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Watchdog – concerns over big name pharmacies selling slimming pills online

The BBC's Watchdog programme has discovered that people who are underweight and underage can buy slimming pills from Boots and Lloyds Pharmacy.

Alli was launched last year in the UK as the first slimming pill which can be bought over the counter without prescription. It is only licensed to be sold to those over 18 with a body mass index (BMI) higher than 28. It helps people trying to lose weight by preventing some of the fat they consume from being absorbed. There are, however, side-effects. Users can experience abdominal cramping and diarrhoea after flatulence.

Watchdog has found that people with eating disorders are able to buy Alli pills online.

Olivia Goodwill, 19, bought Alli last year from a different, unregulated website. Olivia told Watchdog: "It asked for my BMI but you just put that you're severely overweight and it's as simple as that."

Susan Ringwood from "beat", a leading eating disorder charity, said people had been ringing their helpline telling them they had been able to buy Alli pills online.

Watchdog tested the websites of the UK's two leading pharmacy chains – Boots and Lloyds Pharmacy – to see whether they would sell Alli pills to those who shouldn't use them.

Jenna Newman, 26, took part in the experiment. She has suffered from anorexia and is still officially underweight. She now works for an eating disorder charity in Derby.

She went into branches of Boots and Lloyds Pharmacy to test their in-store policies. After having her height and weight checked she was turned away by staff at both stores.

She then logged onto each company's website. She gave a false BMI, suggesting she was overweight, and both websites agreed to send the pills to her.

"It's terrible, it makes me really angry," Jenna told Watchdog. "It's just like buying a pair of shoes."

Watchdog also tested whether Boots or Lloyds would sell Alli to people who are under age. Grace, a 16 year old with her own bank account and debit card, logged on to both sites.

When she gave her real age at the Lloyds Pharmacy website she was turned away. However, at the Boots website she bought Alli successfully, despite giving her real date of birth and clicking a box saying she was not over 18.

The pills are not licensed for children because not enough trials have been carried out to determine the side effects on under-18s.

Professor Steve Field from the Royal College of General Practitioners say there are other reasons children shouldn't take them: "They can have problems absorbing fat soluble vitamins. That can have major effects on their growth and their bones, as well as on vision."

Boots told Watchdog: "As the UK's leading pharmacy-led health and beauty retailer we are committed to offering our customers the very best advice, information, products and services in convenient and accessible locations and this also includes the safe sale of pharmacy medicines online. Our commitment to the health of the nation includes ensuring people in the UK who want to lose weight to lead a healthier lifestyle can access the products and services they need in a way that is convenient to them.

"Unfortunately, in this isolated incident one of our e-pharmacy team, through an oversight, processed the sale of Alli to someone aged 16. We are sorry this has happened, and have reviewed our process fully. We have now included an automated element to our system to help prevent this happening in the future. However, despite this incident we remain committed to the online sale of pharmacy medicines and know through speaking to our customers that this is a service they want and need.

"There will always be some persons who are willing to act inappropriately to obtain medicines online and instore, and we do everything we can to prevent this from happening. However, we cannot let the actions of a few individuals prevent the vast majority of customers who need and are entitled to purchase these products from accessing them either in our stores or online at boots.com under pharmacy control."

Lloyds Pharmacy told Watchdog: "We are concerned to hear that two people for whom Alli is not clinically appropriate have been able to purchase the treatment from our online service. We are grateful to Watchdog for drawing these incidents to our attention and we have, as a result, introduced additional cross-checks both on the age of the customer and their height and weight measurements. We believe these changes will help to address the concerns raised by the Watchdog investigation.

"Lloydspharmacy offers patients the opportunity to buy a number of treatments online. In particular, we focus on conditions which some people are reluctant to discuss face-to-face with a doctor or pharmacist. These include sexual health conditions and weight management among others. We believe that this service plays a valuable role in making healthcare more accessible.

"With all medicines there is a duty both on pharmacists to dispense appropriately and on patients to take responsibility for the treatments they purchase. Just as in a bricks and mortar pharmacy our online patients are given information about when and how to take the medications they buy, who should and should not take them and any contra-indications.

"Just as in a bricks and mortar pharmacy, our online pharmacists ask questions and refuse to dispense treatments if clinically inappropriate to do so. In the case of Alli, 12% of online purchases are refused.

"Lloyds Pharmacy strives for the highest clinical standards in the online arena, just as we do in our bricks and mortar pharmacies. We have developed our own rigorous Standard Operating Procedures for our online pharmacy which is registered by the Royal Pharmaceutical Society of Great Britain.

"However, there is no room for complacency and we are pleased to be able to make adjustments to our online Alli service on the basis of Watchdog's investigation."

GlaxoSmithKline's written response to Watchdog:

"We are concerned to hear of Watchdog's findings and have been reviewing the online process with Boots and Lloyds and understand changes have been made to tighten it up.

"We want to reassure people of the safety profile of Alli, which contains orlistat, the most extensively studied weight loss medicine available. Alli is for adults (aged 18 or over) with a BMI of 28 or more and should be used in conjunction with a reduced calorie, lower-fat diet. We did not apply for a licence for under 18 year olds because the treatment of obesity in under 18's is very challenging and requires the specialist support of doctors and other healthcare professionals. Importantly, in terms of safety, studies in adolescents have shown that the safety profile of orlistat is similar to that in adults. There is no evidence to support claims that Alli reduces vitamin levels in adolescents to a degree that would cause any harm.

"There are no additional safety concerns for people with eating disorders. If people with eating disorders were to obtain Alli, due to the way that this weight loss aid works, it simply does not provide people with either the purgative action or the rapid weight reduction they may seek. People with eating disorders should not buy Alli or any other weight loss products but seek the help and support they need from their GP or valuable organisations such as beat.

"Obesity and overweight are a major concern and many people need help; online pharmacy provides people with discreet access to advice, care and valuable products such as Alli. Stopping online pharmacy sales could prevent these people from gaining access to the healthcare products they may need. It is the responsibility of the retailers to sell Alli in accordance with the licence and we will be reviewing with online pharmacies any additional measures that could be put in place to tighten up the online process."

The full report will be shown on Watchdog, 8pm, BBC One on 13 May 2010.

TD

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