Interview: Martin Fidock on digital weight loss services and where community pharmacy fits in

The Pharmacist spoke to Martin Fidock, UK Managing Director of Oviva, about digital innovation in weight management, and how community pharmacists might be part of a joined-up obesity strategy.

Obesity is estimated to contribute to over 30,000 deaths each year – alongside increasing the risk of developing cardiovascular diseases, type 2 diabetes and certain cancers – resulting in a growing need for access to services that address what many healthcare professionals are calling an ‘obesity epidemic’.

With a focus on expanding NHS capacity and reducing waiting lists, digital care company Oviva is one such provider aiming to meet the needs of this patient group. Operating exclusively through NHS partnerships, it offers a digital tier three weight management service, among other pathways, across England.

Since gaining national access through the NHS’s Right to Choose framework in September 2024, Oviva has accepted referrals from every ICB in England. Access to the service is strictly via GP referral, using an online eligibility checker to help both patients and practices navigate local criteria, which are based on NICE guidance but vary by ICB.

'The service is designed to ease pressure on GPs by providing full wraparound digital support', explains Martin Fidock, Oviva’s UK managing director. 'Our clinicians – consultant endocrinologists, GPs, psychologists, nutritionists – handle all patient needs which reduces re-access to GP services by being the first point of contact.'

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The service currently supports just under 10,000 patients, with Fidock saying: 'These patients are typically high-risk, with an average BMI of 47. Over half experience depression and many are unemployed or socially disadvantaged, further underscoring the need for intensive, accessible support.'

Active engagement

Oviva integrates directly with GP systems, receiving and managing referrals electronically. It bespoke app supports video consultations, chat and educational content, and uses photo recognition technology that analyses users’ meals and guides dietary decisions. This, combined with scheduled clinical touchpoints, helps monitor progress and ensures that patients remain actively engaged over the two-year period of the pathway – which includes behavioural support and access to weight-loss medications such as Wegovy where clinically indicated.

Although it’s up to patients to input their weight and biometrics regularly, particularly to remain eligible for weight-loss medications, Fidock stresses that 'cheating the system' isn’t in the patient’s interest. 'Their data directly affects dosage, clinical oversight, and the support they receive.'

Approximately 85% (7,000) of Oviva’s patients are on a medication-based pathway, supported by behavioural therapy, following a structured process of pre-clinical learning, triage, dietitian assessment and, if eligible, prescription medications delivered to them at home via a third-party pharmacy.

GPs are kept informed about their patient on an opt-in basis, freeing up their time for more critical interactions. 'GPs told us they don’t want routine letters unless action is needed,' says Fidock, 'so we have a dedicated line and team available for GP queries, and any significant clinical updates are flagged in patient records.'

The company also supports patients without digital access via a desktop version and telephone-based services, although Fidock says 'uptake is low'.

Behavioural foundations

Although the programme is designed as a two-year pathway, early exit is possible if goals are met. At the end of the programme patients can still access the Oviva app and content which Fidock describes as “an ‘off-ramping’ phase that includes medication weaning and continued behavioural support.”

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Indeed, Oviva has been providing behavioural weight-loss services long before the arrival of new medications. Fidock believes this foundation is key to patients achieving sustainable outcomes, but says there is still work to be done to access more people who could benefit.

'There are around 3.4 million eligible patients in England', he says, 'and while Right to Choose gave us a way in, now the challenge is ensuring long-term access and funding so digital services can continue easing pressure on primary care.'

Fidock says Oviva is focusing on 'responsible expansion in partnership with the NHS', but although awareness of the service among GPs is growing, 'confusion persists around funding'. In fact, the mechanism is that GPs refer patients, and Oviva bills the relevant ICB. Medication costs are passed on at NHS list price with no mark-up.

'We’re not making money on the drugs,' Fidock stresses. 'We’re here to increase NHS capacity, and so stronger messaging from ICBs and NHS England would help. GPs are the gateway to this service, which reduces re-access for related conditions like diabetes and mental health, and that’s a win for everyone.'

Another potential barrier is the focus of the obesity treatment narrative on weight-loss jabs. 'The behavioural element of weight loss is critical for sustainable outcomes', says Fidock, 'so oversimplifying the issue could deter patients with obesity from seeking help, and increase their long-term health risks.'

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Despite this, there is a place for Wegovy, and similar drugs, in the Oviva program. They are supplied via a third-party dispenser with Oviva’s clinicians managing prescribing and patient education, including safe use and disposal.

Pharmacy expansion

Looking ahead, Fidock says if weight-loss jabs become available through community pharmacy this would be 'a welcome step' but stresses: 'Any expansion in access is positive, but only if it’s clinically led with wraparound care. Pharmacists could play a valuable role in supporting patients as long as it’s not a piecemeal approach that lacks long-term behavioural support.'

For community pharmacists, Oviva’s approach offers a glimpse into the future of weight management: digital, integrated and focused on long-term change. With NHS backing and a clear clinical structure, models like this could be replicated or extended to community pharmacy – with the right funding and training in place.