As Britain's waistlines expand, so does the market for products designed to help us stay trim. But some of these products are being abused by those who are desperate to lose weight or suffering from eating disorders – with dangerous consequences
Britain has a fat problem. Fuelled by a gut-busting combination of our love of high-calorie foods and the increasingly sedentary lifestyles most of us lead, every year seems to bring new and more terrifying headlines about just how bad the obesity crisis is getting.
Roughly a quarter of the adult UK population was obese in 2012, statistics from the Health and Social Care Information Centre (HSCIC) show – and the problem is set to get even worse, if National Obesity Forum forecasts are accurate. Its 2007 report predicted half of the UK's population could be obese by 2050, at a cost to the government of £50 billion per year. Current levels of obesity suggest that even this bloated figure could be "optimistic", it says.
But as our waistlines grow, so does our obsession with losing weight. The market for nutritional health products – dominated by slimming brands such as SlimFast – is worth over £126 million in the UK alone, according to market research company IRI. This represents a 12.5 per cent increase in market value from last year.
Weight loss remedies such as orlistat and Litramine are also gaining in popularity. Although these products offer obvious benefits to those trying to stay slim, there is also a dark side to their use.
Eating disorders
Eating disorders are becoming increasingly common in the UK. The HSCIC recorded an 8 per cent increase in the number of people admitted to hospital for an eating disorder in England between 2012 and 2013. Hospitals dealt with 2,560 of these incidents in the year to October 2013.
For people who suffer from an eating disorder, the lure of using slimming products to lose even more weight can be hard to resist. Eating disorder charity Beat said over 30 per cent of sufferers it had come into contact with had bought slimming products.
While 70 per cent of these had bought the products online, some 30 per cent had purchased them in a shop. Testimonials from these sufferers give a real insight into the extent of the problem. Victoria, a 22 year old from London, says she has taken slimming supplements since she was 15 years old. Although she has experienced physical side effects as a result, she finds it difficult to kick the habit.
Forty-three-year-old David from London reports similarly bad experiences. He has bought several different types of slimming products over the years that all claimed to speed up his metabolism. But things took a turn for the worse when he bought a drug that claimed it would suppress his appetite, which led to liver damage and a "massive seizure", he says.
Unfortunately, it can be all too easy for people like David and Victoria to get hold of slimming products online. Internet forums on the topic show just how easy it is for people to track down potentially unsafe products.
Forum users often report looking for a "quick fix" to help them shed unwanted pounds when a doctor will not prescribe them slimming pills. While some forum users advocate losing weight through improved diet and exercise, others try to take advantage of the situation by promising to sell their own pills at a discounted price or forwarding on the details of websites where slimming pills are easily available.
Although reputable vendors such as pharmacies often require patients to fill in a form before they will sell the products, there are plenty of websites where they can be bought with little to no regulation. "The internet is a very difficult world to police," Beat explains.
Slimming foods: key facts
● SlimFast currently holds the largest value share in the £126 million category
● Supermarkets, Boots and Superdrug have an 85 per cent share of the category
● Sales of slimming products tend to peak around January, with this being a noticeable trend over the past three years
● The market is growing all the time, and new products launched last year contributed to 9 per cent of value sales
Source: IRI, data for 52 weeks to August 9, 2014
OTC interventions
OTC sales should, in theory, be easier to police. But Beat says they can also be tricky to monitor effectively. "You can't always tell by looking at someone whether or not they have an eating disorder," it says.
The charity "strongly recommends" pharmacists become more vigilant when making sales of slimming products.
But what can pharmacists realistically do? Deepak Lodhia, pharmacist at Monarch Pharmacy in Coventry, says his team follows strict procedures. He became all too aware of the dangers of the nation's slimming obsession after a former patient died from taking diet pills she purchased online. "That's how desperate people are," he says.
At Monarch Pharmacy, patients must first be weighed and measured to ensure their BMI falls within the suitable bounds to buy the product, he explains. Staff are unable to sell products to anyone other than the user, as those who are unsuitable for the products will often send someone else in to buy them.
"[You've got to] make sure it's going to the right person at the right time for the right reasons," Mr Lodhia says.
This also means monitoring patients who are the right weight for the products and may be tempted to rely on them too much. Anyone who buys a slimming aid from the pharmacy will receive advice on how to improve their lifestyle. Mr Lodhia is careful to help them understand that, in order to get the best results, they will have to amend their exercise and eating habits. "[Patients] see the TV advertising and they assume it's a case of taking the product and the pounds will drop off them," he explains.
Mr Lodhia also ensures that patients are informed of the possible side effects of taking slimming products, which are all kept behind the counter to encourage conversation.
Weight management services
Some pharmacies have got even more involved in weight management. By offering bespoke services, pharmacists can support people who need to lose weight while hopefully deterring them from abusing slimming products.
Both Bannside Pharmacy in Northern Ireland and pharmacy chain JN Murray (see case studies below) feel these services are a way of ensuring weight loss is achieved healthily. They may have different approaches, but both pharmacies have seen positive results from their programmes and agree the emphasis should be on helping patients keep the weight off for good.
The message is clear: it's about helping patients lead healthier lifestyles in the long term rather than simply relying on the quick fix of slimming products. "Once you get [patients] engaged and they get involved in the process, the sky's the limit," says Bannside Pharmacy's superintendent Eoghan O'Brien.
With an increasing pressure on both men and women to look a certain way, it is hardly surprising that the market for slimming products continues to grow – or that they are so regularly abused.
Although some patients may be desperate for a fast and effective way to lose weight, it's important to remember there is no magic pill. OTC products can help patients who have a considerable amount of weight to lose, but diet and exercise remain essential. Pharmacists have a key role in spreading this message and preventing abuse of these products wherever possible.
By doing this, pharmacists can hopefully help patients change their unhealthy relationship with their weight for good.
Case study
‘It's not all about weight loss – it's about feeling better'
Eoghan O'Brien
Superintendent pharmacist, Bannside Pharmacy, Northern Ireland
Bannside Pharmacy is set to focus on overall health in its 12-week wellbeing and weight loss service, which launches on September 22. The service will look at blood pressure, sugar levels, exercise and cholesterol, as well as incorporate weekly weigh-in sessions, superintendent pharmacist Eoghan O'Brien says.
The new service was kick-started by the pharmacy's involvement in a local fundraiser, The Biggest Loser campaign, which saw 85 participants lose on average a pound a week for nine weeks. The success of the initiative helped the pharmacy – C+D's Independent Pharmacy of the Year 2014 – secure NPA funding to develop a weight loss service, says Mr O'Brien. He hopes it will make a huge difference to health of people in the area. "We're trying to pick people up who are at risk who otherwise would be slipping through the net," he says.
The service is open to anybody over the age of 18 who wants to improve their diet, and will operate on a first-come, first-served basis to a maximum capacity of 100 people. The service is being run in this way because it is focused on health rather than just losing weight, says Mr O'Brien.
"Someone can have high blood pressure and high cholesterol without being overweight," he explains. "So that's the reason why we're not being selective."
Although Mr O'Brien will not encourage those who do not need to lose weight to adopt a low-calorie diet, he will encourage them to exercise, he says. He believes many individuals in his area may feel "intimidated" by the thought of doing exercise and their health could be suffering as a result. "We're trying to bring in people who very often don't have the confidence to get involved in [exercise]," he says.
Mr O'Brien has high hopes that by showing patients there are enjoyable ways of incorporating exercise into their daily lives and the benefits of a healthy diet, they will change their habits for good.
"This is not necessarily a weight loss project," he says. "It's about feeling better."
Case study
‘We are targeting people with a considerable amount of weight to lose'
Gareth Jones
Pharmacy manager, JN Murray, Burrow-in-Furness Offering patients a safe way of losing a considerable amount of weight was the "number one" reason pharmacy chain JN Murray started offering its weight management service, says Gareth Jones, pharmacy manager at the chain's branch in Burrow-in-Furness.
It started offering the Lipotrim meal replacement service three years ago after being approached by customers who wanted help losing weight. The chain believed offering this service would simply be "a natural extension" of the healthy living advice and support it was already offering, Mr Jones explains.
Under the Lipotrim service, patients can choose from a range of products – including shakes, flapjacks and soups – and must come to the pharmacy for weekly consultations. JN Murray decided to adopt this service in particular because of its "very tight criteria", Mr Jones says.
Before starting the programme, patients must supply a "whole folder's worth" of documentation and fill out a medical screening questionnaire, which is analysed by a pharmacist to gauge whether or not they are eligible for the programme."It's not something where people can just pop in and pick up some products and leave," he says.
Mr Jones's pharmacy branch has helped more than 500 clients lose over seven tonnes in weight collectively through the service. "I think the old-style London bus used to weigh approximately seven tonnes," he says. "So that's the sort of weight we're looking at."
JN Murray relies on "word of mouth" to let news of the service spread, as it has a very specific target group. "It's very much a service for people who have a significant amount of weight to lose," Mr Jones says.
Once patients have reached their goal weight, they are encouraged to take responsibility for keeping the pounds off, says Mr Jones. Patients can also choose to continue to come in for weekly or monthly consultations with a pharmacist once they have stopped the products to help maintain their results.
