Home' Australian Pharmacist : Australian Pharmacist January 2015 Contents Australian Pharmacist January 2015 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
VLEDs may be associated with adverse
effects including sensitivity to cold,
temporary hair loss, bowel changes,
dizziness and fatigue. Extreme dietary
changes may impact on certain medicines
including antidiabetic agents, warfarin,
lithium, diuretics, anti-psychotics or
anticonvulsants; caution and regular
monitoring is required.
Meal replacement products (Celebrity
Slim, Slimfast, Ultra Slim and Optislim)
Meal replacement products can be used
to replace one or two meals each day and
are used as part of a VLED program.
products are largely protein based, and
contain essential fatty acids, vitamins and
minerals, but very little carbohydrates.
Meal replacement programs have been
shown to produce a mean weight loss
of 6.7 kg after 12 months. Evidence
suggests that a reduction in energy intake
achieved by using meal replacements
provides greater weight loss in overweight
and obese adults than general dietary
advice for periods of time varying from
However, although effective, use of
meal replacement products does not
help educate about portion-control and
healthy eating, which is important to
long-term weight loss and maintenance.
Meal replacements are not suitable for
long-term treatment of overweight and
Health promotion and
Pharmacists can make a valuable
contribution to the management of
overweight and obesity in Australia.
Pharmacists are trusted and accessible
healthcare professionals, and are well
equipped to identify high-risk patients,
provide education, and advise on
evidence-based treatments for overweight
management programs and related health
promotions targeted at at-risk population
groups create additional opportunities for
patient engagement, distribution of weight
management information and regular
assessment and monitoring of BMI and WC.
Clinical guidelines recommend that
health professionals use a structured
approach to weight management.
The 5As approach provides a guide
for pharmacists when discussing and
implementing weight management
programs with customers (see Table 1).
1. National Health and Medical Research Council.
Clinical practice guidelines for the management of
overweight and obesity in adults, adolescents and
children in Australia. Melbourne: National Health and
Medical Research Council. 2013. At: www.nhmrc.gov.
2. Australian Institute of Health and Welfare. Australia’s
health 2014. Australia’s health series no. 14 . Cat. no. AUS
178. Canberra: AIHW. At: www.aihw.gov.au/publication-
3. Haby M, Markwick A, Peeters A, et al. Future predictions of
body mass index and overweight prevalence in Australia,
2005–2025. Health Promotion Int 2011;27(2):250–260.
4. Australian Institute of Health and Welfare: National priority areas.
2013. At: www.aihw.gov.au/national-health-priority-areas/
5. World Health Organization: Overweight and obesity –
fact sheet no.311. 2014. At: www.who.int/mediacentre/
6. Overweight and obesity. In: eTG complete. Melbourne:
Therapeutic Guidelines; 2014. At: http://online.tg.org.au/
7. Australian Institute of Health and Welfare: Burden of
overweight and obesity. 2013. At: www.aihw.gov.au/
8. Tytus R, Clarke C, Duffy K, et al. Facilitating access to evidence-
based weight management in Canada: A consensus.
Canadian Pharmacy Journal 2010;143(3):140–144 .
9. Australian Bureau of Statistics. Australian Health Survey:
Biomedical Results for Chronic Diseases, 2011-12 – Obesity
and chronic disease. 2013. At: www.abs.gov.au/ausstats/
abs@.nsf/Lookup/4364.0 .55 .005Chapter1052011-12
10. Hamdy O, Uwaifo G, Uwaifo E. Obesity. Medscape. 2014. At:
11. National Health and Medical Research Council. Australian
Dietary Guidelines. 2013. Canberra: National Health and
Medical Research Council. At: www.nhmrc.gov.au/_files_
12. Grima M, Dixon J. Obesity-Recommendations for
management in general practice and beyond. Aust Fam
Physician 2013; 42(8):532–541. At: www.racgp.org.au/
13. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2014. At: www.amh.net.
14. Fakih S, Marroitt J, Hussainy S. Exploring recommendations
across Australian pharmacies using case vignettes. Health
Ed Research 2014; 29(6):953–965.
15. Padwal RS, Rucker D, Li SK, et al. Long-term
pharmacotherapy for obesity and overweight. Cochrane
Database of Systematic Reviews 2003, Issue 4. Art. No.:
CD004094. DOI: 10.1002/14651858.CD004094.pub2.
16. Dietitians Association of Australia. Best practice guidelines
for the treatment of overweight and obesity in adults. 2012.
Canberra: Dietitians Association of Australia. At: http://daa.
17. Pharmaceutical Society of Australia. Parliament of Australia,
House of Representatives, Standing Committee on Health
and ageing, Inquiry into obesity in Australia. Submission by
the Pharmaceutical Society of Australia; 2008.
1. Which of the following statements
regarding body mass index (BMI) is
a) A person with a BMI >25 is considered
b) The thresholds for overweight are
different for men and women.
c) Adjustment upwards of BMI thresholds
may be required for a person of Maori
d) a) and c).
2. Which of the following statements
regarding lifestyle interventions for
overweight and obesity is correct?
a) Increased physical activity alone has a
significant impact on weight loss after
b) Multicomponent interventions
demonstrate the greatest efficacy.
c) Increase physical activity is only
beneficial to health when associated
with weight loss.
d) Overweight and obese adults should
aim for an energy deficit of 2500 calories
3. Which of the following statements
regarding intensive interventions for
overweight and obesity is correct?
a) Intensive interventions should only be
implemented for people who are obese.
b) Very low-energy diets (VLED) aim to create
a deficit of up to 3,350 kilojoules per day.
c) Compared to placebo or behavioural
interventions, orlistat is associated with
an average increased weight loss of 3 kg
after 12 months.
d) b) and c).
4. Phoebe, 33, presents at your pharmacy
looking for something to assist her to
lose weight. She was married last year,
and is keen to start a family. As she
has been diagnosed with polycystic
ovarian syndrome (PCOS) her doctor
told her losing some weight may
increase her fertility. Phoebe tells you
she started exercising more about two
months ago, but has only lost 1 kg. You
calculate her BMI to be 26.5 kg/m2
Which of the following statements is
a) PCOS is not associated with overweight
b) The pharmacist should supply
phentermine, as orlistat is not indicated
c) Phoebe should be asked about her diet,
as increasing physical activity usually
has little impact on weight unless
combined with dietary changes.
d) b) and c).
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