Weight Loss in Aesthetics
Are you jumping on the band wagon, asks Piroska Cavell
It is apparent, particularly in the aesthetics industry, that a lot of practitioners and businesses are encouraged to take up the next biggest thing incorporated in the blurred lines between aesthetics and wellbeing. But is this serving our patients?
There is a plethora of training courses now available for issues such as weight loss, but is a one- to two-day course ethical? Can that cover enough to help practitioners understand these complex issues? Does learning from a one-two day course online or how to use the pens make you any better than the non-medics who can also access the same level of training for weight loss?
I argue that there is a lot more to weight loss than just being able to prescribe and demonstrate the use of the medication. Statistics show that 13% of adults have considered suicide due to body image concerns1 and a direct correlation between an increased risk of depression with patients having a BMI of 30 and above.2 This is an extremely important area of concern.
Weight loss comes with a significant impact on the patient’s emotional and physical well-being. This is not a treatment that can be easily corrected or reversed. The mismanagement of weight loss treatment has the potential for devastating side effects and psychological damage.
The attempt at regulation to protect patients is flimsy and, at best, confusing. From the Care Quality Commission (CQC): “The regulated activity of services in slimming clinics only applies where a medical practitioner provides or supervises advice or treatment in a clinic, including prescribing medicines, for the purposes of weight reduction” (CQC 2024).3
The key here is “In a clinic.” Although remote prescribing technically goes against regulations and guidelines relating to prescription-only medicine, remote prescribing linked to selling online products is a grey area, and some online pharmacies and companies providing online doctor services are exempt from CQC regulation. Also, the location title is ambiguous. If you do not class yourself as a “Slimming clinic”, you do not fall under CQC regulation. But if you are offering slimming services, you do. It has to do with the CQC regulatory requirement ‘The treatment of disease disorder and injury’; obesity is seen as a disease there, so if you are treating it, you should be registered with the CQC. This fluffy and non-specific language surrounding regulation serves to place vulnerable patients at increased risk rather than offer them protection. As a practitioner, can you hand on heart say you understand the complexities of weight loss? Are you in a genuinely qualified position to discuss patients’ emotional drivers and establish plans for behavioural change? Do you fully understand the links between body image and disordered eating and how to identify and manage a patient with a history of disordered eating? Or are you actually profiting from vulnerable patients and the ease of making a sale?
Harsh, I know, but it is apparent that this is exactly what is happening in certain areas.
Intelligent, affluent patients who do not meet the criteria for these medications, individuals with a history of disordered eating and those who are desperate to lose weight as they are clinically and morbidly obese are all able to access these medications without any real consultation, safeguarding or support.
This leads to some patients suffering worrying side effects from taking medication contraindicated with their other medicines or health conditions. Those who really need help and attempt to rely solely on weight loss drugs without vital guidance and support are often left in an even more desperately unhappy state.
It is impossible for a patient who genuinely requires weight loss treatments to sustain weight loss without significant input from a practitioner who can offer the experience and knowledge to create a personalised plan that is not just a diet sheet but a plan aimed at tackling emotional blocks, gut health, lifestyle, ingrained habits, addiction, and more.
If you are not formally qualified in weight management, and you cannot, or are not offering this level of service, essentially you are purely selling medication. You should ask yourself if this is the level of patient care and service you feel your patients deserve and is it ethical?
- References
MentalHealth.Org.UK (2024) Body Image-How we Think and Feel About Our Bodies [Online] Available at: mentalhealthuk.org. - Moussa,O.M.Ardissimo,M.Kulatilake,P et al (2019) ‘Effect of body mass index on depression in a UK cohort of 363 037 obese patients: A longitudinal analysis of transition’ [Online] Clinical Obesity 9 (3) p12305 Available at: DOI: 10.1111/cob.12305.
- Care Quality Commission (2024) Scope of registration: Who has to register? [Online] Available at: https://www.cqc.org.uk/guidance-regulation/providers/scope-registration-who-has-register.