Implement a patient pathway for your clinic

To provide a seamless weight management journey, it is important to implement a patient pathway. These four steps give your patients a clear plan for their care. We explore these in detail below.

Awareness – Highlight the benefits of weight management responsibly and support patients who need it.

Consultation – Start initiating discussions about weight management sensitively.

Treatment initiation – Assess your patients and begin their treatment plans.

Ongoing support – Keep in touch with your patients after treatment has finished.

AWARENESS

Develop a plan to raise awareness of your weight management programme. As part of this, work out what you can and cannot do in-house and identify areas where you may need additional support.

In clinic there are key areas to focus on. The most important is to train your staff – who are possibly the most powerful awareness tool you have! Make sure you train your staff on how best to communicate the value of your weight management programme to potential clients and not only the basics of the programme and that you offer one.

You can place physical materials around your clinic where potential patients or clients may congregate. Develop leaflets, brochures, banners or posters to raise awareness of your weight management programme. For more engaging and converting potential than posters consider using a digital TV or iPad display. Here you can use unlimited creativity and if your clinic is in an area where people walk past it will potentially drive footfall.

For Direct Communication Channels look at an email campaign: This channel is targeted and can be very powerful; however, it requires data collection and list segmentation. You could look at how you use WhatsApp for a campaign. This is the most popular messaging tool and it is an easy and personal way to connect. Consider creating broadcast lists, e.g. “Living with excess weight”.

Of course don’t forget to update your website with your programme details. You may include a website section dedicated to weight management and banners. Also consider Search engine optimisation (SEO) and other social media campaigns.

Responsible Advertising

For all of these advertising channels be careful not to advertise a pharmaceutical product, but instead focus on your unique weight management programme. The Human Medicines Regulations 2012 prohibits the issue of any advertisement wholly or mainly directed to the general public which is likely to lead to the use of a Prescription Only Medication (POM). You are able to raise awareness of the weight management programme you provide and make information available on the condition or disease state and its management, which may include a balanced overview of the range of therapeutic options. However the material should not draw attention to the POM since this is likely to breach applicable regulations by encouraging individuals to request a particular treatment and this may result in the prescription and use of a POM. Therefore do not use images of the POM and ensure you use appropriate language when advertising your programme.

Provision of Price Lists

A factual list of prices for available treatments may be provided on pages other than the home page. The price list must not include product claims or actively encourage viewers to choose a product based on the price. Special offers on prices of medicines should not be highlighted on the website as they are likely to promote the specific POM.

Frequently Asked Questions on Advertising

Can I say “weight loss injections” instead of Wegovy® or Mounjaro®?

The term “weight loss injection” is likely to be seen as an implied advertisement for those products which are classified as POMs.

Can I use Before and After photos?
Before and after photographs are likely to be understood as a claim for efficacy and therefore a promotional claim, which is not permitted.

Can I rename the Wegovy® or Mounjaro® pen or call the programme Skinny Pen or Flabby Jab?

You cannot rename a brand name product such as Wegovy® or Mounjaro®. Your programme should be named around your whole offering and not just the medication. These types of names would imply an advert for the POM, in particular Flabby Jab which implies an injection. Furthermore, a patient information leaflet would need to be supplied, it is a legal document that cannot be rebranded.

Useful links to find out more information are:

The MHRA Blue Guide – here

ASA Online advice: Weight Control Prescription Only Medicines – here

The Human Medicines Regulations 2012 Legislation – here

CONSULTATION

This section provides tips that can help you establish excellence in weight management, from the initial discussion, treatment initiation and ongoing support.

Initiating Discussions: The complex and sensitive nature of excess weight can make conversations difficult to have with patients. An empathetic approach and asking permission is a helpful starting point. However, it’s important to know that two thirds of people with obesity would like their healthcare professional to raise the topic of weight management.

Remember Language is Important: Obesity” and “obese” are both clinical terms intended to describe a patient’s condition but can also sound judgmental or labelling in a different context. Referring to a patient as obese is something to avoid. Use preferred terms when speaking about weight management and avoid hurtful or offensive words. Try to keep conversations positive and avoid scaremongering. UK Parliamentary Guidelines, ‘Positive Communication About Obesity’: is a helpful guide, that has been developed by Obesity UK to assist those who are professionally involved in discussing issues around weight with their patients. Remember to be empathetic and always address the person’s main health concerns first, open the discussion in a respectful way and approach the conversation in a sensitive manner, allow patients to talk about other issues that may be affecting their physical or emotional health (e.g. family or work issues) and stick to the evidence.

INITIATION

The 5 As is an easy-to-use roadmap that ensures sensitive, realistic, measurable and sustainable weight management strategies that focus on improving health and well-being, rather than simply aiming for numbers on a scale.

A holistic assessment will help you and your patient agree on a treatment plan. Consider assessing their readiness to change, mental health, activity and dietary habits.

Measurements: As discussed in previous lessons, Body Mass index (BMI) and waist circumference are important measures for evaluating excess-weight related health risks. However BMI does not account for the distribution of fat in the body. Abdominal (visceral) fat is more harmful than fat deposited in other areas of the body, like the hips or thighs. Waist circumference or waist-to-hip ratio are more accurate indicators of health risk related to body fat distribution. You can use an online BMI calculator to assess BMI and below you can find steps to ensure waist measurement is comfortable for your patient.

Follow the below steps to ensure waist measurement is comfortable for your patient.

1. Ensure the patient stands facing you.
2. Ask them to hold one end of the measuring tape to their belly button.
3. Request they turn around once so the tape wraps around their waist.
4. Hold both ends of the tape and adjust it to ensure it is positioned at the upper hip bones.
5. Record the patient’s waist circumference

Waist circumference cut-offs – A waist circumference greater than 102cm for men and 88cm for women signals an increased relative risk of obesity-related complications.

ONGOING SUPPORT

Sustained weight loss is hard, because biology drives weight regain. Despite your patient’s best efforts, hormonal changes after weight loss can prevent them from keeping the weight off. This process is known as metabolic adaptation. Ensure you have regular follow-up visits with your patients to support them on their weight loss journey. At the follow-up appointment (which can be face-to-face or virtual), talk to your patient about what has been working well and what challenges they have faced.

Continue to assess your patient’s progress for weight maintenance:

• Continue to calculate your patient’s Body mass index (BMI) and waist circumference
• Assess progress by acknowledging achievements and adjusting goals where necessary
• Make it clear to your patient that measuring weight is not the only factor to the visit: recognise their achievements other than weight loss, such as walking more regularly or eating more healthily
• Explain to your patient that preventing weight regain is the cornerstone of lifelong weight management for any weight loss techniques which they may be using
• Point your patients in the direction of helpful resources such as the NHS website, so that they can explore healthy eating tips and exercise ideas
• Encourage your patients to reflect on how far they have come on their weight loss journey and to focus on their goals, such as what weight loss will help them to achieve in their day-to-day life, so that they remain motivated