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News Article
Much of NHS in England ‘does not take obesity seriously enough’
Patient Safety Learning posted a news article in News
Much of the NHS does not take obesity seriously enough, despite it being an unfolding health disaster that costs the UK £98bn a year, says a report. Only five of England’s 42 integrated care boards (ICBs) – regional groupings of NHS trusts which coordinate care over wide areas – have made tackling obesity or sticking to a healthy weight one of their top priorities, according to the Future Health thinktank. Its analysis found that the other 37 ICBs did not identify obesity as a key issue in their forward plans, which set out what they see as the most pressing issues over the next five years. “Too many parts of the NHS are giving obesity too little priority,” said Richard Sloggett, the report’s author, a former special adviser at the Department of Health and Social Care. “Given what a huge and worsening problem obesity is – for individuals, the NHS, society at large and also its impact on the economy – I was concerned to see that so few NHS bodies regarded tackling it as one of their key priorities,” he added. Read full story Source: The Guardian, 7 July 2024 -
News ArticlePopular weight-loss jabs have been linked to an eye condition that can cause blindness. People with diabetes prescribed semaglutide (brand names Wegovy and Ozempic) were more than four times more likely to be diagnosed with a condition called non-arteritic anterior ischemic optic neuropathy (NAION), according to a new study. Meanwhile, people who were overweight or obese prescribed the drugs were more than seven times as likely to develop the condition as those on other weight-loss medicines. NAION, which is uncommon, occurs from a lack of sufficient blood flow to the optic nerve. People typically suffer sudden vision loss in one eye, without any pain, and patients often notice the issue on waking up. There are no current treatments for NAION and vision often does not improve. The new study, published in JAMA Ophthalmology, was led by Joseph Rizzo, a professor of ophthalmology at Harvard Medical School in the US. He said: “The use of these drugs has exploded throughout industrialised countries and they have provided very significant benefits in many ways, but future discussions between a patient and their physician should include NAION as a potential risk. “It is important to appreciate, however, that the increased risk relates to a disorder that is relatively uncommon.” Read full story Source: The Independent, 5 July 2024
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News Article
Global alert issued over fake Ozempic drugs
Patient Safety Learning posted a news article in News
A global alert about fake versions of Ozempic - which has become popular as a way of losing weight - has been issued by the World Health Organization (WHO). The drug is sometimes known as a "skinny jab" despite its main purpose being a treatment for type 2 diabetes. The WHO said the fake medicines could pose a danger to health. The organisation advised people to source the drug only through reputable sources, such as a doctor, rather than obscure sites online or through social media. The active ingredient in Ozempic - semaglutide - helps people with type 2 diabetes control the amount of sugar in their blood. However, the weekly injection also signals to the brain that we're full. So the drug helps people lose weight by reducing the urge to eat. People without diabetes have been getting hold of the drug as a weight-loss medication, which has led to shortages for people with type 2 diabetes and created a market for counterfeit drugs. “[We advise] healthcare professionals, regulatory authorities and the public be aware of these falsified batches of medicines,” said Dr Yukiko Nakatani, WHO assistant director general for essential medicines and health products. "These falsified products could have harmful effects to people’s health," WHO said. Read full story Source: BBC News, 20 June 2024 -
Content ArticleThis WHO Medical Product Alert refers to three falsified batches of OZEMPIC (semaglutide). This falsified product has been detected in Brazil (October 2023), the United Kingdom of Great Britain and Northern Ireland (October 2023), and the United States of America (December 2023), and was supplied in the regulated supply chain. OZEMPIC (semaglutide) is from a group of medicines called glucagon-like peptide-1 (GLP-1) inhibitors that are indicated for the treatment of hyperglycemia in type 2 diabetes mellitus in adults, adolescents, and children over 12 years of age. The genuine manufacturer of OZEMPIC has confirmed that the three products referenced in this Alert are falsified: the products misrepresent their identify and source as they were not manufactured by Novo Nordisk: batch number LP6F832 is not recognized. the combination of batch number NAR0074 with serial number 430834149057 does not correspond to genuine manufacturing records. batch number MP5E511 is genuine, but the product is falsified.
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News Article
Young women buying Ozempic to get ‘beach body ready’ end up in A&E
Patient Safety Learning posted a news article in News
Young women are ending up in A&E after buying Ozempic online, with the NHS’s top doctor warning that weight-loss injections should not be abused in an attempt to get “beach body ready”. Doctors in emergency care report that “almost every shift” they see “young, beautiful girls” with potentially deadly complications who took the drug despite being a healthy weight. New weight-loss injections including semaglutide, better known by the brand names Ozempic and Wegovy, are being used on the NHS for people with obesity and type 2 diabetes. Some patients, however, including those with eating disorders, have lied about their weight to get them privately from online pharmacies or beauty clinics — leading to complications including inflammation of the pancreas. The drugs are sold by companies including Boots, Superdrug and Lloyds at between £150 and £200 a month. Doctors are calling for “urgent regulation and control” of their sale to ensure they are prescribed only to obese patients. Professor Stephen Powis, NHS England’s medical director, said the drugs should not be seen as a “quick fix for people trying to get ‘beach body ready’ ”. Read full story (paywalled) Source: The Times, 13 June 2024 -
News Article
Unplanned ‘Ozempic babies’ may be harmed by weight-loss drugs
Patient Safety Learning posted a news article in News
Women have been told to avoid using weight-loss drugs to help them get pregnant, as doctors report a rise in surprise “Ozempic babies”. Some women struggling with infertility have unexpectedly become pregnant after being prescribed semaglutide, which is used to treat obesity and type 2 diabetes under the brand names Wegovy and Ozempic. However, scientists have now issued a warning that the weight-loss injections may cause birth defects and should not be used by anyone hoping to become pregnant. Professor Tricia Tan, from the department of metabolism, digestion and reproduction at Imperial College London, said: “Women need to know that these drugs should not be used during pregnancy. You can also see that most of the clinical trials have not included women who are intending to become pregnant. Animal studies did show that the animal babies born to animals who were given these medications had problems.” Read full story (paywalled) Source: The Times, 23 April 2024 -
Content ArticleSet up in January 2023, the Times Health Commission was a year-long projected established to consider the future of health and social care in England in the light of the pandemic, the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Its recommendations are intended to be pragmatic, practical, deliverable and able to be potentially taken up by any political party or government, present or future.
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Content ArticleHealth-compromising behaviours such as cigarette smoking and poor dietary habits are difficult to change. Most social-cognitive theories assume that the intention to change is the best predictor of actual change, but people often do not behave in accordance with their intentions. Unforeseen barriers emerge, or people give in to temptations. Therefore, intentions should be supplemented by more proximal predictors that might facilitate the translation of intentions into action. Some self-regulatory mediators have been identified, such as perceived self-efficacy and strategic planning. They help to bridge the intention-behavior gap. The Health Action Process Approach (HAPA) suggests a distinction between (1) a preintentional motivation process that leads to a behavioural intention and (2) a postintentional volition process that facilitates the adoption and maintenance of health behaviours. In this article, two studies are reported that examine mediators between intentions and two behaviours. One behaviour is smoking reduction in young adults, the other is dietary restraint in overweight patients with chronic disease. A structural equation model, specified in terms of the HAPA, was in line with both data sets but it explained more variance of dietary behaviours among middle-aged or older individuals with a health condition whereas variance of smoking reduction in healthy young adults was less well accounted for. The findings contribute to the elucidation of psychological mechanisms in health behaviour change and point to the particular role of mediator variables.
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News Article
Bariatric tourism care costs NHS more than actual surgery
Patient Safety Learning posted a news article in News
People who go abroad for weight-loss surgery, and then need urgent medical care back in the UK, cost the NHS more than it costs to carry out the operation itself, according to new research. A study featuring five London hospitals recorded the details of 35 people who had suffered complications after travelling abroad for gastric surgery during 2022. The data, shared with the BBC's Disclosure programme, shows the patients suffered from a range of symptoms including severe malnutrition, vomiting, sepsis, hernias and haemorrhaging. Five of them needed feeding tubes inserted, while the average stay in hospital was 22 days. The interventions at the five hospitals for the 35 patients cost the NHS a total of £560,234, or £16,006 per patient, in 2022. The equivalent amount would have covered the cost of about 110 bariatric surgeries in UK hospitals. Consultant bariatric surgeon Omar Khan, one of the lead authors of the study, said the paper was intended "to try and quantify" the effect on the NHS of increasing numbers of people going abroad for weight-loss surgery - sometimes known as bariatric tourism. "We know that the waiting lists in the NHS are unfortunately long. We also know that there are new units, particularly in Turkey, which have been set up to cater for an international market," he explained. "We focused on patients with major complications, patients who were severely ill. They had leaks from the stomach, they had bleeding, they had infections. A significant portion required further surgery and some required revisional surgery." Read full story Source: BBC News, 15 January 2024 -
News ArticleHundreds more middle-aged adults have been dying each month since the end of the pandemic, as obesity and NHS backlogs drive a surge in excess deaths. New analysis of official statistics has revealed that there were an extra 28,000 deaths in the UK during the first six months of 2023, compared with levels in the previous five years. The biggest rise in unexpected deaths has been among adults aged 50 to 64, who are increasingly dying prematurely from preventable conditions including heart disease and diabetes. The Covid inquiry is now being urged to shift its focus from “tactical decisions made by politicians” and to examine the lasting disruption that has kept deaths persistently high since the virus peaked. Experts believe that difficulties in accessing GPs since lockdown and record NHS waiting lists mean that middle-aged patients are missing out on life-saving preventative treatment such as blood pressure medication. Unhealthy lifestyles, obesity and widening health inequalities are also contributing to a rise in avoidable deaths. Professor Yvonne Doyle, who led Public Health England during the pandemic, warned that the official Covid inquiry risks “missing the point” by focusing on the drama and WhatsApps of Westminster politicians. In an article for The Times, Doyle, who gave evidence to the inquiry six weeks ago, says that the tens of thousands of excess deaths since Covid “represent an underlying pandemic of ill health” that should be addressed. Read full story (paywalled) Source: The Times, 13 December 2023
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News ArticleObese adults in Britain are on course to outnumber those who are a healthy weight within five years, a stark report has revealed. Experts have warned there will be a “tipping point” in 2027 when one third of adults will be obese if current trends continue. By 2040, they predict there will 21 million people classed as obese in the UK, and 19 million deemed to be overweight. The analysis by Cancer Research UK shows seven in 10 (71%) people will be overweight or obese by 2040. Of this, almost four in 10 (36%) adults will be obese. At present, 64% of adults are overweight or obese, with figures rising every year. Being overweight or obese increases the risk of at least 13 different types of cancer and also causes other conditions such as high blood pressure and Type 2 diabetes. The new data comes after former Conservative leader William Hague attacked the government for postponing a ban on “buy one get one free” deals for foods high in fat, salt and sugar for a year because of the cost-of-living crisis. Read full story Source: The Independent, 19 May 2022
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News Article
Obesity ‘epidemic’ leading to 1.2m deaths a year in Europe, says WHO
Patient Safety Learning posted a news article in News
Obesity has reached “epidemic proportions” in Europe, the World Health Organization says, as a major report shows the disease is causing 200,000 cancer cases and 1.2 million deaths a year. In the first such study for 15 years, the WHO said overweight and obesity rates had hit deadly levels and were “still escalating”. No country in the region was on track to meet the WHO global noncommunicable disease (NCD) target of halting the rise of obesity by 2025, it said. Across Europe, 59% of adults are overweight or obese as well as 8% of children under five and one in three children of school age. Obesity prevalence in Europe is higher than in any other part of the world except the Americas, according to the report presented at the European Congress on Obesity. Obesity is linked to a string of other diseases, including musculoskeletal complications, type 2 diabetes, heart disease and at least 13 types of cancer. The report said excess body fat led to premature death and was a leading risk factor for disability. “Across the WHO European region, obesity is likely to be directly responsible for at least 200,000 new cancer cases annually, with this figure projected to rise in the coming decades,” the report said. “For some countries within the region, it is predicted that obesity will overtake smoking as the main risk factor for preventable cancer.” Dr Hans Kluge, the WHO regional director for Europe, said reversing the obesity epidemic in Europe was still possible. “By creating environments that are more enabling, promoting investment and innovation in health, and developing strong and resilient health systems, we can change the trajectory of obesity in the region.” Read full story Source: The Guardian, 3 May 2022 -
News Article
Turkey surgery warning as mother-of-four dies after gastric sleeve
Patient Safety Learning posted a news article in News
A father whose daughter died after travelling to Turkey for weight-loss surgery has urged people to think again before doing the same. Shannon Meenan Browse from Londonderry was 32 when she died in August. The mother-of-four travelled for a gastric sleeve operation 18 months ago but, according to her father, got sick almost straight away. The family were told she died in Altnagelvin Hospital from "malnutrition due to gastric sleeve". A BBC investigation in March found that seven British patients who travelled to Turkey for weight-loss surgery died after operations there, while others returned home with serious health issues. One of the UK's leading bariatric surgeons, Prof David Kerrigan said people are taking a "massive risk" by travelling abroad for weight-loss surgery. In the UK, he said, patients undergo a rigorous preparatory process that includes a psychological assessment and there is "a proper after-care programme". Read full story Source: BBC News, 6 September 2023 -
News Article
Weight-loss jabs investigated for suicide risk
Patient Safety Learning posted a news article in News
Europe's drugs regulator has told BBC News it is conducting a review of some weight-loss jabs after being alerted to a possible link to thoughts of suicide and self-harm among users. Member state Iceland notified the European Medicines Agency after seeing three cases. The safety assessment will look at Wegovy, Saxenda and similar drugs, such as Ozempic, that help curb appetite. Product leaflets already list suicidal thoughts as a possible side effect. An EMA official said: "The review is being carried out in the context of a signal procedure raised by the Icelandic Medicines Agency, following three case reports. "A signal is information on a new or known adverse event that is potentially caused by a medicine and that warrants further investigation. "The case reports included two cases of suicidal thoughts - one following the use of Saxenda and one after Ozempic. "One additional case reported thoughts of self-injury with Saxenda. "The EMA will communicate further when more information becomes available." Read full story Source: BBC News, 10 July 2023 -
News Article
Obese patients ‘being weight-shamed by doctors and nurses’
Patient Safety Learning posted a news article in News
Doctors and nurses often “weight-shame” people who are overweight or obese, leaving them feeling anxious, depressed and wrongly blaming themselves for their condition, research has found. Such behaviour, although usually the result of “unconscious weight bias”, leads to people not attending medical appointments, feeling humiliated and being more likely to put on weight. Dr Anastasia Kalea and colleagues at University College London analysed 25 previous studies about “weight stigma”, undertaken in different countries, involving 3,554 health professionals. They found “extensive evidence [of] strong weight bias” among a wide range of health staff, including doctors, nurses, dieticians, psychologists and even obesity specialists. Their analysis found that a number of health professionals “believe their patients are lazy, lack self-control, overindulge, are hostile, dishonest, have poor hygiene and do not follow guidance”, said Kalea, an associate professor in UCL’s division of medicine. She added: “Sadly, healthcare, including general practice, is one of the most common settings for weight stigmatisation and we know this acts as a barrier to the services and treatments that can help people manage weight. “An example is a GP that will unconsciously show that they do not believe that the patient complies with their eat less/exercise more regime they were asked to follow as they are not losing weight." “The result is that patients are not coming back or they delay their follow-up appointments, they avoid healthcare prevention services or cancel appointments due to concerns of being stigmatised due to their weight.” Read full story Source: The Guardian, 10 August 2022 -
News ArticleThe number of knee replacement operations carried out has dropped in regions of England with restrictions on surgery for overweight patients, with people in more deprived areas worst affected, researchers have found. Patients needing surgery but unable to lose weight are being denied surgery that could ease pain and increase mobility, the team from the University of Bristol said. Health campaigners expressed alarm, claiming the policy was a “blunt tool” being used to replace conversations between doctors and patients and risked exacerbating health inequalities. Over the past decade, rules have been brought in by some clinical commissioning groups (CCGs) across England to restrict access to hip and knee replacement surgery for patients who are overweight or obese. The study, funded by the National Institute for Health and Care Research, suggests that regions that introduced policy changes for access to knee replacement surgery based on a patient’s weight or BMI have seen a decline in surgery. The lead author, Joanna McLaughlin, of the Bristol Medical School, said: “Our study raises the concern that these policies are linked with worsening health inequalities with fewer NHS operations for the least affluent groups. “We could see the rates of surgery dropped for those worst off but increased for those who are best off, which correlates with more private surgery going on in those areas.” Read full story Source: The Guardian, 29 June 2022
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News Article
Child diabetes referrals in England and Wales jump 50% amid obesity crisis
Patient Safety Learning posted a news article in News
The number of children being treated at paediatric diabetes units (PDUs) in England and Wales has increased by more than 50% amid a “perfect storm” of rising obesity levels and the cost of living crisis, health leaders have said. Diabetes UK said alarming obesity levels among children had led to a “concerning climb” in the number diagnosed with type 2 diabetes, and predicted that the cost of living crisis could lead to further problems in the years to come. Data from NHS Digital shows that almost one in seven children start primary school obese – a rise of almost 50% in just a year. More than a quarter are obese by the time they finish primary school. The high levels of obesity combined with the squeeze on personal finances are creating a “perfect storm which risks irreversible harm to the health of young people”, Diabetes UK said. It accused the government of “letting our children down” as it called for concerted action to tackle obesity. Chris Askew, the chief executive of Diabetes UK, said: “We are very concerned that this spike in childhood obesity will translate into an even greater increase in children with type 2 diabetes in the coming years, a crisis fuelled by longstanding health inequalities and made worse still by impacts of the cost of living crisis." Read full story Source: The Guardian, 15 June 2022 -
News Article
Revealed: experts who praised new ‘skinny jab’ received payments from drug maker
Patient Safety Learning posted a news article in News
The drug giant behind weight loss injections newly approved for NHS use spent millions in just three years on an “orchestrated PR campaign” to boost its UK influence. As part of its strategy, Novo Nordisk paid £21.7m to health organisations and professionals who in some cases went on to praise the treatment without always making clear their links to the firm, an Observer investigation has found. Among the vocal champions of the Wegovy jabs was a clinical expert who gave evidence to the National Institute for Health and Care Excellence (NICE) and others who publicly praised the so-called “skinny jabs” as a “gamechanger”. The revelations come as the Danish drug giant is investigated by the UK’s pharmaceutical watchdog after it was found to have breached the industry code seven times in relation to a “disguised promotional campaign” of another of its weight loss drugs via online webinars for healthcare professionals. Prof Allyson Pollock, professor of public health at Newcastle University, said Novo’s campaign was “not unusual” in the drugs industry and called for measures to improve trust. “The public really aren’t being made aware enough about the potential for bias and over-claiming,” she said. Read full story Source: The Guardian, 12 March 2023 -
News ArticleA newly approved weight loss jab should be used with caution as it could be harmful to those vulnerable to eating disorders, doctors have warned. Thousands struggling with obesity could be prescribed Wegovy, or semaglutide, which scientists have described as a “game changer”, after the National Institute for Health and Care Excellence (NICE) approved its use. However, eating disorder experts have warned the NHS to proceed with caution in prescribing the drug, with one GP accusing NICE of being “absolutely reckless” in approving it. The drug was approved on Wednesday for use in adults who have at least one weight-related condition, such as type 2 diabetes, high blood pressure, high cholesterol sleep apnoea and heart disease, and a body mass index score of at least 35. It can only be prescribed to those undergoing weight management treatment. Read full story Source: The Independent, 8 March 2023
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News Article
More than half of humans on track to be overweight or obese by 2035
Patient Safety Learning posted a news article in News
More than half of the world’s population will be overweight or obese by 2035 unless governments take decisive action to curb the growing epidemic of excess weight, a report has warned. About 2.6 billion people globally – 38% of the world population – are already overweight or obese. But on current trends that is expected to rise to more than 4 billion people (51%) in 12 years’ time, according to research by the World Obesity Federation. Without widespread use of tactics such as taxes and limits on the promotion of unhealthy food, the number of people who are clinically obese will increase from one in seven today to one in four by 2035. If that happens, almost 2 billion people worldwide would be living with obesity. Evidence shows that obesity increases someone’s risk of cancer, heart disease and other diseases. Prof Louise Baur, the federation’s president, said the stark findings were “a clear warning that by failing to address obesity today, we risk serious repercussions in the future. “It is particularly worrying to see obesity rates rising fastest among children and adolescents.” Countries need to take “ambitious and coordinated action” as part of a “robust international response” to tackle the growing health and economic crisis that obesity involves, the federation believes. “Governments and policymakers around the world need to do all they can to avoid passing health, social and economic costs on to the younger generation,” Baur added. Read full story Source: The Guardian, 2 March 2023 -
News Article
Older and overweight patients ‘hampering efforts to clear NHS backlogs’
Patient Safety Learning posted a news article in News
Older and overweight patients are making it harder to clear NHS surgery backlogs, anaesthetists have warned. New data reveal an “extremely worrying picture” of increasing age, rates of obesity and complexity of surgical patients across the UK, the Royal College of Anaesthetists said. The average age of patients requiring anaesthesia increased by 2.3 years, from 50.5 to 52.8, over the last decade, while their BMI also jumped from 24.9 (borderline normal/overweight) to 26.7 (overweight). The proportion of patients who are complex or have other comorbidities has also significantly increased, the study found. When patients are older, overweight and have other problems, this makes anaesthetic and surgical care more complicated and higher risk, the authors said. Managing these patients safely takes longer during surgery and can lead to slower recovery times, requiring more time in hospital. Read full story (paywalled) Source: The Telegraph, 2 March 2023 -
News Article
Plan for GPs to offer NHS patients weight-loss jab
Patient Safety Learning posted a news article in News
GPs in England may start offering weight-loss jabs to some patients to reduce obesity-related illnesses and resultant pressure on hospitals. Wegovy was approved for NHS use after research suggested users could shed over 10% of their body weight. The drug blunts appetite, so users feel full and eat less. Rishi Sunak said it could be a "game-changer" as he announced a £40 million pilot scheme to increase access to specialist weight management services. But experts warn "skinny jabs" - widely used in the US and endorsed by many celebrities - are not a quick fix or a substitute for a healthy diet and exercise. NHS drugs watchdog, the National Institute for Health and Care Excellence (NICE), says patients can access Wegovy for a maximum of two years via specialist weight-management services. The new scheme will test how GPs could safely prescribe such drugs and the NHS provide support in the community or digitally, contributing to the government's wider ambition to reduce pressure on hospitals and give patients access to the care they need where it is most convenient for them. Read full story Source: BBC News, 7 June 2023 -
News Article
Obese patients cost NHS double the amount of healthy people
Patient Safety Learning posted a news article in News
Obese patients cost the NHS double the amount that people who are a healthy weight do, a landmark new study has revealed. One million patients who were a healthy weight cost the NHS £638 on average in 2019, the research found. Meanwhile, £1,375 was spent per year on morbidly obese patients with a body mass index (BMI) of more than 40. Experts warned the future viability of the NHS relies on combatting increasing obesity as it was leading to record levels of long-term sickness. The research, presented at the European Congress of Obesity in Dublin, is the first to show how NHS spending varies depending on a patient’s weight. The findings showed a staggering rise in spending on heavier patients because they develop obesity-related conditions like type 2 diabetes and heart disease. Read full story Source: The Independent, 18 May 2023 -
News Article
WHO issues warning on weight loss drug Wegovy
Patient Safety Learning posted a news article in News
New weight loss drugs such as Wegovy will not be a “silver bullet” in tackling obesity, the World Health Organization (WHO) has warned. Francesco Branca, WHO director of food and nutrition safety, said weight loss drugs must be used alongside a healthy diet and exercise. Ms Branca’s comments come as the health body conducts its first review of obesity management guidelines in two decades. Semaglutide, marketed as Wegovy by drugmaker Novo Nordisk, is an appetite suppressant drug that has been approved by the UK medicines regulator and described by some as a “game changer” in helping people to shed weight. People will only be given Wegovy on prescription as part of a specialist weight management service involving input from several professionals and for a maximum of two years. Some experts described the decision as a “pivotal moment” for the treatment of people living with obesity but others warned that the drug is not a “quick fix”. Read full story Source: The Independent, 12 May 2023 -
News Article
Online UK pharmacies prescribing weight loss jabs to people with healthy BMI
Patient Safety Learning posted a news article in News
Online pharmacies operating in the UK are approving and dispatching prescriptions of controversial slimming jabs for people of a healthy weight, a Guardian investigation has found. Some pharmacies appear to be issuing prescriptions of such medications to people who lie about their body mass index (BMI) on an online form. In one case a reporter was issued a prescription after accurately saying their BMI was about 20. A healthy BMI lies between 18.5 and 24.9. The findings have raised alarm among eating disorder charities, which have warned that weight-loss medications should only be sold under the strictest conditions. Their concern has prompted calls for online pharmacies to employ stronger health checks and screening for eating disorders. Read full story Source: The Guardian, 10 May 2023
