James Halliwell’s recent editorial rightly raises the alarm on the runaway train-of-hype that is GLP prescribing.
With side effects mounting and the MHRA furrowing its collective brow, James asks if we are swerving around safety in our desperation to inject our way out of diabesity?
But here’s my take: if we’ve swerved, it’s only because the vehicle had no one at the steering wheel and we pharmacists weren’t even in the car!
Let’s be clear, these drugs do work in the sense that weight - make that a lot of weight - is lost.
For some. In the short term. Under controlled conditions.
But as with all magic tricks, the sleight of hand is in what you don’t see, like the patient vomiting behind the curtain, or the cardiologist shaking their head while quietly cancelling their golf game.
Honeymoon over?
In June, C+D revealed that Semaglutide and Tirzepatide have been linked to over 100 UK deaths. That’s not counting the thousands suffering nausea, suicidal thoughts, or what can only be described as Ozempic-level constipation.
And yet prescriptions continue to soar, often to people with no diabetes, no long-term clinical support, and no understanding of the phrase “rebound weight gain.” It’s as if the Titanic has struck the iceberg, but the band is still playing “I’m Too Sexy.”
So here’s a radical idea: what if the very professionals already speaking to these patients weekly, already trained in medicines optimisation, and already managing side effects… were given a formal role in this whole GLP saga?
Read more: Exclusive: CPhO confirms Mounjaro pharmacy service on the cards
Right now, most community pharmacists have no clue why a GLP has been prescribed. There’s no context, no access to the indication, and certainly no time allocated to explain that no, Wegovy won’t make you thin by Tuesday.
We’re flying blind while holding the syringe.
The metabolic paradox
I’m writing this having just returned from a tour of Northern Italy, fresh from chairing the session on the GLPs at the KetoLive Conference in Switzerland.
You know what’s striking? Italians smoke more (twice the rate ) as we Brits. And yet… they’re thinner. Fewer heart attacks. Fewer amputations. More centenarians. Longer lives!
Why? Because they haven’t paved over every pavement with Gregg’s.
They eat real food, walk to dinner, live with their families, and haven’t replaced lunch with a Tesco Meal Deal engineered by a PhD in bliss point optimisation.
We’re not dealing with a lack of medication. We’re dealing with a cultural metabolic meltdown.
GLPs are tools, not saviours
Don’t get me wrong: GLPs can be transformational. But only when used appropriately, short-term, and alongside a food-first lifestyle.
Read more: Pharmacies to pilot NHS weight loss jab expansion, reports claim
Otherwise, we’re handing patients a sat-nav and hoping they’ll dodge the potholes and not steer off the cliff-edge.
Let’s look at the real-world picture:
- Patients using GLPs off-label to shed a few pounds before Ibiza
- No structured support for exercise or nutrition
- No tapering plan in place when the NHS (or their wallet) gives up
- And, in some cases, no diabetes or obesity in the first place
This isn’t patient empowerment. It’s a metabolic Ponzi scheme and we pharmacists are being made complicit.
What we need is a pharmacist-led GLP safety net, which could include:
- Waist-to-height ratio screening (more predictive than BMI, and you don’t need an MRI to do it)
- Lifestyle coaching (yes, we can do that too)
- Mental health red flagging (because these drugs can mess with your head)
- Tapering and transition support (because patients deserve a plan that isn’t just “stop eating and hope for the best”)
We combine CGM insights, education, and deprescribing to deliver actual remission, not just drug-induced appetite suppression. Imagine if that model were standard across the NHS.
Stop passing the (pill) bottle
Integrated Care Boards (ICBs) are already asking pharmacies for “understanding” as costs spiral and risks rise. Here’s our reply: give us the tools, the data, and the funding and we’ll give you the outcomes.
Read more: Mounjaro: NICE sets out £317m annual NHS weight loss jab rollout
Let’s stop using pharmacy as a mere postbox and start treating it as the engine room of metabolic recovery.
Specifically, we need:
- Structured funding for GLP risk review and support services
- Pharmacist access to clinical indication and prescribing rationale
- Permission to challenge unsafe, inappropriate, or cosmetic prescribing
- Integration into reversal strategies—not just administration pathways
James was right to use 'Ozempicola' as a meme. We’ve turned a serious hormone-modulating therapy into a fizzy cultural meme, served chilled, with a side of hype and a garnish of celebrity glow.
But someone has to be the designated driver.
Pharmacists are the logical choice, not just because we’re the ones dispensing the drug, but because we’re the ones best placed to monitor its effects, educate the public, and turn a pharmaceutical intervention into a genuine healthcare journey.
The alternative? We’ll just keep swerving from one miracle to the next until we end up back where we started with another failed obesity drug, another public inquiry, and another overweight generation misled and sick.
If we’re going to take this seriously, give pharmacists the wheel. We’ve got the map, the training, and the metabolic common sense.