Dr Kam Lally and Dr Mayoni Gooneratne discuss the considerations for adding weight loss services to your clinic
During the last couple of years, we have seen a huge disruption to our routines and for many people this also meant their activity levels. Currently, we are seeing a surge in interest for patients seeking weight loss treatments. This needs to be approached in a sensitive and holistic manner incorporating education, in addition to potential pharmacological intervention.
A weight loss clinic offers medical weight loss programmes by having services such as mental health support with an experienced professional to develop confidence and deal with any psychological issues, as well as specific weight management treatments and plans.
This article will explore our experiences setting up weight loss services in our aesthetic clinics and the considerations you should make should you be considering branching into this area.
Setting up a weight loss clinic can help to continue to push the message of primary prevention as there are disease processes that are associated with it rather than just the aesthetic impact. Being able to empower people to improve their self-view is a part of the aesthetics industry. So, if you can help somebody have a higher opinion of themselves, then they will be more accepting of their outward appearance. It’s the aesthetic boost on the inside for their self-confidence. Another positive is becoming a clinic of reference outside the NHS.
Of course, there are business benefits to this as you are adding another service and revenue stream to your practice, but we also believe it helps you return to why you trained to be a healthcare professional and take a more holistic approach. As a healthcare professional, being able to evaluate data and look at medical services that you’re adding from a safety perspective, as well as a business proposition, is satisfying.
Before you get to the stage where you are asking the patient about weight loss, there should have been an acknowledgment that it’s not a topic which is comfortable to talk about. Therefore, your staff need to be appropriately trained when it comes to the right language you use when broaching such a sensitive topic. A great starting point is the Language Matters guide produced by Obesity UK– this helps avoid using stigmatising phrases.1 You may notice that initially you’re rebuffed when trying to talk about the topic. So, it’s something that you need to persist with in a polite, friendly, non-intimidating manner for patients to be open and to get to the core of the matter. Once you’re there, just like a medical consultation where you’re trying to get clues and edge closer to what the underlying problem is, hopefully the patient will open up and say, ‘This has been bothering me for a little while, I’ve tried XYZ, and doing a regimented weight loss programme with a personal trainer and nutritionist is something I’m willing to look into because I’ve tried many other things before’. Therefore, even before you get to the stage of discussing it with the patient, the patient journey should be mapped out before they even know it, and this is where adequate staff training and clinic planning makes sense.
Not every clinic will have a demographic of patients who will use or need services such as weight loss programmes. Therefore, before you start to embark on this journey do your research via patient surveys; ask them if they feel they would benefit from this and understand whether this would benefit your business from a profit point of view as well as from a patient point of view.
In our experience, there is only one purely ‘weight-loss’ person in every 20 generic aesthetic patients which is around 5%. If you look at the numbers, 95% will come with an aesthetic concern or request. This significant majority will get to know you and the clinic over time and become more comfortable with talking about other aspects that bother them. The numbers are relatively low to start off with, but in our experience 60% of interested patients during the second visit will be comfortable to talk more about other concerns and consider a weight loss journey. Of the remainder, approximately 80% by the third visit will have broached the topic of weight loss.
In our clinics, we see a wide variety of patients exploring their weight loss options. This can vary from self-conscious students finishing university to a dad in his 50s who has noticed his weight increasing gradually over the years. One of the commonest demographics we see are middle-aged mothers. The children are at an age where they’re less reliant on their parents and the mother has always put other people before herself. They are usually between their late 30s to mid-to-late 50s. Disposable income is also important. These are women who are working or returning to work, and they will have this income. You need to recognise who you are marketing to. Before introducing treatments, we ask them to fill out a consultation form to discover what areas are of concern.
Sometimes, it may take a while for patients to be interested in weight loss services. Many patients will know about it and have heard of it; however, they’re likely to discuss body contouring treatments like cryolipolysis before they speak about a regimented weight loss programme. Therefore, it is important to continue building a rapport with them and offer weight loss support following appropriate cues from the patient.
We strongly advocate a multidisciplinary team approach to effectively have a roster of professionals that can be referred to on a self-employed basis (e.g. nutritionist, personal trainer, psychologist). You will also need to invest in staff training/upskilling and equipment costs. For example, making sure that your chairs have no arms or they’re slightly broader, so a potential patient isn’t embarrassed if they are unable to fit comfortably, weighing scales that go above the usual sort of numbers, large blood pressure cuffs and double doors. These are some of the actual costs that practitioners need to weigh up prior to setting up. For example, you need to be registered with the Care Quality Commission (CQC) in England, the Regulation and Quality Improvement Authority in Ireland, Care Inspectorate Wales, or Healthcare Improvement Scotland to carry out procedures such as blood tests.
As a practitioner, you’ve got to have the time and the ability to invest in new treatments and devices. This is talking to your real ‘raison d’etre’ for becoming a healthcare professional. You’ve got to want to spend the time to get to know the new treatments and the human beings having the treatments. If you don’t, things slip and not just medically. We believe psychologically you lose, and we think you can arguably do even more damage than good. Therefore, only start a new treatment if you have the time to train and invest in the treatment and the capacity for your team to support these people.
Starting to grow your business in relation to weight loss could be as simple as walking into your local gyms and giving them your number and saying, ‘This is the service I’m offering; we would love you to offer your members an initial complimentary consultation to see if this works for them’. By doing this, you’re not losing out financially but opening yourself up to a market that you might not have been able to access. Also, you may be able to access services that they have within their gyms, such as a nutritionist or personal trainer. We don’t advocate offering discounts (because the weight loss journey often requires the use of prescription-only medicines) but offering added value instead. For example, a free light treatment or a welcome skin peel to everyone who refers in. You should be careful when advertising weight loss services and ensure you do your research – practitioners should be familiar with the Advertising Standards Authority (ASA) guide for prescription medicines.2,3
The literature suggests that medical professionals bring a lot of their own biases to a consultation.4 We believe that patients think XYZ and that they should be doing XYZ to help their weight. A study showed that most doctors inherently believe that if patients are overweight, then they’re probably lazy.4 Therefore, there’s a bigger picture surrounding education and we think for the purposes of aesthetics, maybe we need to do more.
For example, you may think that people with a BMI of 35+ will be the ones coming in for treatments, but in our experience, they’re commonly individuals who are just entering the realm of obesity. So, how do we speak to them? Maybe we will never have those high BMI patients unless you set it up completely separately and market in a different way. Although we need to be ready for them, we’re not always going to be seeing our preconceived ideas of someone who is obese. It’s the impact on their self-image and their confidence that we’re effectively dealing with here. There is also an educational need for practitioners to recognise underlying psychological issues and then refer to a psychologist for support.
Setting up a weight management service requires a certain amount of activation energy, patience and persistence from the healthcare practitioner (and their patients!). Once you have built adequate momentum, watching your patients evolve into happier and healthier humans is incredibly rewarding. However, this journey is not for everyone and if that is the case for you, the best thing you can do for your patient is refer them on.
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