive to the customer’s needs, we can identify opportunities to help with their weight loss,” he says. “If a customer is looking to exercise more regularly then support bandages can be useful in preventing injuries.

“Pharmacies can offer a variety of weight management solutions such as Lipotrim, but people may be looking to take smaller steps first. By listening to the customer and what they are trying to achieve, we can offer many readily available products and services which can contribute to a healthy weight loss plan.”

Jason Perfitt, managing director of Bio-Health Ltd, suggests supplements may help to support people too. “Bio-health’s Super Kelp supplement is rich in B vitamins and essential nutrients and is a natural source of iodine,” he says. “Psyllium husk works in a similar way to some pharmaceutical products, supporting good gut motility and regular stool production.”

The 5:2 diet

A recent small scale study revealed that people seem to prefer being given information and support to follow the 5:2 diet made popular by former doctor Michael Mosley, when compared with standard GP weight management advice, although there was little difference in the efficacy of the diets themselves. Researchers compared different weight loss advice given to 300 adults:

• The usual advice about staying active and portion control, resources such as the NHS Change4Life booklet
• Brief advice on how to follow a 5:2 diet (reducing calorie intake to 500-600 on two non-consecutive days each week) 
• Advice about the 5:2 diet along with a six-week programme of group support sessions.

After one year, 15 per cent of the study participants receiving standard weight loss advice had lost at least five per cent of their body weight, compared with 18 per cent of those who had just received information about the 5:2 diet. Interestingly, 28 per cent of those who were given information along with group support lost at least five per cent of their body weight. 

Dr Katie Myers Smith, chartered health psychologist and senior research fellow at Queen Mary University of London, said: “We found that although the 5:2 diet wasn’t superior to traditional approaches in terms of weight loss, users preferred this approach as it was simpler and more attractive.”