1.1 Why a private community pharmacy weight management service and why now?

Community pharmacy teams’ past experience makes them well placed to provide consultations for weight management and to safely assess and supply medicines for weight loss.

In addition to reducing future ill-health, expanding pharmacy involvement can improve quality of life and well-being, building on the expertise it already has. Supporting people to lose weight and maintain it is not only professionally satisfying but helps to create customer and patient loyalty.

The last 18 months has seen a rapid increase in the number of community pharmacies providing private weight management services with weight loss drugs supplied using PGDs or pharmacist independent prescribing.

An estimated 1,200-1,500 pharmacies are now providing a service funded privately by users and experience has shown that pharmacies can successfully do this. Some are providing face-to-face consultations in the pharmacy; others are delivering video consultations.

It is true to say that the arrival of GLP-1 drugs has revolutionised weight management options, and they have been seen and presented by some as a ‘magic bullet’ solution to weight loss.

In 2024 NICE issued guidance and a plan for gradual NHS roll-out, with current NHS eligibility restricted to a very tightly defined group of people with severe obesity plus specific health conditions. Roll-out to other groups is planned over the next few years. 

GP leaders have already said that GP practices alone will not have sufficient capacity to deliver all of the NHS roll-out, hence the inclusion of community pharmacy in the call for forthcoming pilots for NHS provision of GLP-1- based services.

In the meantime, demand is already high and rapidly increasing, driven by people who are overweight or have obesity but do not meet current NHS eligibility criteria and may otherwise have to wait for years to get access to treatment. In response, a range of private provision has sprung up in face-to-face and online formats.

Careful assessment is needed before starting someone on treatment — provision of continued support is crucial.

The full safety picture for GLP-1s is still emerging and because millions of people worldwide have been using them both on and off-license for years, there is some reassurance.

However, there are some rare but serious adverse effects including pancreatitis and vision problems for which monitoring and awareness are important.

There are currently many people who can only access GLP-1 treatments for licensed indications privately – and that number is growing. Demand is high not only from people who meet the criteria for the GLP-1s’ weight loss licensing but also from people within the ‘healthy weight’ range who want to be thinner. 

Fake GLP-1s are already a problem, supplied online and through a variety of unregulated outlets and people. People can also ‘fake’ their body size online; for example by using altered photos.

Existing private provision ranges from the excellent to the inadequate and even dangerous. The GPhC has recently issued additional advice about these issues. Community pharmacies have a long track record of safe supply of medicines and their services are regulated by GPhC, which is reassuring for the public.

Almost all pharmacies now use PGDs on a daily  basis and increasing numbers have pharmacist independent prescribers. They and their teams are located in the communities where people live and work and are easily accessible.

Pharmacy teams are used to having confidential conversations with customers about potentially sensitive issues as well as to saying no when criteria for licensed indications and safe use of medicines are not met.

Many pharmacies have enhanced access by adopting new technologies including video consultations and online access to information and resources. These are some of the reasons why pharmacies are considering starting a private weight management service.