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CONTINUING PROFESSIONAL DEVELOPMENT
COUNSELLING IN PRACTICE
especially those who are overweight
or obese and wishing to lose weight.
These recommendations include limiting
intake of foods containing saturated fat,
added salt, added sugars and alcohol
and enjoying a wide variety of nutritious
foods from the five food groups listed
below to meet energy needs8,11
plenty of vegetables of different types
and colours, legumes/beans
grain (cereal) foods, mostly
wholegrain and/or high cereal fibre
varieties, such as breads, cereals, rice,
pasta, noodles, polenta, couscous,
oats, quinoa and barley
lean meats and poultry, fish, eggs,
tofu, nuts and seeds
milk, yoghurt, cheese and/or their
alternatives, mostly reduced fat.
Do I have to exercise as well?
Drug therapy with orlistat or phentermine
should always be part of a program that
includes physical activity.2 Importantly,
any increase in physical activity is
beneficial to overall health, even if there is
minimal or no weight loss.
The goal should be to reduce sedentary
activities and build more movement and
activity into daily routines, including
walking more as part of everyday life.
The recommended amount of exercise
in a person who is overweight or
obese is approximately 300 minutes
of moderate-intensity activity, or
150 minutes of vigorous activity, or an
equivalent combination of moderate-
intensity and vigorous activities each
week.8 This exercise is recommended,
together with a reduced dietary intake.
Moderate intensity exercise includes
walking briskly, aqua aerobics and
light gardening, however, this may be
substituted with a lesser amount of
vigorous exercise such as swimming
or jogging. If an individual is unable
to achieve certain types of exercise, a
pharmacist can recommend suitable
alternatives such as water-based
activities for an individual with
According to the Australian Government’s
Physical activity and Sedentary Behaviour
Guidelines, regular exercise provides
considerable health benefits, including
reduced risk of cardiovascular disease,
type 2 diabetes, psychosocial and
What else can I do?
Weight loss and exercise alone do not
make up a weight management plan
and other factors should be considered8:
Setting goals – when trying to lose
weight, achievable goals should be set
keeping in mind that a realistic rate of
weight loss is 1–2 kg per month.2 Goals
should be tailored to the individual and
may be related to something other than
weight or BMI, such as lowering blood
pressure for Alexis.
Ongoing follow up – motivation can
be maintained if the effectiveness
of a weight loss management plan
is continually reviewed. Long-term
weight maintenance requires ongoing
Referral to other health professionals
– a dietician, exercise physiologist or
psychologist may assist with weight
loss in certain individuals.
What if I can’t lose the weight? Is
my obesity ‘genetic’?
The cause of obesity is related to a
caloric intake that, over time, is greater
than caloric expenditure.
there are factors that may predispose
an individual to this energy imbalance
which often overlap including13
genetic predisposition, whereby
heritable causes of obesity may be
present in between 40%–70% of
people with obesity
hormonal disturbances, whereby
strong risk factors for obesity include
hypothyroidism and hypercortisolism
which should be considered14
cultural influences such as lack of
acknowledgement of weight
behavioural dynamics such as large
portion size and a sedentary lifestyle
environmental circumstances such as
a low socioeconomic level.
According to the NHMRC, for adults
with a BMI >40 kg/m2 or for adults with
a BMI >35 kg/m2 and comorbidities that
may improve with weight loss, bariatric
surgery may be considered taking into
account the individual situation. 8
Pharmacists are ideally placed to
provide thorough counselling on weight
loss in overweight and obese patients.
Lifestyle education should include
emphasis on defining what the goals
are for each individual, and providing
reminders of the factors that motivate
them. Practical advice should be given
not only during initial weight loss
but well into the maintenance phase.
Numerous resources are available
online to assist a pharmacist to provide
Where can I find more
The following resources provide further
information on obesity in adults.
National Health Medical Research
Council (NHMRC) Clinical Practice
Guidelines for the Management of
Overweight and Obesity in Adults,
Adolescents and Children in Australia
(2013): the Guidelines follow the
primary care ‘5As’ framework – ask
and assess, advise, assist, arrange.
“...ANY INCREASE IN PHYSICAL ACTIVITY IS BENEFICIAL TO OVERALL
HEALTH, EVEN IF THERE IS MINIMAL OR NO WEIGHT LOSS.
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