Recent newspaper headlines around the weight loss injection Wegovy has been creating demand that we can’t deliver on. The product is now licenced in the UK, but it isn’t available yet.
Exposure in the national media has just created an expectation, and a load of telephone calls and inquiries that we don’t currently have time for.
Press has been widespread on weight loss. Jeremy Clarkson wrote in an article in The Times recently that he was on Ozempic off licence, and there are influencers on TikTok who also claim to be using it in the UK.
We have seen an increase in demand for Ozempic, and that has put enormous pressure on the supply chain for type 2 diabetes; the latest communication we've had is that that shortages will continue throughout 2023. This problem is not isolated to the UK; this week I have seen reports from Australia, where stock has been severely limited recently.
What do I think about all the headlines? We have laws in this country that you can't advertise prescription only medicines. But that is kind of what’s happening, via TikTok, Instagram and other media.
We’re used to people self-diagnosing, but when they come in demanding that they must have X Y or Z, that in itself is unhelpful. We have people asking about weight loss injections all the time.
In my pharmacy, we do advertise our weight loss service, which we do well with Saxenda, a presentation of liraglutide, which isn’t affected by shortages. If people want to proceed with Saxenda, that’s absolutely fine, but I think creating an expectation that we will be offering Wegovy or Ozempic is unhelpful at the moment.
On the NHS, weight loss injections have to be done through specialist clinics, a tier three service, which isn’t available everywhere in the country.
But at the minute, the bulk of the prescribing for these weight loss injections is done privately, often through online doctor services.
And if you want something that much and you're prepared to pay whatever the cost is, I’m sure there would be somebody who would supply it. That’s the view from the GPhC anyway: that sometimes the safeguards aren’t always in place with some online pharmacies. Not all of them by any sense, but some of these operators are doing things that are perhaps less safe, and don't have proper safeguards.
It could be argued that anybody can answer an online questionnaire; put whatever they want in an attempt to get their hands on something, but it could be completely unsuitable for them.
I have heard of people who buy these pens on the internet. They buy the odd pen here and there, they dabble, and that's not really the way they should use it. It's not a crash diet. It's about changing lifestyle. And it’s several hundred pounds a month in most cases, so it's a fairly big decision for somebody.
With all weight loss strategies, when you stop, there's always a risk that you're piling all the weight back on. That's something that people need to consider – how are they going to wean themselves off it and maintain the new healthy lifestyle that they've adopted?
It can be really useful in helping somebody if they need some assistance - but it's not a silver bullet.
Done properly, community pharmacies could deliver this new service.
When prescribing, I always like to see people face to face, so that I can make a proper assessment, see the shape of the body and just understand a bit more about their goals. I think this interaction with them helps to reduce the risk of people misusing it, particularly if they have eating disorders or psychological disorders that predisposes them to that.
Pharmacies could also help with establishing those new routines; new healthy lifestyles and supporting patients when they stop using the injections.
Sometimes the best course of action is nothing: non-therapeutic, non-medical treatments – like the meal replacement sachets available on the NHS. I know someone who’s done really well on that. It has reversed his diabetes and his blood pressure’s better – it’s just great.
It should always be something that you discuss with the patient in a consultation: what's the benefit of not treating, of doing something else?
Pharmacies can advertise weight loss services, indicating that medication is available, but not referencing a particular product, and talking about all the other things that are available for people to try – whether it's medicated or not.
Mark Burdon in Whickham Pharmacy is a community pharmacist and an independent prescriber.
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