Pharmacy diet plans

A growing number of pharmacies are getting into the weight-loss business, but how do these diet plans weigh up?
 
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  • Updated:20 Jan 2009
 

01 .Introduction

Diet plan

In brief

Pharmacy diet plans may help to shed extra kilos quickly, but most fail to deal effectively with the complex broader issues around weight loss.  

CHOICE cannot recommend these programs until consultants improve their training and move beyond the “one-size-fits-all” approach.

Australia has a seriously escalating obesity problem. In the past 20 years the number of people who have a weight problem has doubled; about 60% of Australian adults are overweight or obese, and we’re on track to reach 70% by 2010.

What everyone is looking for is a quick, easy, personalised and private solution – which is why pharmacy-based diet programs appeal:

  • There’s no fronting up for group counselling or public weigh-ins.
  • Most use meal replacements which sound like an easy calorie-counting-free option.
  • Some claim you can lose weight effortlessly in weeks – not months or years.

Our findings confirm these diet plans, if followed closely, will certainly shed the kilos in record time, but are they safe and are customers properly assessed and monitored by the pharmacies? Do these fast-track diet plans address the real issues at the root of the weight problem?  And is it the pharmacies themselves who end up profiting the most?

Please note: this information was current as of January 2009 but is still a useful guide to today's market.


CHOICE investigation

To anonymously assess these programs CHOICE sent three overweight people to a selection of pharmacies offering seven different diet programs, and asked a panel of experts to assess our findings.

All the pharmacy plans involve a weekly visit to your pharmacy consultant and a diet that restricts carbohydrates to some extent. All except Ultra Lite use meal replacements to keep your intake in check. The basics of each program are shown in the table.

Programs we looked at:

  • 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

Can meal replacements be useful?

Doctors and dietitians sometimes use meal replacements 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. Meal replacements are also commonly used before weight-loss surgery, such as gastric banding. They’re most likely to be effective when there’s close medical supervision and effective counselling on long-term diet, lifestyle, behavioural and psychological issues. And this is the critical area where our CHOICE shadow shop found the pharmacy-based meal replacement programs fall short.

 
 

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  Features Consultants' training
Program (in alphabetical order) Meal replacements? Meets Australian meal replacement standard Claimed weight-loss/average time on program Initial Ongoing
AlphaSlim Pharmacy Weight Loss (A)
www.alphaslim.com.au
Two per day, plus a main meal at night and fruit for snacks. A "free day" is introduced after four weeks.
Yes (C)
0.5kg to 1kg per week/until weight lost
Three hours
"As scheduled or required"
Betty Baxter Complete Weight Management
www.bettybaxter.com.au
Two per day, plus a main meal at night and snacks.
Yes
Maximum 1kg per week/six to eight weeks (at a time)
Four hours
Nine to 16 hours per year
Dr Tim's Success
www.drtimssuccess.com.au
Two per day, plus a main meal at night (fruit for snacks after two weeks).
Yes
Up to 6kg (women), 9kg (men) over four week/12 weeks
Three hours
Within first few months, four to six hours; two-hour refresher training available Online training is also available "at any time"
Kate Morgan Weight Loss
www.katemorgan.com.au
Two per day, plus a main meal at night and fruit for snacks.
Yes (D)
1kg per week/12 to 16 weeks
Six hours
No structured program; "experienced staff require little ongoing training"
MediTrim (B)
www.meditrim.com.au
Three per day initially, then two per day plus a main meal at night and fruit/nuts for snacks.
No (E)
1kg to 2kg per week; time on program not known.
Two Days
Not known
Tony Ferguson WeightLoss
www.tonyferguson.com.au
Two per day, plus a main meal at night and fruit for snacks.
Yes
No claims on weight loss/five weeks (at a time)
Two Days
Four-hour training on maintencance diet;advanced/master practitioner training from 2009. An additional 2 days for the Progress program.
Ultra Lite Weight Management
www.ultralite.com.au
None. Based on counting and limiting carbohydrate content using ordinary foods.
na
10kg/five-week program; 15kg to 20kg/10 week program
Two Days
Recommend refresher training once per year.
Xndo Weight Control System
www.xndo.com.au
Two per day, plus a main meal at night and fruit for snacks. There is also a non-meal replacement option.
No (E)
0.5kg to 1kg per week/until weight lost
Two Days
"Regular advanced training courses"
 


  Costs
Program (in alphabetical order) Membership, diet plan/diary ($) Ongoing meal replacements per week ($) Supplements to buy?
AlphaSlim Pharmacy Weight Loss (A)
www.alphaslim.com.au
29.90 43.28
Optional multivitamin; fibre supplement; flaxseed/olive/grapeseed oil; chromium supplement
Betty Baxter Complete Weight Management
www.bettybaxter.com.au
25.90 45.15
Multivitamin; flaxseed oil; chromium supplement
Dr Tim's Success
www.drtimssuccess.com.au
21.00 (F) 45.15 (H)
None (J)
Kate Morgan Weight Loss
www.katemorgan.com.au
24.95 45.50
Multivitamin;fibre supplement; chromium supplement
MediTrim (B)
www.meditrim.com.au
25.00 42.00
MediTrim multivitamin ($24.95/60 tablets); MediTrim Fibre complex ($27.50/500g); MediTrim Balance ($28.50/60 tablets); MediTrim Fat Burner ($34.95/60 tablets); MediTrim Appetite reduce ($34.99/60 tablets); flaxseed oil; apple cider vinegar
Tony Ferguson WeightLoss
www.tonyferguson.com.au
24.95 45.50
Tony Ferguson branded Simply balanced (multivitamin; $26.95/60 tablets), Simply fibre ($18.40/280g), Simply chromium ($13.80/60 tablets)
Ultra Lite Weight Management
www.ultralite.com.au
395.00 (G) na (G)
Flaxseed oil, apple cider vinegar, urine test strips and potassium supplement (K)
Xndo Weight Control System
www.xndo.com.au
19.95 41.86
Xndo branded low joule "snack water" ($15.99 - 16.99/10); low-joule coffee sachets ($18.99/10); lemon tea booster 33 (tea with vitamins and minerals, $39.99 for 30); Xndo Block & Burn ($14.99/week, 15 tablets)
 

Table notes

(A) All information from AlphaSlim. AlphaSlim’s program details were not made available to us in time to include them in the shadow shop.
(B) All information from MediTrim website and shadow shop – company did not return our survey (but did confirm the data we collected as correct).
(C) Shakes meet standard; soups are low in phosphorus.
(D) Kate Morgan evening meals are not meal replacements.
(E) The company does not specifically claim their products are meal replacements. However, they are used to replace meals.
(F) The starter pack is $66 and includes the first week’s shakes, worth $45.
(G) For the five-week program, includes first and then weekly consultations, manual and recipe book, enough vitamin-drink sachets for four sachets per day. Depending on the pharmacy, this cost may or may not include flaxseed oil, apple cider vinegar, urine test strips and a potassium supplement ($47.95 if bought separately); 10-week program is also available.
(H) One shadow shopper was told her weekly visits would cost $5 each, even though the company says they should be free.
(J) No additional supplements are required, according to the company’s information; however, one shadow shopper was sold extra herbal and vitamin supplements in the pharmacy.
(K) These may be included in the program price at some pharmacies. Vitamin-drink sachets are included in the cost.

Are the diets nutritionally OK?

Most programs rely on limiting carbohydrates and restricting kilojoules to put the dieter into a state of ketosis. However, our experts have several issues with the nutrition profiles of the diets.

  • Most are around 4000kJ per day in the main weight-loss stage. Only AlphaSlim, Betty Baxter and Kate Morgan come close to 5000kJ per day, which is regarded as the minimum to get all your necessary micronutrients. At less than 5000kJ – even with added supplements – levels of other nutrients and beneficial food chemicals such as phytochemicals can be compromised. Decreases in metabolic rate are also a risk, as the body tries to protect itself against starvation. Since we assessed the diets, Tony Ferguson has changed its program to include an option which increases the energy to 5000kJ per day and contains more carbohydrates.
  • Some of the programs contain about 100 grams of carbohydrates per day; several contain much less. Too little will result in ketosis and can also risk the loss of muscle rather than fat. Although in some cases eating sufficient protein can help protect muscle, it’s a fine balancing act as too much protein can also cause problems.
  • All the diets fall short on fibre in the weight-loss phase (except Betty Baxter which adds it to the meal replacements). Some are low even when a fibre supplement is included – too little fibre can cause constipation.
  • To keep the carbohydrates low, some programs 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.
  • MediTrim and Xndo replace meals with drinks that don’t meet the Australian standard for meal replacements, but both are careful not to call their drinks meal replacements.
  • The only program to get the nutritional thumbs-up from our experts is 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.

The big upsell

Apart from the cost of the program and meal replacements where they’re used, most programs also include supplements which add to the pharmacy’s bottom line. Multivitamins

  • Multivitamin and mineral supplement. Most programs recommend these, which the pharmacy conveniently sells (program-branded or otherwise). Only Dr Tim’s Success doesn’t require you to buy any additional supplements to meet vitamin and mineral needs and even makes a point of this in its marketing. However, one of our shadow shoppers was sold three pharmacy-packaged vitamin and herbal supplements as part of their Dr Tim’s Success starter kit.
  • The fact so much of the nutritional intake is from supplements or vitamins added to the meal replacements concerned our panel. Real food is the best way to get vitamins and minerals – there is still much not known about the other important components of real food, and taking more of some nutrients than you might need in the form of multiple supplements is not ideal. Diet pills
  • Diet pills. The most popular diet pill-type supplement with most programs is chromium, which is supposed to reduce sugar cravings. But our experts say the evidence for this is far from convincing.
  • Fibre supplements are another popular upsell – either program-branded or not – and they’re available from the pharmacy. According to the experts and our analysis of the diets, you’re likely to need them.
  • The fibre levels of all programs, except Betty Baxter, are too low and constipation is a real possibility.
  • Flaxseed oil. Our experts questioned why several programs suggest daily flaxseed oil as a way of getting sufficient omega-3 fats. Flaxseed oil
  • Flaxseed oil goes rancid very quickly and can have a most unfavourable fat profile. Other more stable oils, such as olive oil, would be better, along with advice to eat fish at some evening meals.
  • Other extras. Xndo had the most extras on offer – instant coffee, soft drink and cordial at $1.60 per serve, which is an expensive way to buy “diet” soft drink and cordial.  

 

 

What is ketosis?

When your body doesn’t get enough carbohydrates, it produces ketones from body fat, which it burns instead of carbohydrates to produce energy. Some people experience ketosis when they eat fewer than 100g of carbohydrates a day; once carbohydrates are at 50g most people will experience it.

Some organs of your body, such as the brain and red blood cells, need glucose for energy, and if you don’t eat enough carbohydrates to supply them, your body will break down protein – from your muscles if you’re not eating enough protein – as an energy source for these organs.

What are the benefits?

Quick initial weight loss (mainly due to fluid loss) may increase your motivation. Some people claim the fluid loss also reduces feelings of bloating. Ketosis can also help make you feel less hungry.

And the downsides?

Some undesirable side-effects are mild dehydration, poor athletic performance, nausea, bad breath, risk of blood pressure problems, an increased risk of osteoporosis and muscle and blood vessel damage. It may also make concentrating on mental tasks more difficult.

Meet the experts

 

 

 

 

 

 

 

 

 

CHOICE verdict

These programs are of obvious financial benefit to the pharmacies, and a constant stream of short-term clients will shift a lot of product off the shelves. Will you lose weight? If you follow them closely, yes. Will the pharmacy setting provide you with your own highly skilled weight-loss advisor? Our experts think not.

Considering the inadequate training of consultants, little ability to tailor programs and deal with individual circumstances and habits, as well as the lack of close, qualified supervision, CHOICE does not recommend these programs. The current regulations and voluntary codes of practice covering weight-loss programs are insufficient. CHOICE wants to see a national accreditation system, including minimum standards for training, covering all programs, consultants and leaders who counsel people on losing weight.

A private consultation?

The least you might expect on your first visit is for your consultation and weigh-in to take place in a private area away from other shoppers. But in five of our 20 consultations, privacy was not considered.

  • One MediTrim consultant used an open area near the pharmacist.
  • One Xndo consultation took place behind a screen next to shelves where shoppers were browsing.
  • One Dr Tim’s Success consultant interviewed our shadow shopper at the pharmacy counter where other people were being served.
  • On average, the first consultation was 40 minutes, however they ranged from a fairly brief 20 minutes for Dr Tim’s Success to about 80 minutes for Ultra Lite. Most pharmacies gave our shoppers the name of a person to keep in touch with and return to for weigh-ins, and suggested weekly follow-up visits.

Weighed and measured

Most consultations involved their weight being measured, and about three-quarters checked waist circumference, which is useful for getting an overall picture and measuring improvements. Some programs used bio-impedance scales (which send an electrical current through the body to measure the resistance of the body tissues to assess body fat).

Our panel thought these assessment methods were generally good, however they were concerned about the limited training consultants received in order to correctly interpret them.

Who will they accept?

Our experts agreed all the program consultants asked our shadow shoppers enough about their health to cover themselves but, at too many pharmacies, little more. Our shadow shoppers were asked about current medical conditions, such as diabetes or high blood pressure, and any medications they were taking.

The majority of consultants didn’t assess family medical history, current exercise levels, usual diet and lifestyle, alcohol intake and previous weight loss methods. No program asked our shadow shoppers all of these important background questions, although Xndo did best, covering more of these issues than the other programs.

But some (Kate Morgan, Betty Baxter and two Tony Ferguson consultants) didn’t ask anything more than the basics. Most claim to screen for people with known risk factors. Those with diabetes must get their GP’s agreement, for example. However, this is no guarantee of their doctor’s ongoing input.

Most programs rightfully said they wouldn’t accept pregnant or breastfeeding women (some would only if their GP recommended it), but Tony Ferguson and Ultra Lite accept some children. Our experts described this as “disgraceful and irresponsible”, as they consider these diet strategies inappropriate for children.

Do you have to be overweight?

The experts are concerned that people who are not overweight are eligible to go on most of the diets. Of the programs that told us about their practices, only Betty Baxter and Dr Tim’s Success excluded people of normal, healthy weight from participating.

Betty Baxter allows people with a normal body mass index (BMI) to join only if they have other measures that suggest they need to lose weight, such as high body fat or waist measurement. Dr Tim’s Success is the only program limited to people who are overweight or obese.

Our "highly trained" consultants

Despite claims such as "dedicated support staff” and “trained pharmacy consultants", four of the programs provide pharmacy consultants with just three to six hours’ basic training. Of the remainder, MediTrim, Tony Ferguson, Ultra Lite and Xndo offer two-day basic training, while only Dr Tim’s Success, Tony Ferguson, Ultra Lite and Xndo and told us they require consultants to pass a test, which our experts supported.

Ongoing training is also variable, ranging from none to an additional 16 hours per year. Only three companies volunteered details of what their training covered and in all cases some of the precious time covered “marketing techniques”, “selling tips” or “overcoming objections”.

Our experts regard the level of training as grossly inadequate to deal effectively with the complex issues surrounding weight loss.

Behavioural counselling – helping people understand why they eat as they do and how to help them make permanent changes – was largely overlooked in the programs’ simplified, one-size-fits-all solutions.


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