BY MICHAEL JOHNSEN
Building a business around advising consumers on supplement and nutrient choices regarding weight loss is an opportunity for drug stores, not only because Americans today are already spending $33 billion on weight-loss products, but also because, like smoking cessation, the one factor that seems to generate better weight-loss results over the longer term is comprehensive care and frequent contact with a healthcare professional.
And who better for that frequent contact than the convenience-driven neighborhood pharmacist?
“Counseling is very important,” said Kevin Huffman, president and founder of American Bariatric Consultants, during the Drug Store News Pharmacy Development Series on vitamins, minerals and dietary supplements. “That’s why the retail setting works so well.”
They’re sobering statistics—two-thirds of America’s population is overweight, and half of those people are considered obese, with a body-mass index greater than 30, which is about where you begin to develop disease comorbidities, Huffman noted. Of those Americans considered obese, 15 million are morbidly obese, which means they are more than 100 pounds overweight.
Obesity is associated with an increased risk across several disease states, including diabetes, hypertension, high cholesterol, asthma and arthritis. “I don’t
American Bariatric Consultants’ Kevin Huffman said pharmacists are in a good position to provide overweight patients with the care they need.
know hardly any condition that, if not brought on by obesity, is not aggravated by obesity,” he said.
Already, the economic impact associated with that extra belly fat totals roughly $93 billion in direct medical bills, with an additional $3.9 billion estimated loss owing to lost productivity.
What’s even more sobering—the trend toward obesity is going up, not down. The obesity rate has doubled among adults in the past two decades, Huffman said, and has tripled among adolescents, suggesting that tomorrow’s generation of pharmacists will be contending with even more consumers seeking nutrient advice on how to lose weight and
keep it off. “There is no dip in the obesity ratio,” Huffman said. The number of patients who are 100 pounds overweight, who are going to die from their disease, has quadrupled in the past two decades.”
Counseling patients on weight loss depends less on recommending one weight-loss diet aid over another, if at all, and more on counseling patients about making lifestyle changes. Huffman outlined an obesity treatment pyramid, in which patients are advised to first start making better decisions when it comes to food choices and to increase exercise, making meal replacement bars and shakes and smaller exercise equipment appropriate recommendations. The next step up in the pyramid is pharmacotherapy options, such as GlaxoSmithKline’s Alli, available over the counter. As with many prescription-drug alternatives, a multivitamin is recommended to be taken in conjunction with an Alli regimen.
Finally, the last resort for morbidly obese patients who have had no success with lifestyle changes or pharmacotherapy interventions is bariatric surgery, which again necessitates the use of supplements after the surgery is complete. For example, micronutrient deficiencies in people who have had gastric bypass surgery performed include iron, vitamin B12, calcium, vitamin D, folate and thiamine, Huffman noted. In addition, patients need some 60 grams of protein per day following surgery, he explained. And only half of those patients do so, Huffman added, because it’s hard to do on a restrictive diet without supplementation.
Botanical medicine Cardellina noted is arguably the oldest that there are already medicine known to several must-have man, argued John botanicals that retail-
Cardellina, a natural ers should have on
products and botani- their shelves: cranber-
cals expert with the ry to benefit someone
Reeves Group last suffering from uri-
month. And many of nary-tract infections,
today’s modern med- for example, or ginger
icines evolved from for nausea. Others
plant-derived medi- include garlic—more
cines—the analgesic The Reeves Group’s John Cardel- than 30 studies have
lina touted botanicals as more
aspirin from willow natural and milder treatments found between a 6
bark, for example, or versus traditional medications. percent and a 12 per-
the decongestant cent reduction in
ephedrine from ephedra. total cholesterol among people
And botanical treatment options who supplement with garlic, he may have a growing appeal to said. Similar in proven efficacy mass merchants, Cardellina said, is black cohosh. More than 20 especially given a rising interest studies on black cohosh have in preventive health maintenance indicated that the botanical and an interest in milder (i.e., few, ingredient is good in relieving if any, side effects) and “more menopausal symptoms, espe-natural” treatments. cially hot flashes.
Two key nutrients—vitamin D and calcium—beneficial to living longer lives, increasing bone strength and preventing hip fractures, are simply not in abundance in people’s diets, noted Mary Ann Johnson, professor of foods and nutrition and a member of the faculty of Gerontology at the University of Georgia.
And that has an economic impact on America’s healthcare system, Johnson said. According to a recent study, people who had the highest levels of vitamin D in their systems were the least likely to have to live in a nursing home. Conversely, some one-third of people with vitamin D deficiencies had been admitted to nursing homes.
To get the recommended amount of calcium, people need to consume three dairy products each day. And as much as 1,000 IUs of vitamin D are recommended each day, Johnson said, with the most prominent sources coming from sunlight, fish and mushrooms.
Americans don’t consume enough fish on a regular basis to achieve optimum levels of vitamin D through their diet. To get to that level of
1,000 IUs per day, a
person would have
to consume 40 eggs,
or four sticks of mar-
garine, or 7 pounds Nutrient deficiencies
of cooked beef. For are raising costs for the
healthcare system, said
those who can stom- professor Mary Ann
ach it, 2. 2 teaspoons Johnson.
of cod liver oil also
contains 1,000 IUs of vitamin D.
Johnson also noted that the type of calcium supplement is important. While calcium carbonate costs less, it is less well-absorbed compared with the more expensive calcium citrate malate, she explained. In addition, calcium carbonate should be taken with a meal. There is not a similar concern with calcium citrate malate.
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