Q&A: The Pharmacist’s Ability to Provide Nutritional Guidance

As pharmacists are experts in medication and possess the social skills to build successful health management plans for their patients, they too are uniquely positioned to guide patients on weight-loss journeys and lifestyle changes designed to improve health. The perfect example of a health care provider moving into both the pharmaceutical and nutritional spaces is Sarah Gray, PharmD, GAICD, known to her patients and followers as “The Nutrition Pharmacist.”

“Before people start to eliminate food groups or go on a keto or a carnivore diet—or all these new diets that come up that won't exist in 10 years’ time because they just keep cycling around—I think they really just need to take care and think about who they're getting that information from,” Gray told Drug Topics. A pharmacist is “not just the white-coat person behind the counter labeling the boxes. We actually come out, we speak to people, and we can do a lot more for you.”

Gray has garnered a notable presence within obesity management and is known to her patients and followers as The Nutrition Pharmacist. | image credit: Smoky / stock.adobe.com

In part 3 of our interview with Gray, she focused on the capabilities of pharmacists to expand their scopes within the nutritional space, but also in health care overall. From her perspective as a pharmacist-turned-nutritionist in Melbourne, Australia, to issues in access to obesity management services, Gray touched on several different areas of her expertise.

Stay tuned for a full-length podcast version of our discussion with Gray on the next installment of Over the Counter.

READ MORE: Q&A: A Pharmacist’s Career Journey to Becoming a Nutritionist

Drug Topics: To whom or where would a patient typically go if they were seeking nutritional counseling? In other words, prior to you offering your services and advancements in technology and the internet, where would people typically go for nutritional advice?

Sarah Gray: In an ideal world, they would be speaking to a qualified nutrition professional. I think that's a pretty common thing. People would usually go to speak to a doctor or somebody about their health and typically be steered to speak to a qualified nutritionist or dietitian. I do actually really like that the eat right website has a great find-a-nutrition-expert function from the Academy of Nutrition and Dietetics. You can actually find someone that's qualified. Sometimes when you do go to seek a nutrition professional, unfortunately, it can be a rather poorly regulated industry across the world in that you may be able to do a really quick 3-week course on nutrition and then label yourself as a nutritionist.

The other place that people look to, if you think about human nature, you just go to other people, don't you? So, if you want to lose weight, or if you want to gain muscle, or you're starting a new healthy lifestyle, you ask your friends and family, which can be great but also can be a challenge because what works for them may not always work for you. Then we look at, in this day and age [of] what people could be doing, I think there's so many more opportunities. Whereas before, people were asking family and friends, now there's the internet, you can just search and ask Dr. Google, or find solutions on social media. It's huge in this space. If people want to lose [weight], they want to look like that influencer [and] they'll follow whatever that influencer did.

But before people start to eliminate food groups or go on a keto or a carnivore diet—or all these new diets that come up that won't exist in 10 years’ time because they just keep cycling around—I think they really just need to take care and think about who they're getting that information from. Then, they can use the tools that they find. They might be health-tracking tools or smart watches that might help support them now, which you wouldn't have had many years ago. So, there's lots of options, which I actually think makes it harder. Whereas before, you would have just been told by your doctor, “Hey, go speak to a dietitian.” Now you've got all these options, and you really can self-direct it without knowing if what you're doing is the best for you from an evidence-based perspective.

Drug Topics: Obviously, with your background as a pharmacist eventually becoming a nutritionist, it's safe to say that you fully support pharmacists branching out as nutritionists. What is it about pharmacists that make them stand out amongst other health care providers when it comes to offering nutrition advice and counseling?

Sarah Gray: To me, the combination of pharmacy and nutrition is a match made in heaven. I actually hope it becomes a really, much more popular path. There are not a lot of people that combine the 2, but more and more, I get people asking me questions through social media or email or in day-to-day life about how can I do this and how have you found it useful? So, I'm glad that we're talking about it. For me, pharmacists have such great skills across many areas. I think the key [area] I've found that really matches well with nutrition is our great patient-interviewing skills and being able to really consider all factors of a patient's life, so what medications they're taking, what medical conditions, what symptoms they have.

Now, adding the nutrition side, I can get a really good picture of all the areas of the person's health. We're really good at doing that in a quick way. So, [if] we've got somebody in front of us in the pharmacy, we're really good at asking lots of different questions to find out the problem in a fast way and helping people quickly. Having that investigative skill is really great. The other thing is our science background. It gives us an added edge when it comes to things like understanding nutritional supplements. We're not just thinking about the nutrient, but we're thinking about how they process in the body, how will they interact with other medications, and things that, if you don't have that background, you're not thinking about as a nutritionist. I found, actually, the supplement side of things has become quite a big part of what I do. Not that I think they are the be all and end all, but [it’s] actually fully understanding those depletions that drugs might cause—drug interactions, drug-nutrient interactions, even drug-food and diet interactions.

I think it's a great opportunity to add in some nutritional advice, education, and giving appropriate supplements. I think the good thing is we can do it at a mass level. When you think about it in a community pharmacy and other pharmacy settings, the amount of people we speak to every single day, if we just add a little bit of nutritional advice to each of those people, we can have a much bigger public health impact than people that go and visit a nutritionist, which is a much smaller percentage. I think that's one of the other great benefits also.

Drug Topics: When it comes to pharmacists in in the nutritional space, or in health care in general, what are your overall hopes for the profession going forward?

Sarah Gray: My hope is that more people can see the pharmacist for all of their glory. What a wonderful profession we are. We're across every bodily area, every system, all the medications, everything we need to help a person. I call us “specialist generalists.” We're not in detail, granular about every single thing, but we have a broad area. How many professions can you ask a question about headaches, or about diabetes, or about weight-loss, and you actually will get a very decent answer and some sort of recommendation? Obviously a doctor can do that, but I'm talking in the sense of an allied health professional that's really accessible for people. We really undervalue ourselves, I think, as a profession. In Australia more so, I'm probably leaning on that reflection, but I think we are such a great profession.

I have the hope that we see pharmacists valuing themselves more and then adding more strings to their bow, so that we can shine in the key pillar of the health profession. We're not just the white-coat person behind the counter labeling the boxes. We actually come out, we speak to people, and we can do a lot more for you. I hope that people find different parts of their areas that can add together. Can you add exercise? Can you become a physiotherapist and a pharmacist? I have friends who have done that. That's amazing, because as a physiotherapist, you're recommending anti-inflammatories and medication, and you understand more about that. Don't be afraid to add things in that might seem a bit strange, but also, as a pharmacist itself, you don't need anything else, really. You can offer so much to people as a profession.

READ MORE: Q&A: Nutritional Pharmacist's Perspective on New Year Dieting Trends

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