Consumers warned about over-the-counter pharmacy diets

Feb 8 2009

Pharmacies across Australia are offering a range of over-the-counter diet plans designed to encourage people to invest in weight loss programs.

Australia, along with other developed countries such as the UK and the U.S. is struggling to come to terms with a burgeoning population of overweight and obese adults and children - in the last two decades the number of people with a weight problem has doubled and as many as 60% of Australian adults are overweight or obese.

While these over-the-counter diet products have the appeal of offering a seemingly simple quick fix for many individuals, experts have been concerned for some time about weight loss programs being sold in chemists where staff often have little training and are not qualified to assess health factors which could impact on weight loss.

The consumer watchdog Choice was aware of the growing concern about over-the-counter weight loss plans and conducted a survey of seven different diet programmes sold over-the-counter at pharmacies.

Choice say they found many staff had received minimal training and were shocked to find some programs had included children.

Choice sent three overweight shoppers to 21 pharmacies who sell diet programmes and then asked a panel of experts assess the findings.

The experts, Dr. Rosemary Stanton, Associate Professor David Cameron-Smith and dieticians Susie Burrell, Melanie McGrice, Matt O'Neill say there are several issues with the nutrition profiles of the diets and even with added supplements - levels of other nutrients and beneficial food chemicals such as phytochemicals can be compromised.

They say decreases in metabolic rate are also a risk, as the body tries to protect itself against starvation and some of the plans allow too few carbohydrates which can result in the loss of muscle rather than fat and all fall short on fibre in the weight-loss phase - too little fibre can cause constipation.

To keep the carbohydrates low, some programmes either ban or severely limit cereal foods, including wholegrains, which are proven to have long-term health benefits, such as reducing the risk of some cancers and heart disease.

It was also found that some meal replacement drinks fail to meet the Australian standard for meal replacements and the only program to get the nutritional thumbs-up from the experts was Betty Baxter, which has a reasonable amount of kilojoules, enough carbohydrates to keep ketosis in check and allows low-GI wholegrain carbs even in the early stages.

It was revealed that most 'consultants' did not ask customers about food and lifestyle choices, family medical history and exercise levels and half of the over-the-counter diet programme consultants had only undergone a few hours of basic training.

Choice describes this as "grossly inadequate" and says two programmes were "disgraceful and irresponsible" for allowing some children to take part.

Choice is now calling for a national accreditation scheme, which includes a standardised training program for weight loss consultants.

Choice spokesman Christopher Zinn says consumers are being sold a "one-size-fits-all" solution, and which is highly questionable.

The Pharmacy Guild has defended the sale of diet plans in pharmacies and president Kos Sclavos says the programs do work if patients stick to the programmes as they are outlined.

But this is not the issue and Choice says it is not a case of whether the products as a calorie restricted diet work, but rather if they stop taking them, will they gain weight again.

Choice says most fail to deal effectively with the complex broader issues around weight loss and no group counselling or public weigh-ins are included and most use meal replacements which sound like an easy calorie-counting-free option.

Some claim you can lose weight effortlessly in weeks rather than months or years but Choice says such fast-track diets fail to address the real issues at the root of the weight problem and questions who ends up profiting the most.

All the pharmacy plans involved a weekly visit to the pharmacy 'consultant' and a diet that to some extent restricted carbohydrates.

The diet programmes looked at were:

• AlphaSlim Pharmacy Weight Loss
• Betty Baxter Complete Weight Management
• Dr. Tim's Success
• Kate Morgan Weight Loss
• MediTrim
• Tony Ferguson Weight Loss
• Ultra Lite Weight Management
• Xndo Weight Control System

All except Ultra Lite use meal replacements to keep intake in check but while this approach is sometimes used by doctors and dieticians in hospitals and clinics to treat obese and very obese people, whose health is seriously at risk, these people usually have health problems, such as heart disease or high-blood pressure, and have failed to lose weight using other approaches.

Choice says meal replacements are also often used before weight-loss surgery, such as gastric banding and are most likely to be effective under close medical supervision and along with effective counselling on long-term diet, lifestyle, behavioural and psychological issues.

Choice says this is the critical area where pharmacy-based meal replacement programmes fall short and in view of the inadequate training of consultants, little ability to tailor programmes and deal with individual circumstances and habits, as well as the lack of close, qualified supervision, they cannot recommend these programmes.

Choice says the current regulations and voluntary codes of practice covering weight-loss programmes are insufficient and a national accreditation system is called for, including minimum standards for training, covering all programmes, consultants and those who counsel people on losing weight.