IN NORTHERN IRELAND, APPROXIMATELY 37% OF THE POPULATION ARE OVERWEIGHT AND 28% ARE OBESE
scale given the large number of eligible patients and current primary/ secondary care capacity pressures.
Adopting a similar MDT-led approach in Northern Ireland, using extensive resources and slower roll out, will inevitably lead to widening of the health inequality gap. The authors of the TBI report5
highlight that, “Prevention models need
to meet people where they are: online, at home and in the high street, as well as at work” and advocate for the use of lower cost strategies for a more efficient and wider roll-out. They recommend that in the short term, existing Pharmacy First and GP data-sharing contracts should be used to initiate the roll out of AOMs. They advocate the use of online pharmacies for a faster roll-out, accepting concerns over the level of wrap-around support provided by some private online pharmacies. Regulators have been actively monitoring and challenging the inappropriate use of weight loss injections especially those purchased online and without proper clinical governance, to avoid serious adverse events, including hospitalisations and fatalities.
An accessible, practical and more economical approach could involve a commissioned community pharmacy-led service. Community pharmacies are well positioned to provide wrap-around support services during monthly face-to-face reviews, aligning with AOM medication supply and ensuring consistent patient monitoring. A further Quality Standard (QS212)6
recently published by NICE in August
2025, recommends that patients who have been prescribed tirzepatide should also “receive feedback and monitoring at regular intervals for a minimum of 1 year [post-stopping treatment] so they can get help if they are not maintaining changes”. The accessibility of community pharmacy makes it the ideal setting to continue to support patients in the important period after stopping AOMs to help ensure the benefits of treatment and weight loss are maintained in the longer-term.
Northern Pharmacies Ltd Trust Fund (NPLTF) is a charity set up to promote the development of community pharmacy in Northern Ireland in the interests of the adult population and ultimately local
The proposed pilot would involve 10 community pharmacies selected from across NI, who each would enrol 20 patients (200 patients in total). In the initial 12 months, it is proposed that patients would be provided with support to effect behavioural change in diet and exercise alongside supply of the AOM tirzepatide. After 12 months, patients would continue to be supported for a further 12 months post-stopping treatment, in line with NICE guidance. The primary objective of the intervention would be to achieve at least 10% weight loss in all participants at 12 months and to maintain at least 5% weight loss at 24 months. Following completion of a pilot study, a report would be produced on the outcomes which could help inform policy decisions on future service activity. NPLTF is seeking interested parties to help take this pilot forward, in the interest of the many patients who are currently living with obesity in our communities.
References: 1. Information Analysis Directorate. Health Survey (NI) First Results 2023/24. Available at:
https://www.health-
ni.gov.uk/sites/default/files/2024-12/hsni-first-results-23-24-full -report.pdf (accessed October 2025). 2. Department of Health. Establishment of a Regional Obesity Management Service for Northern Ireland. May 2025. Available at:
https://www.niassembly.gov.uk/assembly-business/official- report/written-ministerial-statements/department-of-health--- establishment-of-a-regional-obesity-management-service-for- northern-ireland/ (accessed October 2025). 3. Breslin G et al. A whole systems approach to obesity prevention: a rapid synthesis of evidence to inform the Northern Ireland Obesity Prevention Strategy Project Board. Dublin: Institute of Public Health. 2023. Available at:
https://www.publichealth.ie/sites/default/files/resources/A%20 whole%20systems%20approach%20to%20obesity%20prevention.p df (accessed October 2025). 4. NICE: Tirzepatide for managing overweight and obesity: Guidance TA1026 Dec 2024. Available at:
https://www.nice.org.uk/guidance/ta1026 (accessed June 2025). 5. Tony Blair Institute for Global Change. Anti-Obesity Medications: Faster, Broader Access Can Drive Health and Wealth in the UK Available at:
https://institute.global/insights/public- services/anti-obesity-medications-faster-broader-access-can-d rive-health-and-wealth-in-the-uk (accessed October 2025). 6. National Institute for Health and Care Excellence. Overweight and obesity management. Quality standard. Reference number:QS212. Published: 05 August 2025. Available at:
https://www.nice.org.uk/guidance/qs212/chapter/Quality- statement-7-Advice-and-support-after-stopping-medicines-for -weight-management-or-completing-behavioural- interventions (accessed October 2025).
pharmacyinfocus.co.uk 39
health outcomes. To help address the challenge of obesity in NI, NPLTF is proposing to part-fund a pilot pharmacy-based obesity management service. This service would provide behavioural change support with regards to diet and exercise, alongside AOMs to patients with a BMI of 35 or over who have at least one weight- related co-morbidity.
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