Weight Management

Following an indulgent Christmas period, it appears that it is not only the turkey that will be stuffed this festive season. The New Year will see many people battling the bulge and trying to squeeze back into their favourite jeans as part of their New Year resolutions.

The body mass index (BMI) is used to determine if your weight is in the healthy range.
• You are in the normal range if your BMI
is between 18.5 and 25 (kg/m2).
• You are overweight if your BMI is between
25 and 30.
• You are obese if your BMI is 30 or higher.
• You are morbidly obese if your BMI is 40 or higher.

Government figures show that at least one in four men and one in three women are overweight in the UK.

The Department of Health predicts that if this trend continues, by 2010 around 6.6 million men will be obese compared to 6 million women.

Psychologically, being overweight can affect your body image and damage self-esteem. In some cases this can cause social anxiety and depression. Common physical problems include:
• Difficulties breathing
• Difficulties walking or running
• Increased sweating
• Pain in the knees and back
• Skin conditions such as acne
• Gallstones

The following medical conditions are also more common in obese people than in those of normal weight:
• High blood pressure
• High cholesterol
• Cardiovascular disease
• Type 2 diabetes
• Some types of cancer.

These conditions are often known as obesity-related diseases and are some of the most common causes of death before the age of 75. This is why obesity increases your risk of mortality.

The obesity epidemic, as the Government has called it, is costing the NHS millions every year and is resulting in an unhealthier nation. With the reduction in outdoor activity, increasingly busy work lives and access to cheap fast food, it is becoming easier for our population to become more and more obese and unhealthy.

Community pharmacists are ideally placed to help manage this problem with professional advice, medication and referral if
necessary.

The market for weight loss products and health and fitness is huge, a multi-million pound concern. There are opportunities for community pharmacies to tap into these markets and help make up the shortfall in funding by the Government for a pharmacist’s ‘bread and butter’ in dispensing and purchase profits.

A healthier lifestyle is a major part of weight reduction. Pharmacists should always advise their patients, no matter what weight loss product they may purchase, that they must also increase their physical activity and eat healthy.

For patients who have a BMI value over 28, a major step forward in community pharmacy was the availability of
Orlistat as a P medicine. Alli as it is know over the counter, has become a very popular product in our pharmacy and has enabled pharmacists to help these people lose weight and keep the weight off. Not just by taking Alli, but also healthy lifestyle advice.

The patients I have on Alli have a weekly five minute meeting with me; we do a weigh in and brief discussion about their  rogress. We are in the process of producing our own weight monitoring diaries for our patients which they will purchase as part of their treatment regime. They also include tips for healthy eating and a sample exercise plan. They have been tailored to suit the patients, we asked each patient what they would like to see in the booklet and have devised it to suit.

This is just one example of the opportunities available to the pharmacists. There are numerous other weight loss products that
pharmacists can also supply, for example adios, lipobind and recently lipotrim.

The products recommended are equally as important as the input you as a pharmacist or pharmacy team give to your patient to help them achieve their goals. I have also started a referral scheme with a couple of local gyms, any patients that I am sending and who join them are given a free personal training session and I receive some commission. It is important to try and think of new and novel ways to integrate the pharmacy business with other aspects of health to benefit all parties. The
patient is happy because you are helping them achieve their health goals and you are happy as you are making a difference and also earning some well needed extra income.

Pharmacy as a profession now need to evolve and accept the fact dispensing and purchase profits will no longer pay the bills as long as the Government keeps clawing back more and more money. Pharmacists need to look at other avenues, such as smoking cessation and weight management, to better the health of the nation and show the Government that community
pharmacy should play a key role in the National Health Service (NHS).

Pupinder S Ghatora is a pharmacist from Woodland Pharmacy and was the Pharmacy Business Young Pharmacist of the Year 2008.