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Weight loss service: ‘We want people to feel it’s approachable rather than prescriptive’

By Saša Janković

24 Feb 2021

Community pharmacist Gareth Evans talks to Saša Janković about adding sleep and snoring advice to his weight management service at Wansford Pharmacy in Peterborough.

Service type: Weight management and sleep advice service.

Name of pharmacy: Wansford Pharmacy, Peterborough.

Name of pharmacist: Gareth Evans.

Why did you start offering this service?

I set up the Waistaway weight management programme in 2004, and have also been working with Lipotrim as a pharmacy advisor and trainer since then.

I first came across Lipotrim during my pre reg year in 1997 when it was still a GP-only programme, and it wasn’t until 2001 that I trained up to offer Lipotrim to patients, which had only just been released to pharmacists around that time. I had a consultation room put in at my pharmacy, and we had loads of patients coming through the programme. I then sold the pharmacy and started the Waistaway weight loss and weight management programme in 2004, in order to pick up patients outside the pharmacy setting but still under my professional credentials. Now I work as a locum at Wansford Pharmacy one day a week, and use my weight management skills there.

How much did it cost to set up the service?

Lipotrim provides the scale and height measurement free of charge and I have my own laptop and computers in the pharmacy, so the only cost is the product and that’s minimal.

What, if any, training did you or other team members have to undergo?

I did my initial training through Lipotrim, and over the years I’ve completed Saxenda training and worked thought the CPPE packs on weight management and obesity. I’m always learning from other pharmacists as well as my patients.

In a nutshell, what does the service involve?

People come to us via GP referral, word of mouth, and our website also signposts them to the service. It’s all drop in; we don’t do an appointment systems as we want people to feel it’s an approachable rather than prescriptive service. I start the consultation by taking the person’s height and weight measurement if I can, so we can work out their BMI. If they want to get cracking, I can direct them to plenty of written materials and videos on the website that can explain what they need to do, as well as supplying weight loss products if suitable.

If it’s simply a brief lifestyle intervention that’s needed, I will talk about the Eatwell Portion Guide and the appropriate ‘portion plate’ or ‘diet plate’ for them. It may be that they suit partial or total food replacement from Lipotrim, so if that’s the case I will go through a medical questionnaire to qualify them, and explain that the rates of weight loss they can expect. More than 1lb a week is relatively unattainable on any weight loss programme outside of total replacement, but those on total replacement can expect to lose a stone a month for women and a stone and a half for men. After that I’ll see patients every week for a weight check, and chart their progress. Accessibility can be an issue for people with high obesity in desperate need of help, and they may not regularly leave the home, so sometimes I do home visits as well.

You can’t just say to someone “can I talk to you about being overweight”, but customers asking us about snoring and sleep apnoea is a great way get the conversation started because these conditions are often related to being overweight. I recently completed the free Snorer Pharmacy ‘sleep training’ programme and now use their screening tool with patients. During the pandemic this has meant having an initial chat with them on email or by phone to fill them in, followed by a Zoom meeting with me, them and their partner – because they are the ones who really know what’s happening. The 10-minute Snorer Pharmacy screening programme gives a detailed report that I can talk through with the patient, giving them lifestyle advice, referring them to a sleep trained dentist, or to their GP to investigate further. We can supply a home sleep apnoea test as well, and they can take their screening report and the sleep report to a GP or sleep clinic and get to where they need to be a lot quicker than if they just went to the GP.

Are there any opportunities to sell OTC or prescription products during or after the consultation?

Customers may have issues surrounding digestion, constipation or heartburn so there are peripheral products you can link sell, but more importantly it’s about driving footfall and getting patients back into the pharmacy.

How have patients responded to the service?

Our patients see about a 10% weight loss on average and say we are changing their lives. We had one patient who was having 30 sleep apnoea episodes in a night, then lost two stone and got this down to one episode a night.

Roughly how often each month do you carry out the service?

When I was working in pharmacy full time I could see about 40 people a week on the Waistaway programme. Even during the pandemic I still have a handful of regular patients accessing the service.

How much do you charge for the service?

The initial weight management consultation is free, and then £3 a week thereafter, unless they purchase products. The diet plate and the portion plate are £20 and £10, and if they go for the total meal replacement option it costs £45 a week for women, and £60 a week for men.

Roughly how much a month do you make from offering the service?

It fluctuates, depending on the time of year. We make about 40% profit on what we do, which is a good margin.

Would you recommend offering this service to other contractors?

Yes. It’s been up and down, as most pharmacy services are with the level of attention we can give them because of being pulled around by everything else we have to do, but weight management is fundamental to health care. You’ve got the footfall so you can start from a basic level and build up from there.

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