With “losing weight” being one of the most popular New Year resolutions, Victoria Goldman investigates how pharmacies can help customers to achieve this goal – and stick to it

According to the latest NHS statistics on obesity, 26 per cent of men and women were classified as obese in 2010, with a further 42 per cent of men and 32 per cent of women classified as overweight.

Losing weight isn’t easy, however, and surgery is often seen as a simple solution. NHS statistics show that there were more than 8,000 hospital procedures for weight-loss stomach surgery in 2010-11, a 12 per cent increase from the previous year and a 30-fold rise in the last decade. According to a review by the National Confidential Enquiry into Patient Outcome and Death in October 2012, many people are opting for obesity surgery without proper consideration of the risks, with almost a fifth of patients having to be readmitted to hospital because of complications. “The major issues at the moment appear to be that of gastric surgery and the messages that surround it,” says Ajit Mahli, head of pharmacy affairs for Celesio Group (UK). “It is a subject that we all need to be aware of since patients are bound to ask further questions. The key is to advise the patient as to what options best suit them and mutually agree some goals that both parties can work towards.”

Customers should avoid so-called fad diets and diets that are particularly restrictive, as these approaches are likely to cause binge eating and eventual weight gain. You need to find slimming regimes that suit your customers in the long-term rather than provide a quick fix. So what can you offer customers this New Year in terms of weight loss support?

Weight management services

Many pharmacies offer weight loss advice as part of a medicines use review or as a standalone weight management service. Ajit Mahli says that since weight management is a sensitive area for many people, it should be approached with care. “My advice would be to start by talking in terms of general health improvements,” he says. “Offer blood pressure screening and cholesterol checks and engage the patient with advice on living a healthy lifestyle in the first instance. It is certainly not a subject that can be handled with offers of miracle cures and overnight success.” Pharmacy-led weight management services can be particularly beneficial for customers who have a lot of weight to lose and need ongoing support. According to Helen Bond, British Dietetics Association spokesperson, customers need to learn to decrease their portion sizes of healthy foods and increase their exercise levels. “With today’s fast paced society, many people want to see extreme weight loss results within the shortest amount
of time,” she says. “But it’s probably taken years to accumulate the extra weight – so taking a year or so to lose the weight is
completely reasonable. Research shows that it’s far healthier and safer to lose weight slowly and steadily – around 1 to 2lbs (0.5 to 1kg) each week.”
There is no set way to lose weight and each customer will respond to different approaches.
“We are all very different and the way that we behave in relation to external and internal stimuli varies considerably, so what works for some people may not be right for others,” says Bridget Benelam, senior nutriti on scientist at the British Nutrition Foundation. “There are lots of different options to choose from in terms of making changes in our behaviour that could have a positive impact on our health.”

Meal replacement programmes

Meal replacement programmes are a popular choice for dieters. Some programmes offer total meal replacements, while others involve a combination approach, mixing meal replacement products with healthy meals. Research in the American Journal of Clinical Nutrition in September, 2012, found that commercial weight-loss programmes, especially the very low calorie diets (meal replacements providing 500 calories a day for six to 10 weeks), can be effective at helping people to slim down. “There is plenty of clinical research backing the role of meal replacements, which usually work by reducing calorie intake,” says Helen Bond. “These can be used as a tool to kickstart healthy eating plans.”
Meal replacements are convenient as they avoid the need for portion control and calorie counting. However, pharmacists need to educate customers about how to change their eating habits as well, so that they don’t put the weight back on again afterwards. The Slim-Fast plan is backed up by online support teaching the principles of healthy eating and how to manage everyday food and drink.

Lipotrim, which started out in 1987 as a GP programme but was extended to pharmacies in 2000, involves using Lipotrim Total Food Replacement formulas in place of all regular meals alongside weekly visits to the pharmacy.

“Lipotrim is aimed at the severely overweight or obese,” says Dr Stephen Kreitzman, the nutritionist who established the brand and is co-director of the company. “Pharmacists have to be trained and are backed up by our helpline. Maintaining the weight loss afterwards is very difficult and this is when most people need advice.”

Weight loss products

There are many weight loss products available and customers should buy products backed by clinical research, such as alli, XLS-Medical and Adios. “It is important that pharmacists look at the evidence behind each product and make sure that they won’t interact with anything else the customer is taking,” says Helen Bond.

Alli 60mg hard capsules, from GSK, are back on shelf after an absence and are being supported by an intensive marketing campaign to raise awareness and drive sales through pharmacy. Aimed at women aged 35-plus with a BMI of 28 or more, the brand’s key message is “for every 2lb lost through healthy eating, alli can help you lose 1lb more”. “We are delighted that alli is back in time to help people achieve their weight loss goals at a time when health and fitness will be top of their minds,” says alli brand manager Laura Street. “We will once again be hosting consumer information online to help people take responsibility for long-term changes and encourage a healthier lifestyle and sensible eating to achieve gradual weight loss.”

According to a double-blind, placebocontrolled clinical study, published in the journal Obesity, the recently launched XLSMedical Fat Binder helps dieters lose 3lbs for every 1lb they lose on their own. This patented natural fibre complex supplement comes with a free 12-week online weight loss programme (www.123hellome.com) designed to help dieters manage their weight loss successfully without cutting out important food groups.
According to marketing manager for the brand Nicole Ehlen, pharmacists and pharmacy assistants play a very important role when it comes to weight management. “A lot of consumers are looking for professional advice about how to lose weight and which products could help them,” she says. “Pharmacists should ensure customers understand that weight loss requires a long-term commitment and results won’t be achieved overnight. Encourage people to set themselves realistic weight loss goals.”
To achieve the maximum benefit from XLSMedical Fat Binder, the product should be taken regularly: two tablets, three times a day after each meal with plenty of water.
Additional support is also available on the brand’s website (www.xlsmedical.co.uk), where customers can find healthy eating and exercise tips from the company’s experts as well as a free online support programme to help dieters achieve their goals.

Case study

The Buchanhaven Pharmacy in Peterhead, Scotland, set up its weight management programme around four years ago. According
to pharmacist Samantha Melrose (pictured second from the right, with her team), the programme was introduced in response to customer demand. “We had always offered weight, height and BMI measurement, but just added more services to the bundle as they became available,” she says. “We then heard about Lipotrim and investigated its potential in the pharmacy. Celebrity Slim was then launched by Numark and, along with the launch of alli, this gave us a pretty comprehensive package. We also offer the Numark plan, which is similar to the Weight Watchers idea, where we offer lots of advice and a weekly weigh in.”
With its wide range of products and services, the programme has something to offer every customer. “Some products come with their own restrictions for use, but I believe that we offer something to suit everyone wishing to lose some weight,” says Samantha. “Some customers attend weekly, while some use the services on a more ad hoc basis, such as in preparation for a special event. We have had lots of really positive feedback. One of our Lipotrim customers brings the staff doughnuts every time she attends!”
All of the staff are fully trained in the services. “Many of our staff have used the products themselves and that helps the quality of the service we offer,” says Samantha. “We have a great team here and they are all extremely encouraging and delighted to help. Some services involve our pharmacist more than others, but we offer a very joined up approach involving the best person in the team for that customer.”
The programme is promoted regularly to attract new people to the pharmacy and remind regular customers that the weight management programme and other services are available. “We use our Facebook page every day to promote health and pharmacy news and messages,” says Samantha. “We also have a new website and we use our windows to their best advantage.
Of course, word of mouth is very important too. One happy customer will tell many more!”

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