LET’S SHOW WHAT COMMUNITY PHARMACY CAN DO IN THE MANAGEMENT OF OBESITY
Obesity is a worldwide public health crisis that national health services struggle to manage.
By Dr Deborah Bell and Emma McGuckin, Northern Pharmacies Limited Trust Fund
O
besity is, of course, a significant cause of morbidity and mortality that impacts adversely on health budgets at a time
when budgets already find it difficult to address expanding demand.
In Northern Ireland (NI), approximately 37% of the population are overweight and 28% are obese.1 Recently, the Department of Health announced the establishment of a Regional Obesity Management Service (ROMS) to address this crisis and bring NI in line with other UK regions.2 Core to this will be the use of effective Anti- Obesity Medicines (AOMs), such as tirzepatide. With access to AOMs for obesity management in NI currently only available through private providers, there is concern about the impact of this on the health inequality gap already evident. A recent Institute of Public Health report3
has
highlighted that “…socially disadvantaged communities [are] experiencing an excess of obesity-related harms” and so it is important that access to AOMs is equitable, instead of treatment being limited to those who can afford to pay.
In December 2024, the National Institute of Health and Care Excellence (NICE) recommended that tirzepatide should be prescribed, in addition to a reduced-calorie diet and increased physical activity, to adults who have an initial BMI of 35 kg/m2
related comorbidity.4
or more and at least one weight- Delays in, and restrictions
on, the roll out of these medications will likely contribute to the growing health inequalities in NI. To achieve roll out at scale though will be a challenge for the NI Health Service, certainly within its existing service framework. It is suggested that only through innovative approaches, such as harnessing the accessibility of the community pharmacy network, that we could meaningfully tackle current levels of obesity in the community in a way that is fair and equitable.
Wrap-around services that provide advice on diet and exercise, as well as psychological support, have been shown to improve adherence to AOMs, long-term weight loss and clinical safety. A recent report5
by the Tony Blair Institute (TBI) for Global
Change argues that NHS England’s proposed multi-disciplinary team (MDT) care model (which includes consultants/GPs, dieticians, nurses, pharmacists, healthcare assistants and psychologists) is very resource intensive, expensive and likely impractical to deliver at
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