Chemists should tell shoppers to lose weight, cut their alcohol intake and quit other unhealthy habits, new NHS guidance says.
The guidance from the National Institute of Health and Care Excellence says pharmacists should have a much stronger role in getting the nation in shape.
Pharmacists are being told to start conversations with shoppers about topics like weight loss when they pick up their prescriptions, or buy over the counter products.
Health officials say trips to the local chemist are a good time to remind people of the need to overhaul their lifestyles.
Two in three adults are overweight or obese, with Britain’s obesity rates the highest in Western Europe.
But critics said nanny state interventions could offend many shoppers, deterring some from collecting prescriptions or undergoing medical checks.
The Nice guidance states: “Community pharmacy teams can engage with people who regularly buy over-the-counter medicines, collect prescriptions or ask for advice.
They can use the opportunity to start a more general conversation about health and wellbeing … offer support with adopting a healthier lifestyle, including stopping smoking, reducing alcohol consumption and managing weight.”
While suggesting such conversations would happen openly on the shop floor, the NHS advice says pharmacies should also have “areas that offer privacy” for customers who want to discuss matters in more detail.
Chemists will also be encouraged to refer shoppers to GPs or other health services that could help.
Christopher Snowdon, head of lifestyle economics at the Institute of Economic Affairs think-tank, said: “Nice seems to think that GPs and pharmacists have nothing better to do than deliver banal health lectures to the public.
“I suspect the majority of customers would feel as offended by a pharmacist commenting on their drinking habits and body weight as they would if it came from any other shopkeeper.”
Tam Fry, from the National Obesity Forum, said the idea was promising.
He said: “Popping into the local chemist and having a chat about health issues is, for a lot of people, hugely less threatening than a formal appointment with 'the doctor'.
“A lot of people are conscious about their weight, but if they they have a friendly association with their pharmacist and the right language is used, it could be a step in the right direction.
"Some people may object, but a lot of people will also welcome being offered help, as long as it is done in private."
But polling of more than 1,000 GPs found one in three had seen patients take offence when they had raised the issue of their weight.
Professor Gillian Leng, deputy chief executive of Nice said: “Community pharmacists engage every day with people who buy over-the-counter medicines, collect prescriptions or ask for advice.
“This is a vital opportunity to support people to maintain good health but also signpost them to other health services.”
Record numbers are being treated on the NHS for obesity-related conditions, with cases rising by almost one quarter in just a year.
Latest figures show the number of hospital episodes linked to excess weight has tipped 1 million for the first time, with spiralling cases among toddlers and young children.
The statistics for England show that in 2018-19, there were almost 1.1 million hospital episodes involving a diagnosis of obesity – up from 884,000 the year before.
The burden has doubled in just five years, with 442,000 such cases in 2013/14, the figures show.
Primary care minister Jo Churchill said: "Highly-skilled community pharmacists are an integral and trusted part of the NHS and we want every patient with a minor illness, or those seeking wellbeing guidance, to think 'Pharmacy First'.
"As the health service treats more patients than ever before, it is paramount that, where appropriate, patients can be assessed close to home, saving unnecessary trips to A&E or their GP and helping them get the care they need quicker."
Keith Ridge, chief pharmaceutical officer for the NHS, said: "The NHS is making care more easily and conveniently available on the high street, with pharmacists offering more expert services than ever before."
"Pharmacists are already playing a bigger clinical role in the NHS through providing advice and treatment to people with minor illnesses, as well as increasingly being able to advise on killer conditions like heart problems and helping to tackle antibiotic resistance."