OSCE Toolbox | Weight Loss Counselling 1 - Scenario

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By Femi Lana • May 26, 2026 • Last reviewed: 2025-12-13 •

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Summary Expert

In this scenario, you are a pharmacist working in the community. You are tasked with counselling a patient who has come in to discuss options for weight-loss support. The student must provide appropriate advice, answering any questions they have.

Please ensure that this scenario and mark scheme align with the most up-to-date guidelines from the UK NICE and the BNF when using it for your OSCE assessment.

You will need a student pharmacist and an actor for this OSCE station.

Revision Topics

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Student Instructions

Actor Instructions

This may reveal scenario objectives!

You are Hana Patel (HAH-nuh Puh-TELL)

Opening Statement:

“Hi… I’ve been struggling with my weight for a really long time, and I was hoping you could tell me more about this Mounjaro® injection I’ve been hearing about.”

Name: Hana Patel
Age: 44
Address: 14 Rosewood Crescent

Main concerns:
- “I’ve been overweight for most of my adult life, but the last five or six years have been the worst.”
- “I’ve tried so many different diets and programmes, but I can never stick to them properly. It’s hard when you’re juggling work, kids, and everything at home… there’s just no time to meal plan and exercise.”
- “My friend at work started one of those weight-loss injections and she’s lost loads of weight. It made me wonder if something like that could help me too, because I just can’t keep doing this on my own.”
- “My weight has always been around 95kg but over the last few years I’ve crept up to 98kg - when I last checked my BMI was 37.”

Symptoms:

“I’m starting to feel really low about it. I look in the mirror and just feel fed up.”
“It’s embarrassing… I avoid photos now. I don’t feel like myself.”
“I get out of breath very easily, I have to take a break walking up the stairs.”
“My knees and lower back hurt when I stand for a long time.”

If the student asks:
- “I haven’t had sudden unexplained weight gain.”
- “No fainting or dizziness.”
- “No bowel habit changes.”
- “I don’t binge eat.”
- “I’m not pregnant.”
- “No history of eating disorders.”
- “No skin changes”

Past Medical History:

“I was diagnosed with high blood pressure 1 year ago. It’s under better control.”
“My GP said I have pre-diabetes.”

Medication History: “I take a 10mg amlodipine tablet every morning"
Allergies: “I don't have any.”

Lifestyle Factors/Social History:
- “I have two kids - 12 and 9 - and mornings are chaos. I usually skip breakfast because I’m rushing to get them ready.”
- “I work full-time in a call centre so I’m sitting down all day, I rarely ever do any exercise.”
- Diet:
  - “At lunch I just grab something quick and convenient… usually a sandwich, crisps, maybe a chocolate bar.”
  - “In the evenings, I’m exhausted after work and the school run. We end up having takeaway at least two or three times a week.”
  - “I snack at night because that’s when I finally relax. Crisps, biscuits… anything, really.”
- “I don’t drink alcohol.”
- “I’ve never smoked.”

Questions to ask:

My friend takes Mounjaro®… how does it work?
Would that be something I’d be able to take?
How long would I need to take it for?

Mark Scheme

Introduction

0 / 2

Introduces self as the pharmacist with an appropriate greeting

+1

Confirms patient details: Name, age

+1

Answer Q1: My friend takes Mounjaro®.… how does it work?

0 / 3

Student confidently explains the mechanism of action at a level understandable for patients:

Explain that Mounjaro® is a brand name for a medication called tirzepatide and is a once-weekly injectable medication.

+1

It acts on two natural hormones (GIP and GLP-1) that help regulate appetite, slow stomach emptying, increasing fullness and reducing cravings

+1

This helps people eat less and feel satisfied sooner

+1

Answer Q2: Would that be something I’d be able to take?

0 / 4

Explains that patients must meet eligibility criteria in order to start weight loss medication, and the criteria changes depending on the medication

+1

Eligibility criteria take into account BMI and comorbidities such as diabetes and HTN.

The patient would need to have their height and weight measured to calculate their BMI

+1

Before being eligible the patient will need to have engaged with both dietary and activity changes

+1

Explain that it must be prescribed by a GP or specialist weight-management service/clinic

+1

Answer Q3: How long would I need to take it for?

0 / 4

Explains that treatment starts with a dose-escalation schedule, where the dose is increased gradually over several weeks to help reduce side effects

+1

Explains that once the patient has reached their highest tolerated dose, their progress is reviewed at 6 months

+1

States that the patient is expected to have lost at least 5% of their starting body weight after 6 months on their maintenance dose

+1

Explains that if less than 5% weight loss is achieved, a decision must be made about whether to continue treatment or trial a different medication, based on the benefit/risk profile in the individual patient

+1

Management

0 / 4

Provides patient with appropriate lifestyle advise:

Advises on eating a balanced diet and using the Eatwell Guide.

+1

Advises on exercise e.g. reaching 150 minutes of moderate exercise a week or 75 minutes a week of vigorous exercise and suggests examples of how to reach this e.g. walking during lunch breaks.

+1

Offers appropriate health referrals:

Encourages patient to engage in local NHS weight management services

+1

Excellent students may refer the patient to the NHS Digital Weight Management Programme

Refer patient to GP to discuss concerns and co-existing symptoms to rule out alternative cause

+1

Due to low mood, knee and back pain and tiredness

Communication

0 / 6

Use appropriate language for the person and situation.

+1

Demonstrates empathy

+1

Ensure the patient understanding and signposts to further resources (e.g. NHS website or BNF)

+1

Signposts and refers patients to relevant resources e.g. NHS website

+1

Concludes the conversation well by asking if there are any further questions

+1

The student did not say anything that could harm the patient

+1

This includes but is not limited to, providing incorrect information or medication, misdiagnosing conditions, neglecting to inquire about allergies, making incorrect referrals, or failing to act on red-flag symptoms.

Time Management

0 / 1

Completed the scenario in time and achieved 70% of marks

+1

Referral Criteria

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