The DDA Podcast
The DDA has created its own series of podcasts with information and analysis of dispensing doctor matters in conversation with DDA Board Members and invited guests.
The DDA Podcast
12. Private weight loss clinics
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New oral orforglipron GLP1 (marketed in the USA by Lilly as Foundayo) was authorised for use in weight management and type 2 diabetes in August 2026 in the UK, making the UK the first country in Europe to do that. At the time of recording (mid September 2026), this product is not yet listed in the Drug Tariff
In this podcast, DDA Communications Officer Ailsa Colquhoun speaks to Usmaan Hafiz, who is the practice pharmacist at DDA member practice Garstang Medical Practice in Lancashire and lead pharmacist at the practice's Kepple Lane pharmacy. Among the things we cover in the podcast are the role of GLP1s in weight loss, tips and hints to help people with their weight loss journey, and the ins and outs of running private weight loss clinics for pharmacists and GPs.
Referenced in the podcast are:
Guardian newspaper article: Where did all the XXL clothes go? Fashion brands are scrapping plus sizes in the GLP-1 era
BMA guidance: Private practice and GP contracts
DDA Quality in Practice 2025 Dispensing Guidance Section 1.9: Private sales
National Health Service (General Medical Services Contracts) Regulations 2015 (sections 24 and 25)
General Pharmaceutical Council guidance: Supplying medicines for weight management
New oral orphoglypron, a GLP marketed in the USA by Lily as Van Dio, was authorized for use in weight management and type 2 diabetes in August 2026 in the UK, and making the UK the first country in Europe to do that. At the time of recording, however, which is mid-September 2026, the product is not yet listed in the drug tariff. Today I'm speaking to Uzman Hafiz, who is the practice pharmacist at DDA member practice Gas Dang Medical Practice in Lancashire. And he is also the lead pharmacist at Keppel Lane Dispensary, a hybrid pharmacy operation also based at Gas Dang Medical Practice. Among the things we're going to speak about today are the role of GLP1s in weight loss, tips and hints to help people with their weight loss journey and the ins and outs of running private weight loss clinics for pharmacists and GPs. I'm Elsa Cahun, Communications Officer at the DDA, and this is the DDA podcast. Welcome, Edmund.
SPEAKER_00Thanks for having me.
SPEAKER_01So since their inception, GLP1s have become a very popular option for people seeking weight loss support both on the NHS and in private clinics. There was a story in the Guardian newspaper in August, and I'll put the link to that in the notes, saying that US retailers are beginning to discontinue their larger sizes, the three XLs and four XL sizes, et cetera, and increasing their smaller sizes thanks to the effect on the population and shoppers of the GLP ones. So, Usman, GLP ones, what difference have they made? What can the GLP ones do and can't do? And what clinical and counselling issues do people taking these drugs need to be aware of?
SPEAKER_00They've made a huge difference. People have found it tremendously difficult to lose weight through whatever dietary plans and measures they have. And GLP ones have massively changed that data. And what I've seen is people's body weight losing to 15 to 25%, which in in previously was compared to biatric surgery and so forth. So you know the benefits are huge for I've seen.
SPEAKER_01Are they a magic bullet for weight loss? Do they have limitations in your view?
SPEAKER_00The conception from patients is that, yeah, they do think initially that it is a you know a magic pill that's going to make them drastically lose weight. And a lot of times when I'm when I'm speaking to the patient, explaining how it actually works from a pharmacological point of view, they don't have that understanding. The purpose of it is to reduce your appetite and and help you control your food intake. But as as with all diets, is you know, what you what you eat and what you do from lifestyle exercise and the types of foods you eat, they will predominantly reduce your weight. So yes, it's not a magic pill, not at all.
SPEAKER_01So what difference do you think Lily's new oral or foglypron will make to the market? Obviously, we have already oral Vegovi, uh, which was launched in June. What difference do you think it's going to make to consumers and maybe to the drugs marketplace?
SPEAKER_00To encourage patients, but maybe that might have better data to show that it reduces weight better. There will also show ways of compliance. So obviously, you have comparisons between tablets and injections. Tablets you may have better compliance because you know it's on a daily basis. Injections obviously have weekly, and then obviously you have aspects where people might not like the fact of injecting themselves with a needle. And then with Golvy tablets, they basically have to fast before taking it. They have to drink a limited amount of water before they have their tablet. So that somewhat has a restriction for most of us if we have certain routines.
SPEAKER_01So it's essentially it's an option that adds certain lifestyle benefits, it'll fit in better to certain patients' lifestyles that uh that will be useful.
SPEAKER_00There is obviously a percentage of patients that when they think of a needle, they think, oh no, that's not for me. But if you've got an option of a tablet, then yeah, I certainly think that there will be uh there will be certainly a population out there that will be encouraged to think, yes, I'll this time round I'll I'll have a go.
SPEAKER_01Now you mentioned earlier on that behaviour change and healthier lifestyle choices are important. I mean, it was forever thus, wasn't it, that you know, lifestyle change and healthy, healthier behaviours has has been something that the the NHS has advocated and has has has promoted forever. People still have trouble with it, hence, you know, why GLP ones have have come into the market. So, how do you nudge people as a pharmacist to start making and continue making healthier lifestyle choices? That's just not easy to do.
SPEAKER_00We're very fortunate that a lot of the companies that provide Minjaro and Wagovia are a few that have provided excellent training with with their products. And we obviously from pharmacists we have training of healthy lifestyle choices and dietary plans and things like that we talk about on a day-to-day basis. But as with anything, when you start exercise or diet, you hit walls, that's part of the battle one you have with patients, is that you have to support them through that journey. You have to support them to say that it's not just about losing weight, it's about changing your lifestyle, having habits, doing exercise, and encouraging it so that when you do come off the GLP ones that you are you can actively still doing that. And a lot of the patients that I have uh have six, six to nine months, there's there's points where we do get to three to six months and they've hit the the maximum weight they think they can lose, and and then obviously it's about or hitting the target they want, and then obviously it's about titrating them down and and and encouraging them as they're coming down and that food noise is coming back to support them where uh with uh you know that they've got this they've got this physique now, they've got this weight that they wanted and to try and maintain that. And and I think that's the difference with GPUs is that it gives you it gives you the results that you want.
SPEAKER_01Do you have a number one tip for helping people when they've reached that peak or they've they're beginning to lose the motivation, the initial sort of spark?
SPEAKER_00I think every patient's different. A lot of patients talk about you know how they feel some some say they they feel different, that so the collars are getting big as they're losing weight. Others say that people comment about how they've lost weight, others feel or feel healthier, and and you have to pick up on those, those, those comments and encourage them, and obviously say to them, you know, if people are not to sing it, then you know that's that's to encourage and you you need to keep you need to keep on this journey, if you will. Because obviously when they do get discouraged and it and they're losing weight and they want to get to that BMI, it it's part of part of obviously getting to the to the healthy BMI, which I think is very difficult for all of us, the best of us. But they want the because they've lost so much weight and they want to get to that point, it's it's it's difficult for them to keep on with that. But then obviously encouraging them with what friends and family are saying and what what they're seeing physically. We are probably our our own worst critic when we look at ourselves and when we look at our scales and we look at that, but it's it's family support that they need or or friends or or or me actually saying to them because a lot of time when I do see them on video calls in person, you do see the difference, and you do you do have to tell them that. Um when I when I do say to them that because obviously we've been on a journey together, uh it is somewhat comfortable to say it because they know it's that patient uh clinician kind of relationship.
SPEAKER_01It's great to hear that as a healthcare professional, you know, like you say, you've been on a journey with people. So your pharmacy clinic, that leads us nicely on to that. So, what's the the background to that? You run it as a pharmacist initially from your pharmacy's consultation room, which is important to make clear because for NHS GPs, the rules on private clinics are quite different. And and I'll touch on that later. So, with your pharmacist hat on, when did you start? How do you staff it? How do you market it? Who comes? And you know, what lessons have you learned?
SPEAKER_00So I started it in uh this this year actually, I started in January. I uh I was contemplating starting it before that, and I think we were late in the day, the the market had grown so much, and it was also at the point where um the pricing was was reasonable until the the obviously the pricing structure changed with Wagovy Manjaro, which rocketed. At that point, we were having patients walking in and asking whether we did it or not, and they were using online services. And from a from a an employee point of view, we we felt that we needed to start the private services. It was it's more of an operational problem that was the issue. Is one is that I needed to have um independent prescribers to support me, and also with private clinics, there's I had to create like a workflow of how I would capture the patients through my website or capture them through the the the pharmacy on the face-to-face basis, and then create appointment systems which we'd never really done before. Generally, most of our community pharmacy work is was walk-in, it was basically, or it was or it was a paper diary. And it was trying to develop some sort of portal for patients to inquire about their the weight loss injections or weight loss service. Uh and again, that was a dilemma because obviously there are restrictions and how you would advertise it as well, from a certain from a GPHC point of view, that there are restrictions and how you promote a weight loss clinic and how you word it. And then once that occurred, it was about how I would then review these patients and whether they would qualify for the service and then arrange appointments and then also arrange follow-up appointments and and how we'd operationally do that. We didn't have anything in place, so I had to obviously invest in software. I had to invest in create pre-consultation forms and things. A lot of this stuff wasn't available for pharmacy. It is it is available on the some certain patient medical record systems within the the pharmacy for dispensing prescriptions, but then also having a private service aspect. But the system we had in place didn't have that. So I had to get an additional PMR system for that. And then also it was about keeping costs down because uh and time, and is it it was a growing is and whether it would grow because of obviously the competition that we we were we were against. So initially I thought I would start it after Christmas, which I thought was an ideal time because everyone has a very merry time over Christmas, and we all put a weight and we all drink. Yeah, and I thought that's the time where everyone wants to join a gym or everyone wants to maybe look at weight loss. And and yeah, so I I opened it up at the website, and uh yeah, it it very much of Facebook promotions, I had posters that we have digital displays in the in the pharmacy. It was very much run by myself and then an administration person who dealt with the paperwork, arranged my appointment, and then I did the the face-to-face and the online consultations through a private PMR system.
SPEAKER_01Uh, is there a typical patient client demographic for the private service?
SPEAKER_00Initially, I found patients that didn't want to use online, they wanted the same person to do the consultation with them. Some wanted to come in and speak to somebody personally face to face. Others were basically told by the doctors that they hadn't met the criteria for the from the ICB to have it on the NHS uh and to visit the the pharmacy. And obviously, if the if they come to the medical practice, then the nearest pharmacy was next door, so they would they would come to us to source it. Now six months in, I'm getting patients that are sorry, six, nine months in, I'm getting patients that were initially buying it online or are coming to me now because they've heard that I do video calls or I do face-to-face consultations and they want do want to discuss it, whereas they weren't getting it from from other providers.
SPEAKER_01Is there a gender bias?
SPEAKER_00Yeah, I think if if if I have to put a a statistic, the majority of them are women. Uh but I I do have a few men. I uh some of the some of the gentlemen who have have come in are are are ones that are just generally been conscious about their weight uh as they've got older uh uh and and and basically wanted to to reduce it because of fitness or whatever it may be.
SPEAKER_01You touched there on the sort of pricing of drugs. Obviously, that's key to the profitability and and of the service. What's the market like at the moment in terms of drugs pricing? And do you think that the new Lily oral tablet might change things?
SPEAKER_00From from a business perspective, we have we have um a stock manager that orders stock, and I I get told the the pricing and the margins from that, and then I I reflect on what the market is around me. It's very difficult to compete with some of the some of the the big provide because you have to quantify the time that you spend with a patient, spending 30 minutes to an hour on the patient, you know, and you're only making a certain amount of money, then it it becomes possible that you're actually losing money from from providing a product. I don't I don't look at that. I I look at supporting this patient on their journey and reducing their weight from a healthcare professional. It's about obviously getting this patient reducing their weight, and obviously from a cardiovascular point of view and and and from a health point of view, just uh helping on that journey. But yeah, it's it's difficult to because it it does it does fluctuate. Um and a lot of a lot of the companies are based on on your purchasing and your discounts from the quantities that you purchase as well.
SPEAKER_01And uh, we don't yet know what difference the what the pricing's likely to be on the new lily drug and and the difference that'll make. So I mean it's just too early, really, to to comment on that at the moment.
SPEAKER_00I mean Wagovi came out recently, the tablet, and it doesn't seem to have made an effect on on any of the injectables. Uh the prices have stayed the same. Yeah, and you would have thought that potentially they may have dropped a little bit, didn't like needles that were forcing themselves to use needles, may switch over to Wagovi. Uh but that doesn't seem to have changed at all.
SPEAKER_01Yeah. So, in terms of you know, your your biggest surprise or your biggest challenge, hidden hidden challenge, but what's been your, if you like, your sort of number one surprise or in both a good or a bad way?
SPEAKER_00I mean, the the bad way was probably from a pharmacist point of view, we like everything to be in order and have a procedure and it uh it has to be all perfectly checked and double checked. And and the way that I I sorted out the um the the weight management clinic, it wasn't it was a bit clunky because I didn't know how to capture the the data, how to capture the patients, how to have a PMR system, how to respond to them and follow up. But from a from a a positive point of view, six you know, six to nine months in seeing some of my patients and how they look and the weight that loss they've had and how they feel is is amazing. And the positivity of I actually having some patients now that are titrating off it now and and you know looking forward to coming off it and having uh habits and and and changing their lifestyle. And thanking me for for you know the support through it is really encouraging.
SPEAKER_01Uh are you encouraged them to give you chocolates and uh whiskey at Christmas time as a thank you or not, given he's a weight loss clinic?
SPEAKER_00I mean, I'll take chocolates, but whiskey I think can be frowned upon with my face. But yeah, I'm always always partial to chakras. I uh unfortunately I'm one of those patients, uh one of those people that people hate, but for some reason I can eat whatever way, and it doesn't go anywhere on me. Oh uh yeah, so I'm one of those. So yeah, uh and it's strange because it's a private service and it is a lot of money, and they do pay a lot of it. The the gratitude you get from it is is is is really rewarding. Really rewarding.
SPEAKER_01Thank you. Usman has been very helpful and gives us plenty of guidance for pharmacists out there that might be considering a clinic. Thank you very much for your time.
SPEAKER_00Thank you very much, Lisa.
SPEAKER_01So, as I said earlier, Usman is a pharmacist and he offers a weight, a private weight loss clinic from a pharmacy. For NHS GPs, the situation is quite different in terms of offering private services and more restrictive. Uh in summary, BMA guidance on private practice and GP contracts states that an NHS GP cannot offer private services to their NHS patients during NHS working time and on NHS funded property if those services fall within the scope of primary medical services. Section 1.9 of the DDA Quality in Practice 2025 dispensing guidance also covers guidance on private sales. The DDA's advice, England only, is that a dispensing practice can dispense privately for their NHS patients only those items that are blacklisted, e.g., Panadol, and only if the patient is a dispensing patient. Legislation underpinning all this is the National Health Service General Medical Services Contract Regulations 2015, sections 24 and 25. I'll put the links to all of these pieces of guidance and legislation, and also links for guidance and regulation relating to pharmacy private clinics in the notes of the podcast. So do feed out there. Basically, the advice is check the restrictions on private clinics and any local NHS commissioning conditions before starting out. Thank you very much for listening.