The number of obese people in England has more than doubled in the past 25 years, with 24 per cent of men and 26 per cent of women classed as obese and a further 41 per cent of men and 33 per cent of women overweight. Middle-age is the time we’re most likely to pile on the pounds, according to recent studies. The University of London found that two-thirds of men and half of women in their early forties were overweight or obese, in a study that looked at 10,000 people born during one week in 1970. Obesity among children is on the rise, with three in 10 two- to 15-year-olds either overweight or obese (Health & Social Care Information Centre, 2013). The financial burden to the NHS is huge, with hospital episodes related to obesity in 2011/2012 up by 11 times the number a decade earlier and around 0.9 million prescriptions dispensed for the treatment of obesity a year.
Pharmacies have a proven track record with behaviour change programmes such as smoking cessation and they run other health improvement services such as NHS Health Checks, diabetes care and MURs, all of which can also be used to identify customers who would benefit from a weight loss service.
Many pharmacies now offer weight loss schemes, though few are commissioned or NHS funded. Most are set up and run by pharmacy support organisations or linked with manufacturers of weight loss products.
For example, Alphega Pharmacy offers a weight loss scheme and one of the most successful independents taking part is St Clears Pharmacy in Carmarthen, Wales. Pharmacist Chris Jenkins explains: ‘We have many overweight people in our community and I think most need help with losing weight. Our customers like the one-to-one service we offer.’ They have around 50 customers on the scheme at any time, peaking in January, with three pharmacy assistants trained to run the service. It costs £25 for a series of appointments.
‘First we do a cholesterol and blood sugar test and an MUR to assess whether the customer is suitable for our service. We do a BMI and refer any concerns to the GP. We talk about what they eat and changes they need to make,’ says Mr Jenkins.
They set a target weight loss goal for six months and ask the customer to keep a daily food diary and bring it in each week when they are weighed. ‘We do it all in a private room and it takes five to 20 minutes, depending on how much there is to discuss,’ says assistant Julie Glanville. ‘We have one lady who’s lost 50lbs but keeps coming to ensure the weight stays off. Customers like our personalised approach. To keep them motivated we give them a small gift every time they lose half a stone.’
Numark runs successful weight loss services, giving members a choice between advice-based and product-based schemes. ‘Pharmacists are in a great position as they see customers every day who need to lose weight, coming into store with related conditions such as heart disease and diabetes. As part of an MUR they can discuss lifestyle changes, including weight loss and signpost to their own service,’ says director of pharmacy Mimi Lau. ‘We offer a range of services: advice-based, which include weigh-ins, food diaries and counselling, and others linked with a product such as Lipotrim. harmacies can choose which are the best options for their customers. We’ve had lots of positive feedback from staff and customers – the staff like being able to make a difference to their customer’s welfare and it builds excellent customer loyalty too.’
NHS Central Lancashire ran a pilot scheme over 12 months in 10 pharmacies. The service targeted customers with a BMI of 25-40 and was based on behavioural change and lifestyle advice, including diet and exercise. Customers showed an average weight loss of 2.9kg.
At All About Health (AAH Pharmaceuticals), service development pharmacist Charan Kaushish says: ‘Pharmacy is well placed to provide weight loss services because we are convenient and discreet. Many people prefer the anonymity of a pharmacy weight loss programme with no public weigh-ins or peers to compare with. Patients are able to work with their pharmacist to agreed diet and fitness plans with mutually agreed goals. Discussing fitness with patients is crucial. Our pharmacists receive literature and PoS to help them liaise with patients on how best to maintain a healthy lifestyle, advising on fitness routines to suit the individual.’
AAH members are offered a service that focuses on monitoring weight and giving advice on diet and exercise. ‘The great thing about a pharmacy-led programme is that each one is tailor made to suit the patient,’ says Charan Kaushish.
New draft guidelines from NICE on ‘Managing overweight and obesity in adults’ suggest referring obese patients to weight loss programmes, with emphasis on an integrated approach to the prevention and management of obesity. They recommend signposting to weight loss services customers who use other local services such as smoking cessation, diabetes care and the NHS Health Check. NICE stresses the importance of adopting a sensitive and tactful approach with overweight customers. ‘Be aware of the effort needed to lose weight and avoid further weight gain and the stigma that adults who are overweight or obese may feel. Ensure the tone and content of all communications is respectful and non-blaming. The terminology used to describe the person’s condition should respect individual preferences.’ When carrying out a weight loss service NICE stresses the importance of ensuring your equipment and facilities meet the needs of the heaviest patients and suggest that you measure the waist circumference of those with a BMI of less than 35. NICE also emphasises the importance of setting out realistic goals and expectations for those joining a programme, taking time to explain:
How can you best help customers keep their interest in weight loss? Leyla Hannbeck, NPA’s head of pharmacy services, advises:
By 2017 the diet and weight control foods market is forecast to grow by 18 per cent up to £1,927 million, according to Mintel. The largest sector is biscuits and cereal bars, taking a third of sales. Only one in 20 consumers has used slimming products such as appetite controllers and meal replacements, though the market is growing steadily. Over half of Britons have tried to lose weight during the past year.
Omega Pharma has developed a bespoke weight management training module to help pharmacy staff refine their skills. Available at www.omegapharmatraining.co.uk, the training focuses on category information and advice, scenario based learning and recommendations of weight loss supports such as XLS-Medical. XLS-Medical Carb Blocker is the newest weight loss aid from Omega, a naturally derived, clinically proven carbohydrate blocker for weight control when taken in conjunction with a balanced diet and physical activity, including concentrated glycoprotein complex derived from white kidney bean. It claims to help dieters lose up to three times more than dieting alone, helping to reduce up to 66 per cent of the calories absorbed from dietary carbohydrates.
This month sees the return of the XLS-Medical Fat Binder real women TV campaign, alongside a press campaign for the XLS-Medical range.
A double-blind study at the University of Liverpool found that taking herbal supplement Zotrim resulted in 20 per cent fewer calories consumed and lessened desire for high-fat foods. ‘The big issue in the weight loss category remains the fact that there are few says Nature’s Remedies Dr Trevor Jarman. Zotrim active ingredients include South American yerba maté extract, said to reduce appetite, and guarana, to increase metabolic rate and burn calories. It is also available in a drink format – Fibretrim. Each sachet is the equivalent of three Zotrim tablets.
Weight loss product Slimsticks contains Konjac, a plant-based fibre from Japan, which claims to help you eat less without cutting out food groups. Sanjay Mistry at Inovate Health has the following tips to pass on to customers: ‘Say no to yo-yo dieting and avoid strict detox diets that ditch entire food groups. Weight loss is all about shaving off calories, whether through diet or exercise and preferably both.’ Inovate Health is currently working with charity Heart UK to evaluate consumer views on a new product launch for the coming year.