Ad description
Claims on the home page of www.bodylineclinic.com, a medical slimming service, under the heading "Welcome to Bodyline Clinic" stated "The specialists in medical weight loss at UK based slimming clinics. Bodyline offers support for weight loss and long term weight management for men and women. Our team of dedicated doctors and specialised nurses will put together a personal weight loss programme for you. At our diet clinic you will receive advice and guidance on lifestyle, nutrition and diet. Where appropriate you will be prescribed appetite suppressant pills, to help you manage your appetite and lose weight". Text stated "Get 50% off your first week's weight loss. Leave your name and email address to get your first week's medication at half price" and "Recommend a friend and receive 1 week free for you and your friend ...".
Claims under the heading "What happens on your first visit?" explained the procedure by which patients were assessed. Claims at the end of that section stated "You will then be recommended a particular diet to follow, explaining what you should and should not do. If appropriate, you may be prescribed Phentermine or Diethylpropion. They are appetite suppressants often known as diet pills, or lipase inhibitor to help you adapt to your plan. These come in the form of a tablet or capsule".
Claims under the heading "Why choose Bodyline?" stated "A recent study published in the Lancet, one of the world's most respected medical journals, has shown the effectiveness of slimming tablets, such as Phentermine. This report has shown that patients taking these medications had significantly higher rates of weight loss compared to those not taking any medications. They also showed improvements in blood pressure, blood sugars, and cholesterol levels in those patients who lost weight. All medications used at Bodyline diet clinics hold licences to be prescribed. All our doctors and prescribers work for the NHS and are GMC registered and all our nurses are registered with the nursing council, we work to the highest professional standards. Bodyline is also a member of the Obesity Management Association who regulates obesity management in the UK."
One of the changing flashing ads at the top of the home page stated '"DIET PILLS THAT WORK AND ARE SAFE"'.
Under the heading "Bodyline Blog" text stated "The UK's best pills that work fast", "The only way to buy real Phentermine in the UK" and "Bodyline's guide to UK slimming pills that work".
Claims on the "Diet / Slimming Pills" page, which featured a picture of drug capsules on a spoon, stated "There are many diet medications and pills that claim to help you lose weight and aid slimming. There are also many herbal supplements that say they can reduce your weight. There is little or no evidence that these readily available pills and supplements work. There is however evidence that prescription only medications can help patients lose weight. If you are considering using medication when slimming this should be done under the supervision of a fully trained and registered doctor. Doctors are the only people that can provide prescription only slimming medication. These medications have been shown in clinical research and trials to actually help patients lose weight. Diet pills should also be part of a weight loss management plan which also looks at changes in diet, lifestyle and exercise. When any patient is taking prescribed slimming pills they should have regular check-ups with a doctor to monitor their response and health. Beware of medications available on the internet as these will often be fake or can potentially be harmful to your health. Only take medication under the supervision of an experienced doctor". Claims under the sub-heading "How do prescription only weight loss pills work?" stated "These prescription medications can work by a few mechanisms depending on the tablet. Some pills such as Phentermine can help suppress appetite and reduce hunger, these are called appetite suppressants. Some tablets reduce the digestion and absorption of fat, these are known as lipase inhibitors". Claims under the sub-heading "Do Phentermine slimming tablets work?" stated "There is a good amount of evidence that prescription only slimming medication works in helping patients lose weight. This evidence comes from clinical research and trials when patients are given the medication or placebo (a tablet with no medical effect or active ingredient). The results showed that those taking the prescribed diet tablets had much more weight loss than those taking the placebo pills. There is little or no evidence that diet supplements and pills that you can buy over the counter help in weight loss".
Issue
The complainant challenged whether the claims breached the Code by advertising prescription-only medicines to the public.
Response
The Bodyline Clinic Ltd explained that their weight-loss programme was one where the client was seen by a doctor who would devise a bespoke weight-loss programme including advice on diet and exercise. In some cases they might, as part of the programme, prescribe weight-loss medication. All of the medications they used were licensed. Bodyline said they were doctor and nurse-led and employed a doctor as their clinical director, who oversaw all the clinical team who are all registered with the Nursing Council or the General Medical Council (GMC).
Bodyline Clinic said they were regulated by the Care Quality Commission (CQC) and the Obesity Management Association (OMA). They had clear guidance from the CQC that they must give and provide clients with relevant information about the medications they prescribed and believed that they adhered to that requirement, both in written materials provided in clinics and the information published on their websites. Bodyline Clinic said all their guidance came from the GMC, Nursing Council and the OMA, along with their clinicians’ experience in specializing in the weight-loss field. They regularly reviewed the information and guidance on the website. Bodyline believed that, in terms of presenting information on their website, there was no difference between them and a business such as an online pharmacy which made the same drugs available.
Bodyline said one of their directors was a proactive member of the OMA and they were actively involved in promoting responsible and professional behaviour in the wider field of medical weight loss. They said they had been in business for nine years and treated over 8000 clients on the Bodyline Clinic medical weight-loss programme and believed they were currently operating and informing current and potential clients in a very responsible manner via their website.
Assessment
Upheld
The ASA understood that the advertising of prescription-only medicines (POMs) to the general public was prohibited by the Human Medicines Regulations 2012 (HMRs) and that was reflected in CAP Code (Edition 12) rule 12.12 12.12 Prescription-only medicines or prescription-only medical treatments may not be advertised to the public. However, we further understood that certain types of content that could be characterised as reference material or announcements of a factual and informative nature were not covered under the scope of HMRs' definition of advertising and, as a result, could not be considered advertisements for the purposes of rule 12.12 12.12 Prescription-only medicines or prescription-only medical treatments may not be advertised to the public. We therefore assessed the claims on the website to establish whether they were of that nature, and could be considered as advertising for the purposes of rule 12.12 12.12 Prescription-only medicines or prescription-only medical treatments may not be advertised to the public.
We noted the Bodyline Clinic website was for a clinic that was focused on promoting a consultation service for advice on the treatment of weight-related conditions. We also noted some of the treatments offered involved prescribing a POM. We considered that it was acceptable for a website to refer to a POM as a treatment option, presented in the context of the promotion of a consultation where a range of therapeutic options would be discussed, provided the focus was on the promotion of the consultation rather than promoting any associated POM.
We noted a number of claims referred to specifically named POMs and their effectiveness, which we considered to be advertising for the purposes of rule 12.12 12.12 Prescription-only medicines or prescription-only medical treatments may not be advertised to the public. The claim "If appropriate, you may be prescribed Phentermine or Diethylpropion. They are appetite suppressants often known as diet pills, or lipase inhibitor to help you adapt to your plan" appeared on the home page. Although we considered that the wording of the claim itself was unlikely to promote a POM, because it only referred to their names and intended purpose, we were nonetheless concerned that it appeared on the home page. We considered that its appearance in that context meant that consumers' attention was drawn to named POMs immediately on arriving at the website and before they had had an opportunity to assess whether they might wish to find out more information about the consultation service offered. We considered that presenting consumers with the references to named POMs on the home page advertised POMs to the public and therefore breached the Code.
We also noted the following claims appearing on the home page: "A recent study published in the Lancet, one of the world's most respected medical journals, has shown the effectiveness of slimming tablets, such as Phentermine. This report has shown that patients taking these medications had significantly higher rates of weight loss compared to those not taking any medications. They also showed improvements in blood pressure, blood sugars, and cholesterol levels in those patients who lost weight". In addition to our concerns about its appearance on the home page, we considered that by highlighting the effectiveness of the drug and its other potential benefits, the claim went beyond reference material or announcements of a factual and informative nature, such as those which could be found in the product's summary of product characteristics (SPC) in a way that was promotional and breached the Code by advertising a POM to the public.
However, we noted the statement "These prescription medications can work by a few mechanisms depending on the tablet. Some pills such as Phentermine can help suppress appetite and reduce hunger, these are called appetite suppressants" appeared on the "Diet / Slimming Pills" page. We considered that the claim was not promotional but factual and informative in nature. We also considered that the claim's positioning on a sub-page of the website, meant that it was only likely to be seen by those consumers who had chosen to seek out more information and browse more deeply into the website. For those reasons we did not consider the claim to be promotional in nature and was therefore not in breach of the Code.
We considered the claim "Get 50% off your first week's weight loss. Leave your name and email address to get your first week's medication at half price" was clearly a discount sales promotion for the named POMs and the claim "Recommend a friend and receive 1 week free for you and your friend ...", in the context of the other claims on the home page, implied a free week's worth of POMs and therefore both claims were promotional in nature and in breach of the Code.
The flashing ad at the top of the home page, '"DIET PILLS THAT WORK AND ARE SAFE"' and the blog entries "The UK's best pills that work fast", "The only way to buy real Phentermine in the UK" and "Bodyline's guide to UK slimming pills that work" were all promotional claims for the POMs efficacy rather than information of a factual or informative nature and therefore amounted to advertising. We considered those claims were also in breach of the Code.
We considered that the claims "Get 50% off your first week's weight loss. Leave your name and email address to get your first week's medication at half price", "Recommend a friend and receive 1 week free for you and your friend ...", '"DIET PILLS THAT WORK AND ARE SAFE"', "The UK's best pills that work fast", "The only way to buy real Phentermine in the UK", "Bodyline's guide to UK slimming pills that work", the references to the Lancet article and the named POMs appearing on the home page were all promotional in nature and we therefore concluded that they breached CAP Code (Edition 12) rules 1.3 1.3 Marketing communications must be prepared with a sense of responsibility to consumers and to society. (Social responsibility) and 12.12 12.12 Prescription-only medicines or prescription-only medical treatments may not be advertised to the public. (Medicines).
Action
We told Bodyline Clinic Ltd to remove the references to named POMs from their home page and to ensure that all other references to named POMs on the website were not promotional in nature, for example, by ensuring that those references were in line with the information found in the SPC or product information leaflet.
CAP Code (Edition 12)
1.3 12.12 13.1 13.10 13.9 3.1 3.11 3.7
