counterskills - Alliance Healthcare

training
skills
COUNTERSKILLS
training programme
Weight
management
assessing an adult's
weight
balanced diet and
exercise
16
workbook
skill builder:
advising confidently
common diets
using WWHAM
weight loss products
activities & assessment
merchandising aid
Supported by:
Weight management
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Alphega Pharmacy team continue to offer comprehensive support and training
packages for the whole pharmacy team. For more information please contact:
Member Support on [email protected] or speak to your
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Content developed by:
2 Counterskills
Weight management
Section overview
Market
0: Lorem ipsun
Weight management
overview
Weight management value
Weight Management Category is worth
approximately £60 million in the total market
and is up 6.9% year on year. In Chemists the
category is worth approximately £3.8 million
and is up 1.3% year on year.
There are those that need to lose weight or
gain weight for health reasons and those
that simply want to lose weight for cosmetic
reasons.
A recent report entitled, State of the Nation’s
Waistline*, estimated that half the UK
population will be obese by 2050. Obesity
is to the 21st century as tobacco was to the
20th century, an entirely preventable cause of
chronic diseases and premature death.
On the flip side people of all ages also use
products to build them up. Some use it when
they have low energy; others when they might
not feel up to eating. Malnutrition has serious
health implications and can be life threatening.
The market shows peaks in January and
February in terms of value (new year, new you
key period for weight loss) and July (summer
holidays preparation). However, there is still
significant value throughout the other months
of the year. November and December are
clearly the least active months for sales as
people are too busy celebrating the lead up
to Christmas!
Chemist Value
-40.0%
Growth
Growth
Total TY
Total TY
1 - Nov - 13
-30.0%
£0
1 - Sep - 13
-15.0%
-20.0%
£50,000.00
1 - Oct - 13
1 - Nov - 13
1 - Sep - 13
1 - Oct - 13
1 - Jul - 13
1 - Aug - 13
1 - Jun - 13
1 - Apr - 13
1 - May - 13
1 - Mar - 13
1 - Jan - 13
1 - Feb - 13
1 - Dec - 12
1 - Nov - 12
£0
£100,000.00
1 - Jul - 13
-10.0%
£1,000,000
-10.0%
1 - Aug - 13
£2,000,000
0.0%
£150,000.00
1 - Jun - 13
-5.0%
10.0%
£200,000.00
1 - Apr - 13
£3,000,000
£250,000.00
1 - May - 13
0.0%
£4,000,000
20.0%
1 - Mar - 13
£5,000,000
30.0%
£300,000.00
1 - Jan - 13
5.0%
40.0%
£350,000.00
1 - Feb - 13
£6,000,000
50.0%
£400,000.00
1 - Dec - 12
10.0%
£7,000,000
£450,000.00
1 - Nov - 12
Total Market Value
Counterskills 3
Weight management
Market overview
Weight loss – purchase
thought process
The process a customer will go through to
make a purchase is illustrated by the below
chart. As this decision tree illustrates the top
choice is product type – whether you are
looking for a meal replacement or a pill, then
brand with format and flavour coming last. It
pays to be aware how important these areas
are so you can ensure you stock not only pills
but meal replacement products to cater for all
different types of slimmer.
* Source: http://www.nhs.uk/news/2014/01January/
Pages/Report-warns-of-a-looming-UK-obesity-crisis.aspx
Slimming Aids
Meal
Replacement
Pills
Brand
Powder
Flavour
RTD
Flavour
Brand
MRB
Format
Flavour
Snacks
Snack Bars
Flavour
4 Counterskills
Snack Bars
Flavour
Weight management
Weight build-up insights
There are only two brands available as over the
counter weight build-up products. The rest are
prescribed as oral nutritional supplements such
as the brands Fortisip and Ensure.
Shoppers buy weight build up products at a
time of crisis but often continue to purchase
to maintain health afterwards. The majority
of people who use these products do so
because of illness, post hospitalisation, ageing
appetite loss, feeling lonely/bereaved and stress.
Often it will be a concerned relative, usually a
daughter that will buy these products for their
elderly parents or an elderly relative. Counter
staff need to be aware of these products and
their benefits so they can give customers the
confidence to purchase.
Make weight management easy to
find at times of crisis
ocate next to Vitamins and
•LSupplements
or separate out on Weight
Management fixture
Do not place on low shelves – difficult
for older shoppers to pick up
•
Drive loyalty through availability
nsure a good range of core flavours are
•Estocked.
Shoppers are very loyal to their
brand and flavour and will go elsewhere
to buy it if not available
Education will drive incremental
purchases
ecommendation by the pharmacists
•Rcan
drive additional purchases at times
of crisis.
Counterskills 5
Weight management
Section 1: Introduction
Weight control can be described as either
trying to reduce or increase weight with the
overall result of achieving a healthy weight.
You may be asked for advice on how customers
can best achieve their end goal. This can
be a difficult journey for some and so any
support you can provide them with will be
gratefully received. This could be in the form of
discussing diet, exercise and possible products
that may help boost weight loss or increase
calorie consumption, as appropriate.
This workbook covers how you can assess
and support adult customers. Requests for
support with children should be referred to
your Pharmacist as the assessment tools differ,
along with the amounts of exercise and diet
requirements.
Overweight or obese
The number of people in the UK who are
overweight or obese is increasing. As a nation
we have the highest percentage of obese
people in Western Europe. Obesity levels in
the UK have more than trebled over the last
30 years and might mean that by 2050, more
than half the UK population could be classed
as obese.
Being overweight or obese is damaging to a
person’s health as they are at a higher risk of
developing one or more of the following:
• Type 2 diabetes
• Heart disease
• High cholesterol
• High blood pressure
• Gallstones
6 Counterskills
• Strokes
• Osteoarthritis
• Cancer.
Obesity is linked to over 9,000 premature
deaths a year in the UK and has been said to
pose just as much of a health risk as smoking.
A person is classed as being overweight if they
have a Body Mass Index (BMI) of between 25
and 29 and obese if they have a BMI of 30
or more. The latest figures for England show
that 61.7% of adults are classed as either
overweight or obese.
For most people, becoming overweight or
obese occurs over a period of years, starting
in our early twenties, but for others it starts
in childhood. A simple way of looking at
weight gain is that we eat more calories than
are necessary to provide the energy we need
for our daily activities. Over the years our
daily activities have become more and more
sedentary and access to quick convenient food
has increased, so it’s not a surprise that the
problem is growing. The government has been
trying to change our way of thinking through
a number of campaigns led by Change4Life,
which offers diet and exercise advice. The
following sections will help you to assess your
customers’ weight, offer support on a healthy,
balanced diet and levels of exercise, provide
advice on the different diets and products to
support weight loss.
Weight management
Underweight
It is important to note that although the
majority of requests for support with weight
control are likely to come from customers who
wish to lose weight, you will also come across
customers who need support to put weight on.
Being underweight can be due to a number of
reasons, some of which are more serious than
others. This can be a loss of appetite through
stress, illness or lifestyle factors, such as being
too busy to make time to eat properly.
Being underweight is damaging to a person’s
health in the following ways:
Weakened immune system, meaning
that they are more susceptible to
infections
•
eficiency in essential vitamins and
•Dminerals
such as iron (which can lead
to anaemia), calcium and vitamin D
(increasing the risk of osteoporosis)
•Lack of energy
n women, periods can be disrupted
•Iand
they may experience difficulties in
becoming pregnant.
If your
customer has
When
fer lost weight
suddenly,
to re
there is no
obvious reason
for the weight
loss, they have been ill
recently, you suspect they
are depressed or they are
complaining about feeling
bloated or uncomfortable
after eating, then refer
them to your Pharmacist,
as this could be a sign of
something serious.
Being underweight could just be a matter
of not getting enough calories in their diet.
Providing your customer with some advice on
eating a healthy balanced diet should start
to improve how they feel and provide a slow
weight gain. They should avoid eating high fat
and high calorie products such as chocolate
and biscuits as these will only increase body fat
and not build a healthy body mass. These foods
are also lacking in the nutrients the body needs
to be healthy. Further information on a healthy
balanced diet can be found in section three of
this workbook.
Counterskills 7
Weight management
Section 1: Introduction
As we get older, being underweight becomes
more problematic. It has the same damaging
effects to health but as we get older health
problems can lead to complications, which
can become very serious. For example, being
deficient in vitamins and minerals can lead to
osteoporosis and a lack of energy could lead
to a fall.
If your
customer
describes
feeling
anxious
or stressed
about eating
or thinking about food,
requests products for
treating constipation on a
regular basis or products
for boosting weight loss
when they are already
underweight, refer
them discreetly to your
Pharmacist as they may
have an eating disorder.
This can affect people of
all ages.
When
fer
to re
8 Counterskills
It is common for older people to lose their
appetite and start to eat smaller amounts of
food. If this is making them underweight,
you could suggest a tonic, which may help
to increase their appetite. Tonics are liquid
preparations which contain vitamins and
minerals along with additional ingredients such
as gentian infusions (a bitter ingredient thought
to stimulate the appetite) and caffeine.
You could also suggest the use of a meal
replacement shake, drink or soup, such as
Complan or Build-up. These are nutritionally
balanced and contain protein, energy, vitamins
and minerals. They are a useful alternative to
preparing a meal for those who either don’t
have the time or inclination to do so. They
are also a useful way to increase weight by
introducing one or two between meals.
Other advice would be for your customer to
have smaller more manageable meals if they
are put off by a large meal, and introduce
healthy snacks throughout the day, such as
a handful of unsalted nuts, a piece of fruit,
peanut butter, beans, sardines or avocado on
toast, or milky drinks. They should try to avoid
high sugar snacks such as fizzy drinks, cakes
and biscuits which will not provide them with a
sustainable energy source.
Weight management
Section 2: Assessing an
adult's weight
Before you can advise customers on their
weight, you will need to assess their weight to
see if they are underweight, overweight or the
ideal weight for their height and gender. There
are a number of ways this can be done:
• Waist circumference
• Waist to hip ratio
• Body Mass Index (BMI).
Waist circumference
It is believed that people who carry too much
fat around their middle are associated with
high cholesterol levels, therefore increasing
their risk of suffering with heart disease, Type 2
diabetes or a stroke.
Waist to hip ratio
The waist to hip ratio requires an additional
measurement to the waist circumference
measurement. The waist should be measured
as above and then the hips should be
measured at their widest point. Then divide the
waist measurement by the hip measurement. If
the figure is greater than 1.0 for a man and 0.8
for a woman, they are at risk of suffering from
health related problems. Customers should
again be advised to make changes to their
lifestyle in order to reduce this figure to within
the limit.
The waist circumference is measured by
placing a tape measure around the narrowest
point of the waist (between the ribs and
hips). When the measurement is being taken
customers should be told to breathe out and
the measurement taken at this point. If the
measurement is greater than 80cm (32 inches)
for a woman or 94cm (37 inches) for a man,
they are at risk of suffering with the above
associated health problems. Customers should
be advised to make changes to their lifestyle
in order to reduce this measurement to below
the limit.
Counterskills 9
Weight management
Section 2: Assessing an
adult's weight
Body Mass Index (BMI)
BMI is commonly used to establish if someone
is underweight, overweight or obese. It is
calculated by dividing a person’s weight in
kilograms by their height in metres,
squared, or:
Weight in Kg/Height m2
BMI of 18.5 or under = underweight
BMI of 18.5 - 24.9 = normal
BMI of 25 - 29.9 = overweight
BMI of 30 or over = obese
For example, if someone is 1.5 metres tall and
weighs 75 kilograms, their BMI would be:
75/(1.5 x 1.5) = 33.3
This would mean that this person would be
classed as obese.
10 Counterskills
If someone’s BMI puts them into the last two
categories, i.e. they have a BMI of 25 or more,
they should consider losing weight. If they have
a BMI of less than 18.5 they should consider
how they can gain weight as the aim is to get
everyone into the normal category.
The BMI measurement is not always an
accurate measure, however, as people who
carry a lot of muscle could be deemed as
overweight or obese simply because muscle
weighs more than fat. So it is worth noting
that there are limitations with this tool.
A person’s weight can be just one risk factor
for heart disease. Smoking, drinking too
much alcohol, lack of exercise, unhealthy diet
and stress are all risk factors that need to be
addressed if the risk of heart disease is to
be reduced.
Weight management
ACTIVITY
Calculate the BMI and which category this
places them in (underweight, normal,
overweight or obese), based on their weight
and height below:
Weight 69Kg
Height 1.3m
Write your answers in the box below.
my r
we
ans
Ask your Pharmacist to review your answer and discuss it with you if required.
Counterskills 11
Weight management
Section 3: Balanced diet
and exercise
Eating a healthy, balanced diet and having a
regular exercise regime are both important for
overall health and wellbeing.
Balanced diet
A balanced diet means consuming the right
types and amounts of food and drink to supply
nutrition and energy to the body to maintain
body cells, tissues, organs, and for supporting
normal growth and development. This can be
achieved by consuming the right amount and
type of the following:
• Carbohydrates
• Proteins
• Fats
• Salt
• Water.
Carbohydrates
There are two types of carbohydrate:
• Simple
• Complex.
Simple
Simple carbohydrates are the sugars found in
food. They are contained in cakes, sweets and
jams. Examples are sucrose, lactose, fructose
and glucose. Their function is to provide a rapid
release of energy. They are not required as part
of a balanced diet as this energy can be gained
from other foods.
Complex
Complex carbohydrates are found in pasta,
bread, rice, potatoes, cereals, fruit and
vegetables. Their function is to provide a
gradual release of energy and these should be
included in a diet.
12 Counterskills
Weight management
Proteins
Protein is found in meat, eggs, fish, pulses
(such as lentils and beans), and nuts. It is
needed in the diet as it helps the body to grow
and repair itself. It cannot be stored in the
body and so a regular supply is needed. Some
protein rich sources can be high in fat (such as
cheese, whole milk) and so care is needed to
ensure a variety of protein sources are eaten.
Cholesterol is a fat that can stick to the inside
of blood vessels. This can lead to a blockage
of the blood vessels, increasing the risk of
coronary heart disease (CHD), heart attacks
and stroke.
There are two types of cholesterol; good
cholesterol (or high density lipoprotein - HDL)
and bad cholesterol (or low density lipoprotein
- LDL). It is the bad cholesterol, which blocks
the blood vessels, good cholesterol protects
the blood vessels and stops the bad cholesterol
from sticking to the blood vessels.
Saturated fats contain bad cholesterol.
Fats
We need some fat in our diet as it helps the
absorption of fat soluble vitamins and provides
fatty acids which cannot be made in the body.
There are two types of fat:
• Saturated
• Unsaturated.
Saturated
Saturated fats are found in cheese, whole milk,
butter, meat fat and in processed foods such as
chocolate, crisps and some ready meals. They
provide the richest source of energy. A diet rich
in this type of fat is likely to lead to weight gain
and high cholesterol levels in the blood.
Unsaturated
Unsaturated fats are found in sunflower oil,
olive oil, margarine and oily fish. They again
provide a rich source of energy and help to
increase good cholesterol in the blood. Intake
should still be monitored as unsaturated fat
eaten in excess can lead to weight gain.
Counterskills 13
Weight management
Section 3: Balanced diet
and exercise
Salt
Water
Salt is essential for the body, but too much salt
can lead to high blood pressure and so intake
should be kept to a maximum of 6g a day for
adults. There are many products that come
with added salt such as cereals, cooked meats
and readymade meals and sauces. Processed
foods tend to be high in salt such as canned
vegetables and soups.
Water is essential for the body and makes up
around 70% of a person’s body weight. Some
water will be absorbed from the food we eat,
the rest will need to come from drinks.
The easiest way to reduce salt intake is to
add salt to the water during cooking rather
than when the food is served. Adding salt
towards the end of cooking, rather than at the
beginning, will reduce the amount absorbed
into the food.
There are various notification systems in
place that help identify how much salt a food
product contains, such as the traffic light
system. At a glance a customer can see if the
food has a high (red), medium (amber) or low
(green) salt content, along with fat, saturated
fat and sugars. In short, the more green lights,
the healthier the choice.
14 Counterskills
To maintain good hydration, the body needs
around eight to ten 250ml glasses of water a
day (around two litres). This can come from
drinks such as tea and coffee but should be
restricted to a maximum of five a day if they
contain caffeine. This is a diuretic, (which
means they make the body lose water).
Sugary drinks should be kept to a minimum
as they will damage teeth and contain simple
carbohydrates.
Weight management
Exercise
The government recommends that adults
under the age of 65 should complete two
and half hours (or 150 minutes) of moderate
intensity aerobic activity a week. Moderate
intensity activity is classed as activity that raises
the heart rate and makes breathing faster and
the body warmer. Whilst completing this type
of activity you should still be able to talk.
and/or maintain muscle strength, flexibility and
balance. These types of exercises are counted
in repetitions and sets and not in minutes.
A repetition is one complete exercise such
as lifting a weight or doing a sit up. A set
is the number of times this is repeated. For
each activity, the aim should be to complete
between eight and 12 repetitions and build to
two to three sets of each.
Examples of moderate intensity activity are:
Examples of muscle strengthening activity are:
• Fast or brisk walking
• Water aerobics or swimming
• Cycling
• Gardening
• Playing tennis or badminton
• Vigorous housework
• Dancing.
One way of incorporating this activity into a
person’s lifestyle, without it costing a lot of
money or taking up too much time, is to break
it down into 30 minutes of activity for five days
a week, such as a brisk walk at lunchtime. This
should be manageable for most people and will
have the added benefit of reducing stress and
getting some fresh air and a break from their
daily activities.
• Lifting weights
• Using resistance bands
• Push ups and sit ups
• Yoga
• Pilates.
For customers who are 65 or over, the same
principles apply although their ability may be
impeded and so they should be careful before
starting anything new. Exercise should not be
painful, so if they are experiencing any pain
they should stop and speak to their GP. This should be coupled with some muscle
strengthening activity twice a week that works
all the major muscle groups (legs, chest,
shoulders, arms, abdomen, hips and back).
Ideally these sessions should be spaced out in
the week and not completed on consecutive
days. This type of exercise will help to improve
Counterskills 15
Weight management
Section 3: Balanced diet
and exercise
ACTIVITY
A customer comes into your pharmacy
asking for advice on how to eat
more healthily.
Write down below any advice you would give her.
my r
we
ans
Ask your Pharmacist to review your answer and discuss it with you if required.
16 Counterskills
Weight management
Section 4: Common diets
This section covers some of the many diets
available and provides insights on how
they work as well as some advantages and
disadvantages for each one. This knowledge
will help with your discussions with customers
who are trying to lose weight. With all diets,
once complete, lifestyle changes need to be
made to ensure weight is not regained.
The diet was originally developed to help
prevent kidney stones and urine infections by
adjusting the acidity levels in the urine. The
added benefit of weight loss is more likely due
to the fact that this diet cuts out refined sugar,
processed foods and alcohol and follows a
healthy diet, bar the omission of dairy products. Advantages
his diet cuts out alcohol, refined sugar
•Tand
processed food and includes lots of
Customers
requesting
When
fer advice
on losing
to re
weight, who
are taking
medication, are
diabetic, pregnant or breastfeeding should be referred
to the Pharmacist.
fruit and vegetables all of which is good
for health
Disadvantages
he lack of dairy products in this diet
•Trequires
some attention to ensure
calcium is found in other food sources
lose attention to what is allowed and
•Cwhat
is restricted makes it hard
to follow.
Alkaline
The Alkaline diet is based on a theory that
some foods cause our body to produce too
much acid, which in turn causes weight gain
and conditions such as arthritis, osteoporosis,
tiredness, kidney and liver disorders.
The diet consists of eating plenty of fruit,
vegetables, some nuts, seeds, tofu, soy beans
and legumes and cutting out meat, wheat and
other grains, refined sugar, dairy products,
processed foods, caffeine and alcohol.
Counterskills 17
Weight management
Section 4: Common diets
Atkins
Cambridge
The Atkins diet is a low carbohydrate, high
protein diet. It consists of four phases,
Induction, On-going weight loss, Premaintenance and Maintenance.
The Cambridge Weight Plan (formally known
as the Cambridge diet) is a low calorie plan
consisting of a range of meal replacement
products. These products come in the form
of shakes, bars, soups, porridge, rice pudding
and meals. They contain protein, carbohydrate,
fibre and over 30 nutrients. Weight loss occurs
as the amount of calories and carbohydrate is
limited making the body use stored body fat
for energy.
The Induction phase lasts for around two
weeks and consists of lots of protein and a
limited amount of carbohydrate (20 grams)
a day. Expected weight loss in these first two
weeks is around 15 pounds. For the following
three phases, weight loss slows to around one
to two pounds a week as more carbohydrates
are slowly introduced in the form of fruit and
vegetables. The aim is to then work out the
right amount of carbohydrate to maintain the
weight loss.
Advantages
apid weight loss can be motivating for
•Rsome
people
rocessed carbohydrates and alcohol
•Pcannot
be consumed on this diet, which
is a plus in terms of health.
Disadvantages
he diet is high in saturated fat, which
•Tcould
increase the risk of heart disease
weight loss is unhealthy and can
•Rbeapid
unsustainable. The weight loss in
the beginning could also lead to people
stopping the diet and so regaining
weight
side effects include bad breath,
•Cdryommon
mouth, lack of energy, dizziness and
constipation.
18 Counterskills
There are a number of plans to choose from; a
Cambridge Weight Plan Consultant conducts
a visit and takes a number of measurements
including current weight. They then decide on
the plan and provide advice on exercise.
Plans range from 440 to over 1,500 calories a
day, depending on the amount of weight to be
lost. The Cambridge Weight Plan Consultant
provides support and advice on the right plan
and exercise throughout the programme, which
varies in length depending on the amount of
weight to be lost. The Cambridge Weight Plan
Consultant can also provide support and advice
on maintaining the weight loss.
Weight management
Advantages
weight loss results so can be useful
•Rforapid
those who are obese and have not
been successful in losing weight
utritionally balanced meal replacement
•Nprogramme
so no counting calories or
weighing out food during the diet
upport from the Cambridge Weight
•SPlan
Consultant.
Disadvantages
•
S ubstituting real food with shakes and
bars can be very difficult to stick to
ommon side effects are bad breath, dry
•Cmouth,
lack of energy, dizziness, feeling
sick and constipation.
Celebrity Slim
The Celebrity Slim diet is a part meal
replacement programme with some meals
and snacks, designed for quick weight loss.
It restricts the amount of carbohydrate and
calories in the diet. Weight loss occurs as the
amount of calories and carbohydrate is
limited making the body use stored body fat
for energy.
People should eat four to six meals a day, along
with two litres of water for maximum weight
loss, depending on which phase they are
doing. There are three phases to choose from,
TRIM, RAPID and MAINTAIN. The TRIM phase is
designed for long term weight loss and allows a
little flexibility in the daily food allowance. The
RAPID phase is designed for a more rapid loss
with exercise but is not recommended for more
than two weeks. The MAINTAIN phase, as the
word suggests, helps to maintain weight loss.
Advantages
utritionally balanced meal replacement
•Nprogramme
with the addition of meal(s)
and healthy snacks depending on which
phase is being completed
meals can be purchased or recipes
•Rareeady
provided for meals
upport can be accessed through
•Sforums,
personal consultancy via a
trained consultant and helpline/email.
Disadvantages
real food with shakes can
•Sbeubstituting
very difficult to stick to, although this
is mainly with the RAPID phase
ommon side effects are bad breath, dry
•Cmouth,
lack of energy, dizziness, feeling
sick and constipation.
Counterskills 19
Weight management
Section 4: Common diets
Dukan
The Dukan diet is based on a low intake of
carbohydrate and fat, and a high intake of
protein. Although there is no restriction on the
amount of food that can be eaten on the diet,
the foods, which can be eaten, are strict.
The Dukan diet is described as having four
phases; Attack, Cruise, Consolidation
and Stabilisation.
The Attack phase lasts for between two to
seven days with an expected weight loss of
two to eight pounds. During this phase lean
proteins are allowed such as chicken, fish,
eggs and fat free dairy. No carbohydrates are
allowed, including fruit and vegetables, except
for a small amount of oat bran each day to
provide some fibre.
The Cruise phase lasts for as long as is needed,
in order for the customer to achieve their
‘true weight’, which is calculated when they
start the diet. This phase introduces a list of
vegetables that can be included into the diet
on alternate days.
The Consolidation phase is designed to prevent
weight lost being regained, by gradually
introducing other foods in limited quantities to
the diet. A pure protein day a week should be
included.
The last phase, Stabilisation, is designed as an
on going diet to follow in order to maintain the
weight loss.
It is recommended that 20 minutes of walking
is completed every day to help with weight
loss, and that a pure protein day a week
is continued.
20 Counterskills
Advantages
eight loss occurs quickly in the first
•W
few days which can be motivating to
some people
asy to follow as there is no weighing
•Eout
of food and allowed foods are listed
ood for people who like a prescriptive
•Gdiet
to follow.
Disadvantages
weight loss is unhealthy and can
•Rbeapid
unsustainable. The weight loss in
the beginning could also lead to people
stopping the diet and regaining the
weight
ot a healthy balanced diet. A vitamin
•Nsupplement
is recommended due to the
lack of fruit and vegetables
ommon side effects experienced in
•Cthe
first few days of the diet are bad
breath, dry mouth, lack of energy and
constipation
Weight management
Fast
Jenny Craig
The Fast or 5:2 diet is based on intermittent
fasting. It is a simple way to reduce calorie
intake. People should eat normally on five
days of the week and fast for the other two
days of the week. On the fasting days, the
recommendation is to have a calorie intake of
around 500 for women and 600 for men.
The Jenny Craig programme has three main
elements; weekly telephone support, meal
delivery service and exercise plans. The weekly
telephone consultations provide advice and
support to keep motivation levels high. They
also explore the reasons for the weight gain
and help to change behaviours towards food.
It is estimated that for most people, provided
they don’t overeat on the non-fasting days,
they should lose around a pound a week.
The meals and snacks are packed into single
portions. Low fat diary products, fruit and
vegetables need to be added.
There are also some studies that show there are
a range of health benefits such as a reduction
in blood pressure and cholesterol.
Expected weight loss is between one to two
pounds a week.
Advantages
ll meals and snacks are calorie
•Acontrolled
and home delivered
ieting for two days a week rather than
•Dseven
days a week is more achievable for
some people
wo days a week on a restricted diet can
•Tlead
to increased loss of body fat.
Disadvantages
ot suitable for customers who have had
•Neating
disorders, suffer with diabetes or
are pregnant
ommon side effects experienced on
•Cthe
fasting days are lack of energy,
irritability, headaches and difficulty
concentrating
Advantages
here is no meal replacement so this
•Thelps
it to feel less like a diet
eekly telephone support helps keep
•W
motivation high and helps to support
behavioural changes for sustained
weight loss.
Disadvantages
eals do not contain fruit, vegetables or
•M
low fat dairy products, which need to be
added.
he non-fasting days should still be
•Thealthy,
so eating an unhealthy diet on
these days of the week will not provide
results and could lead to a deficiency in
vital vitamins and minerals.
Counterskills 21
Weight management
Section 4: Common diets
LighterLife
The LighterLife weight loss plan combines
weekly group counselling with a very low
calorie meal replacement diet. Depending
on the persons BMI, they start on either the
Total (BMI of 30 or more) or Lite (BMI of 25
- 30) plan. There is also a Fast plan (suitable
for people with a BMI of 20 or more) and a
Management plan to keep the weight off.
Before starting the Total or Lite plan, people are
advised to check with their GP.
o weighing or measuring so easy to
•Nfollow.
Disadvantages
weight loss is unhealthy and can
•Rbeapid
unsustainable. The weight loss in
the beginning could also lead to people
stopping the diet and then putting all
the weight back on
ubstituting real food with Foodpacks
•Scan
be very difficult to stick to,
particularly if following the Total plan
For the Total plan, four Foodpacks a day
(containing vitamins, minerals, protein, fibre
and essential fats) replace normal food intake
and should provide rapid weight loss of 14
pounds in a month. This is due to the calorie
intake of around 600 per day.
The Lite plan consists of three Foodpacks and
a small meal a day, providing a slower weight
loss, although still a very low calorie diet of
around 1,000 calories a day.
The Fast plan consists of two days a week of
fasting and eating normally on the other five.
On the fasting days, four Foodpacks replace
normal food intake. This plan is to keep weight
in check and stay healthy.
The Management plan is started after the Total
or Lite plan has enabled the target weight to be
achieved. It helps support the transition from the
diet to ensure the weight loss is sustained.
Advantages
roup counselling can help people
•Gwho
have struggled with weight loss
and help them to understand their
relationship with food, which can help
keep the weight off
22 Counterskills
ommon side effects are bad breath, dry
•Cmouth,
lack of energy, dizziness, feeling
sick and constipation.
Weight management
Lipotrim
Lipotrim is a food replacement programme,
which is available through pharmacies and GPs.
The pharmacy run programme involves a
Pharmacist conducting a consultation, where
they weigh the person and complete a medical
screening form to decide whether they are
suitable to join the programme.
Once on the programme, the pharmacy
provides one week’s worth of meal
replacement products including drinks,
chicken soup and flapjacks. These products
are nutritionally balanced and low in calories.
The customer then visits the pharmacy on a
weekly basis to pick up their next week’s worth
of meal replacement products and be weighed
and where possible have a urine test. The urine
test is to check if they have been sticking to the
programme and drinking enough fluid.
Advantages
weight loss results so can be useful
•Rforapid
those who are obese and have not
been successful in losing weight
utritionally balanced meal replacement
•Nprogramme
so no counting calories or
weighing out food during the diet
upport from the Pharmacist on a
•Sweekly
basis
aintenance products help to keep the
•M
weight off.
Disadvantages
ubstituting real food with shakes and
•Sbars
can be very difficult to stick to
ommon side effects are bad breath, dry
•Cmouth,
lack of energy, dizziness, feeling
sick and constipation.
Expected weight loss for women is 14 pounds
a month and for men is 21 pounds a month.
Once they have reached their target weight,
maintenance products are available in the
form of drinks, soup, desserts and a bar. They
have a high soluble fibre content and are low
in calories. They should be consumed before
meals to make people feel fuller quicker and
so reduce the amount eaten during the meal.
These products can be used between meals as
a snack if they are hungry.
Counterskills 23
Weight management
Section 4: Common diets
Paleo
Rosemary Conley
The Paleo or caveman diet is based on foods
that our hunter gatherer ancestors would have
lived off during the Palaeolithic era or Stone
Age. It is a low carbohydrate, high protein diet.
Rosemary Conley’s Diet and Fitness plans
combine a low fat diet (less than 5% fat, bar
oily fish, porridge oats and lean meat) with
exercise and a weekly weigh in meeting. The
weekly meetings offer support and advice on
portion size and calorie counting. An exercise
class is included as part of the weekly meeting.
Portion pots are provided on joining to measure
out foods such as rice, pasta, and cereal.
Foods allowed on the diet include nonprocessed meat, fish and seafood, eggs, fresh
fruit and vegetables, nuts and seeds and
unrefined oils such as olive oil and coconut oil.
The plan is designed to promote healthy
eating for life and people can expect to lose
around two pounds a week in the first seven
weeks, then one to two pounds until they have
reached their target weight.
Advantages
ortion pots help promote the
•Pimportance
of portion control
•Combines exercise with a low fat diet.
Disadvantages
Advantages
his diet encourages eating lots of
•Tfruit
and vegetables and cutting out
refined sugar and processed food and
so reducing the number of calories
consumed
imple diet, easy to follow with no
•Scounting
calories.
Disadvantages
an be expensive due to the high
•Cquantity
of meat and fish required
follow the current guidelines of
•Da oesn’t
healthy balanced diet due to the lack
of diary and whole grains.
24 Counterskills
alories and fat content needs to be
•Ccounted/checked.
Weight management
Slimming World
Slim-Fast
Slimming World’s approach is based on low fat
foods that are naturally filling. There is a list of
‘free foods’ that can be consumed in unlimited
amounts such as fruit, vegetables and eggs and
an allowance of ‘syns’ is allocated per day.
The Slim-Fast diet is a low calorie meal
replacement plan, aimed at people with a BMI
of 25 or more. The plan includes eating three
snacks a day, two meal replacements (meal
bars or shakes) and then a balanced meal
chosen from one of the recipes available.
There is a weekly weigh in and exercise class at
group meetings where support on eating plans
(of which there are three) is also provided.
The plan is designed to promote healthy eating
for life and people can expect to lose around
one to two pounds a week until they have
reached their target weight. Advantages
o restrictions on the amount of food
•Nconsumed
and no calories to count
•
Combines exercise with a low fat diet.
Disadvantages
oes not teach people about portion
•Dcontrol
or calorie intake so keeping the
weight off after the diet can be difficult
lans can be difficult to work out to
•Pmake
sure the customer is not combining
the wrong foods and so exceeding the
‘syns’ for the day.
The plan is nutritionally balanced as the meal
bars and shakes contain 22 essential vitamins
and minerals, protein, fibre and essential fats.
Expected weight loss is between one to two
pounds a week. Once the target weight has
been achieved, it is recommended that a meal
replacement shake, two healthy meals and two
snacks are consumed each day to maintain the
weight loss.
Advantages
lan is convenient and involves no
•Pcalorie
counting.
Disadvantages
oes not teach people about portion
•Dcontrol
or calorie intake so keeping
the weight off after the diet could be
difficult
ubstituting real food with shakes and
•Sbars
can be very difficult to stick to.
Counterskills 25
Weight management
Section 4: Common diets
South Beach
Glycemic Index (GI) is a measure of how
quickly blood glucose or blood sugar levels rise
after eating a certain food. Foods with a low
GI (such as lentils and wholemeal spaghetti)
release glucose slowly and steadily and make us
feel fuller for longer. Foods with a high GI (such
as white bread and sugar) provide a quicker rise
in blood sugar that is short lived and can lead
to cravings for a further burst of energy.
The South Beach Diet is a low GI diet. It
consists of three phases. Phase one is aimed
at people who have more than 10 pounds to
lose and lasts for 14 days. This should stabilise
blood sugar levels and eliminate cravings.
Foods included are lean protein, low GI
vegetables and unsaturated fats. During Phase
two and three, low GI carbohydrates are reintroduced. All phases recommend three meals
and two snacks a day and an exercise plan.
Expected weight loss is around 13 pounds in
the first two weeks, dropping to around one to
two pounds a week.
Advantages
fter Phase one, the diet follows a
•Ahealthy
balanced diet with no calories to
count or portion control.
Disadvantages
one could be very difficult to keep
•Ptohase
due to the lack of carbohydrates,
which could lead to side effects such as
bad breath, dry mouth, lack of energy,
dizziness, feeling sick and constipation
oes not teach people about portion
•Dcontrol
or calorie intake so keeping the
weight off after the diet could
be difficult.
26 Counterskills
WeightWatchers
The WeightWatchers plan is based on a
‘points’ system, weekly weigh ins and support
meetings and an individual exercise plan.
The points system is known as ProPoints that
provide a value to foods and drinks based on
protein, carbohydrate, fat and fibre content.
An allowance of ProPoints is given and can
be used however the person wants. Fruit and
a selection of vegetables can also be eaten in
unlimited proportions.
A weekly ProPoints safety net is also provided,
for times when points may be exceeded. These
can be saved up for a treat or a night out,
allowing a little flexibility to the plan, keeping
motivation levels high.
Expected weight loss is around two pounds
a week.
Advantages
•No counting calories or portion control
•Combines exercise with a low fat diet.
Disadvantages
ounting points can be as difficult as
•Ccounting
calories
oes not teach people
•Dabout
portion control
or calorie intake
so keeping
the weight off
after the diet
could
be difficult.
Weight management
Practical advice
•
dvise customers to think about changes
A
they will find most difficult to make and
choose a diet that doesn’t require them
to make these changes where possible.
For example, if hunger is a concern, diets
with unlimited food will be easier to
stick to than a meal replacement diet
them to drink eight to 10 glasses
•Aofdvise
water a day to keep their body
hydrated and help to stop them from
feeling hungry
uggest that they get into a habit of
•Sdoing
some exercise such as a brisk walk
for 30 minutes every day as this will help
with their weight loss.
Counterskills 27
Weight management
Section 4: Common diets
ACTIVITY
A customer comes into your pharmacy.
She tells you that she wants to lose weight
and is considering two options. One friend has
recommended Lipotrim. The other friend has recommended
Celebrity Slim.
Write down below the advice you would give her about the
pros and cons of these two products.
my r
we
ans
Ask your Pharmacist to review your answer and discuss it with you if required.
28 Counterskills
Product recommendations Weight management
Slim.Fast
Key Attributes
•Slim.Fast is designed to help dieters lose weight using a convenient and easy plan that fits around their life
•The 3-2-1 plan allows people to eat six times a day
- The Slim.Fast snacks are the perfect way to satisfy cravings for only 95 kcals per bar or bag, dieters should pick
three per day
- The Slim.Fast meal replacement products provide 1/3 of the recommended intake of most essential vitamins
and minerals, and come in a range of tasty flavours, dieters should replace two meals a day with a meal
replacement product
- The third meal should be a 600-calorie balanced meal for women (800 calories for men).
Why recommend
•Slim.Fast is a scientifically proven low-calorie diet (about 1,400 calories a day)
•Slim.Fast 3-2-1 plan is endorsed by nutritionists.
OTHER
ADVICE
To maintain the weight lost, dieters should replace one meal a day with a meal
replacement product
Counterskills 29
Weight management
Section 5: Weight loss products
This section describes the various products
available to support weight loss including
fat binders, carbohydrate binders, appetite
suppressants and herbal supplements.
These products have a role in keeping your
customers’ motivation high, as they may help
provide a higher weight loss at the start of a
weight loss journey, motivating your customer
to persevere on reaching their target.
It should be noted however that there is no
‘magic pill’ and that a healthy balanced diet
and exercise is still the best way for sustainable
weight loss.
Orlistat, or alli™ is clinically proven to boost
weight loss by 50% when used in combination
with a low calorie, low fat diet. It works by
blocking 25% of the fat eaten from being
absorbed. It does this by preventing enzymes in
the stomach and small intestine from breaking
down fat during the digestive process to allow
it to pass into the blood stream. It is taken
at meal times to prevent fat contained in the
meals from being broken down and absorbed
by the body. This means the body can’t use the
fat as a source of energy or convert it to fat
tissue and it is passed out of the body naturally.
It can be sold to customers who have a BMI of
28 or more and are or over 18 years old and
under 75.
It is available as a 27mg chewable tablet or a
60mg hard capsule, and should be taken three
times a day with meals. The tablet and capsule
are equivalent even though the dose seems
lower for the tablet. One is not stronger than
the other. The difference is to do with how the
active ingredient is released from the tablet.
Customers taking orlistat will also need to take
a multivitamin at bedtime to ensure adequate
absorption of fat soluble vitamins (A, D, E
and K).
When
fer
to re
Customers
requesting
orlistat
should
be referred
to the Pharmacist, as
they have to measure
the customer’s BMI and
assess their suitability for
this treatment.
30 Counterskills
Weight management
XLS Medical Fat Binder
XLS Medical Fat Binder contains the clinically
proven Litramine™ that binds with up to 27%
of fat contained within food. This forms a
large fat fibre complex, which is too big to be
absorbed into the blood stream from the small
intestine.
This product also contains fat soluble vitamins
A, D and E that are released after the fat
binding has taken place to ensure optimum
vitamin absorption.
Two tablets should be taken with each meal
with a large glass of water, to a maximum of
six tablets in a day. It is recommended that a
small glass of water is drunk between meals to
help avoid feeling ‘blocked up’.
Litramine™ is made from an organic plant
source, is gentle on the body and well tolerated.
In order to get the best results from taking this
product, customers should be advised to eat a
healthy balanced diet and exercise regularly.
XLS Medical Carb Blocker
XLS Medical Carb Blocker contains the clinically
proven PhaseLite™ that helps reduce 66% of
calories absorbed from carbohydrates within
food. It does this by reducing enzyme activity
during the digestion of carbohydrates.
It is claimed that as carbohydrates tend to be
stored around the waist, over a period of four
weeks, 8cm could be lost.
Counterskills 31
Weight management
Section 5: Weight loss products
Two tablets should be taken before each meal
with a glass of water, to a maximum of six
tablets in a day.
PhaseLite™ is made from a vegetable source
and has no undesirable effects. It is useful for
customers who struggle to limit their intake of
carbohydrates, which in turn limits their ability
to lose weight.
XLS Medical Appetite
Reducer
XLS Medical Appetite Reducer contains the
clinically proven Redusure™. It is a natural
product containing fibres that absorb water
and swell to form a thick substance in the
stomach. The natural fibres can swell to 50
times their original size. It gives the feeling of
being very full and so is useful for appetite
control and for people who feel constantly
hungry and so overeat, putting on weight in
the process.
Three capsules should be taken 30 minutes
before a meal and/or between meals to
avoid snacking with a full glass of water, to a
maximum of nine capsules in a day.
XLS Medical Appetite Reducer helps to
deliver best weight loss results when taken
in combination with a balanced diet and
regular exercise.
32 Counterskills
Weight management
Appesat™
Appesat™ contains a seaweed extract that
swells in the stomach, which makes people
feel fuller. This in turn reduces the amount they
want to eat and helps to reduce cravings and
control appetite.
It works by stimulating hunger sensors in the
stomach wall, which then send a signal to the
brain to say the stomach is full.
Three capsules should be taken 30 minutes
before a meal with a full glass of water. It is not
recommended to take with a hot drink, as it
may not work as effectively.
Appesat™ helps to deliver best weight loss
results when taken in combination with a
balanced diet and regular exercise.
When
fer
to re
Customers
requesting
herbal
remedies
to support
weight loss who are taking
prescribed medicines,
should be referred to
the Pharmacist as some
may interfere with their
prescribed medication.
Other supplements
There are many products marketed for their
benefits in helping weigh loss. This includes
green tea, acai berry and raspberry ketone
supplements. There are claims on how these
and other products can support weight loss,
such as increasing metabolism and therefore
burning more calories as well as increasing
the rate the body breaks down fat. There is
limited evidence to support this, although some
customers may have had success and wish to
buy them.
Counterskills 33
Weight management
Product recommendations
XLS-Medical Fat Binder
Key Attributes
•Binds up to 27% of dietary fats
•Gentle on your system
•Clinically proven.
For best results take 2 tablets, 3 times a day.
Available in 5 day, 10 day, 20 day and 1 month
supply packs.
OTHER
ADVICE
34 Counterskills
Why recommend:
•Clinically proven to help you lose up to 3x more
weight than dieting alone*
•The UK's No.1 Weight Loss Tablet**
•Voted Slimming Product of the Year 2014.
For more information and to sign up
to the FREE 12 week challenge visit:
www.XLSmedical.co.uk
Product recommendations Weight management
Metasys®
Weight Loss, Wellness and Beauty 120 capsules and 360 capsules
Key Attributes
•Highest strength Green Tea Extract Capsules available
with special weight reducing properties
•Safe and effective weight reduction through (1) the
breakdown of excess stored fat (2) preventing the
absorption of unhealthy saturated fats within the gut
•Most weight loss occurs in second and third month
and the product should therefore be taken for
three months
•Suitable for vegetarians and vegans.
Why recommend
•Clinically Tested and subject of four published
scientific studies
•Average weight loss over three months, without
dieting or exercise was 3.5kg. With dieting and
exercise it’s possible to lose 5 to 8kg
•Average waist reduction over three months, without
dieting or exercise was 4.14 cm
•The capsules provide additional health and
beauty benefits due to their anti-oxidant and
anti-aging properties
•Celebrity endorsed by the super-model Caprice.
OTHER
ADVICE
Ingredients: Patented standardized green tea extract with 25% natural, active
catechols (375mg per capsule), Anti-caking agents: Silicon Dioxide and Magnesium
stearate of vegetable origin. Capsule Shell: Hydroxypropylmethylcellulose. The
Metasys Green tea extract is produced by a non-alcoholic, aqueous extraction,
which is the healthiest extraction method. The 25% catechol concentration is the
highest possible, which makes this extract the most active and effective for weight loss and general
health and well-being. Pack sizes are 120 capsules and 360 capsules. Suggested Dosage: For
moderate weight loss, targeting around 2kgs over three months, take one capsule twice daily. For
maximum weight loss, targeting around 4kgs over three months, take two capsules twice daily.
Capsules should be taken together with food in the morning and early afternoon but never in the
late evening as any increase in the metabolic rate and energy level may cause some disturbance to
sleep. If taken on an empty stomach, it is possible this may result in some mild tummy disturbance
and a mild form of diarrhoea although this is very rare. Taking four capsules daily, 120 capsules last
one month and 360 capsules last three months.
Warning: Do not take when pregnant or breast feeding without consulting your Doctor. Do not exceed the
recommended daily amount and do not take on an empty stomach. Store in a cool, dry place and keep in a safe place,
out of the reach of children. Children below the age of 16 years should not be given this product. 120 capsules RRP
£29.95 Trade £16.72 (exc.VAT) 360 capsules RRP £79.95 Trade £44.64 (exc.VAT).
Counterskills 35
Weight management
Section 6: Check your
understanding
Complete the following multiple choice
questions on family planning. Ask your
Pharmacist to check your answers.
ACTIVITY
Question 1
Being overweight is damaging to a person’s health as they are at a higher risk
of developing:
A) Heart disease
B) Acne
C) Halitosis
Question 2
Older people who are underweight may benefit from:
A) Drinking fizzy drinks
B) Using a tonic
C) Eating chocolate
Question 3
If a woman’s waist measurement is 35 inches then she may be at risk of:
A) Suffering a stroke
B) Low blood pressure
C) Becoming constipated
36 Counterskills
Weight management
Question 4
BMI stands for:
A) Body Mass Indices
B) Body Mass Indicator
C) Body Mass Index
Question 5
Simple carbohydrates are contained in:
A) Pasta
B) Potatoes
C) Cakes
Question 6
To maintain good hydration the body needs around:
A) 2 litres of water a day B) 1 litre of water a day
C) 3 litres of water a day
Question 7
The Atkins diet is good for:
A) Decreasing the risk of heart disease
B) Rapid weight loss
C) Providing additional energy
Counterskills 37
Weight management
Section 6: Check your
understanding
Question 8
The South Beach Diet is a:
A) Low GI diet
B) High GI diet
C) Medium GI diet
Question 9
alli™ works by blocking:
A) 15% of the fat eaten from being absorbed
B) 25% of the fat eaten from being absorbed
C) 35% of the fat eaten from being absorbed
Question 10
XLS Medical Fat Binder:
A) Contains vitamins A, D and E
B) Contains vitamins B and C
C) Contains vitamins A, B and C
38 Counterskills
Weight management
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Content developed by:
©2011 Scientia Skills Limited Copyright in the whole and every part of the workbook
belongs to Scientia Skills Limited (“the Owner”) and may not be used, sold,
transferred, copied, adapted or reproduced in the whole or in part in any manner or
form or in any media to any person without prior written consent of the Owner.
Counterskills 39
This planogram has been provided as a guide to help you optimise the sales opportunity on the weight management category. For a full listing see the ‘Star Ratings’ document
included with this workbook which contains essential, additional and supplementary brands within pharmacy.
Planogram