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Weight loss programs (pharmacy) - what to ask before you buy

If you're thinking of joining a pharmacy based weight loss program, but you're not sure what to ask before you sign up, here are some questions to ask to help you decide if it's really worth the money.

Click on a question below for more information.

Need: Do I need a pharmacy weight loss program?
Cost: What will the pharmacy weight loss program cost?
Program: How does the pharmacy weight loss program work?
Exercise: Does the weight loss program include exercise?
Health: Are the weight loss program meal substitutes healthy?
Fresh food: Does the pharmacy weight loss program include plenty of fresh fruit and vegetables?
Fibre: Does the pharmacy weight loss program include plenty of fibre?
Support: What kind of support is available while you're on the pharmacy weight loss program?
Assessment: How do they conduct the initial assessment for entry into the pharmacy weight loss program?
Alternatives: What alternatives are there to pharmacy weight loss programs?

1. Do I need a pharmacy weight loss program?

The first aim of pharmacy weight loss programs is to make money for the pharmacy. Do you want to contribute regularly to the profitability of the pharmacy?

If you are not overweight or obese you probably don't need to join a pharmacy weight loss program.
If you are overweight or obese, it is recommended that you check with your health professional before joining any weight loss program, especially if you suffer from any medical conditions or chronic illness.

Note: The February 2009 issue of Choice Magazine states that "the current regulations and voluntary codes of practice covering weight-loss programs are insufficient." Choice Magazine does not recommend any of the weight loss programs it investigated.

2. What will the pharmacy weight loss program cost?

Find out the full cost over time, which may include any or all of the following:

Joining fee
Meal replacements (smoothies, soups etc.)
Drink replacements (these can be quite expensive, especially compared to drinking plain water)
Nutritional supplements (vitamins and minerals) that you will need because you may not consume sufficient fresh food to obtain these naturally while using meal replacements..
Fibre (either as powder or tablets), as you may not be taking in enough fibre and will need to supplement this to avoid constipation
Flaxseed oil which is expensive and must be kept in the correct conditions to retain its food value - light and heat will destroy many of its suggested benefits.
Fresh food which you will still have to purchase for the meals that are not 'meal substitutes'.
Diet pills to reduce food cravings.

3. How does the pharmacy weight loss program work?

Find out what the program aims to do.

If it is based on reducing carbohydrates, this must be carefully monitored. Reducing carbohydrates too much can cause ketosis, where the body tends to burn muscle because it doesn't have the carbohydrates. Also, reducing carbohydrates quite often means not having the good carbohydrates that are in whole foods like wholemeal bread and pastas.
If it is based on reducing kilojoules (the metric version of calories) this should also be carefully monitored because reducing kilojoules too much will slow your metabolism and cause your body to store fat in the belief that you are in a famine and may starve if it doesn't do something.
If the meal substitutes contain high levels of fructose, avoid them. Fructose is a type of sugar (ordinary household sugar and honey are about half fructose and half sucrose). However, fructose is associated with weight gain, increased fat in the blood, and even has negative effects on your thinking processes. If you are desperate for something to sweeten your food, glucose (dextrose) can be substituted, but its kilojoules will still count.

4. Does the weight loss program include exercise?

Regular exercise is associated with a lot of positive effects (physically and mentally) with or without a program.

However, exercise is not a short cut to losing weight.

Obviously, if you burn more kilojoules than you consume, you will lose weight. But if you drink a can of soft drink, for example, you'd need to ride a bicycle 8 kms to work off those kilojoules - or run 6 kms to burn off a takeaway burger. A lot of people would find it easier not to consume the calories in the first place than to 'exercise' them off.

Also, think about this. Let's say your body uses around 600 kJ an hour doing nothing, just staying alive. If, instead of doing nothing, you do an hour of exercise and burn 1000 kJ, that amount includes the energy you burn to stay alive. So the 1000 kJ your burn for that hour is actually only a net gain of 400 kJ.

If you have any questions about your health or fitness to use a treadmill or any other piece of fitness equipment, check with your doctor or health professional first - preferably before you join a program.
It is strongly recommended that you get medical advice if you've been previously inactive, have heart disease, have close relatives with heart disease, or have any other major health problems. Strenuous activity during pregnancy should be avoided unless you have strict medical supervision.

5. Are the weight loss program meal substitutes healthy?

Weight loss meal substitutes may be expensive, but they are not healthy, whole, natural food and they are also likely to be more than half sugar.

When mixed with water, they are likely to still contain five teaspoons of sugar per serve.

The only reason the manufacturers can call their smoothies 'low GI' is by using 'fructose' instead of ordinary sugar (because fructose doesn't cause a spike in your insulin levels). But fructose is still sugar, and when added to food it's still bad for you and it will still make you fat.

Note: Fructose consumed as part of whole fruit (not just juice) doesn't appear to cause the problems caused by refined fructose added to foods. Two to three pieces of fruit a day will provide the small amount of fructose required for your body's metabolic processing.

In America, diabetics are advised not to consume fructose.

Furthermore, recent research indicates that there is a direct link between consuming fructose and 'impaired cognitive function' - in other words, fructose is bad for your brain.

Research consistently shows that fructose makes you fat, and by increasing the fat circulating in your bloodstream, it increases your risk of heart disease and encourages diabetes.

One of the problems with fructose is that it bypasses your body's food regulating system which normally tells you when you've had enough. You can just keep eating it and getting fatter and your body won't stop you.

If you want to know more about fructose before you pay good money for something that is not good for your health, you owe it to yourself to read the article Weight loss shakes do a fat lot of good.

6. Does the pharmacy weight loss program include plenty of fresh fruit and vegetables?

Remember that replacing the 'fast food' in your current diet with something healthier (in terms of less refined sugar, less salt, less fat) such as fresh fruit and vegetables, you are likely to lose weight, whether you're on a program or not. Why not just do that instead of paying for 'fake' food? It will be heaps cheaper.

7. Does the pharmacy weight loss program include plenty of fibre?

Whole grain breads and cereals are a great source of fibre. If the weight loss program restricts or eliminates these, you'll need to add the fibre somehow, either through fresh fruit and veges or added fibre in powder or tablet form to avoid constipation. You can avoid having to pay for the meal substitute and the added fibre if you eat more fresh fruit and vegetables instead of the meal substitute.

8. What kind of support is available while you're on the pharmacy weight loss program?

How often must you visit the pharmacy for a weigh-in and/or progress report? Will they try to sell you more products every time you go there? Are you a captive audience once you turn up?
Can you get help online or by phone at any hour of the day or night? If not, what kind of support to they actually offer?
Are their counsellors trained to help you deal with the behavioural or psychological reasons for your weight gain?
How much training has the 'consultant' had - and how much of that training is only about selling the product? Can they answer your health questions - for example, about the effects of fructose on the human body; ketosis; slowed metabolism? You may be better off seeing your health professional or a nutritionist.

9. How do they conduct the initial assessment for entry into the pharmacy weight loss program?

Apart from establishing your current weight, they may also:

Check your Body Mass Index (BMI)
Check your waist measurement
Check your current medications
Check your current medical history (including allergies, heart conditions, diabetes etc.)

Note: You may be providing this information to a person with very little training and no professional obligations. If privacy and/or confidentiality are important to you, you should clarify these issues with the 'consultant' before you start.

If they conduct the interview in the middle of a pharmacy full of shoppers, you may want to think again.

10. What alternatives are there to pharmacy weight loss programs?

The alternatives are too numerous to mention here. There are probably as many 'diets' and 'weight loss programs' as there are overweight people.

However, if you would like to know more about how and why we get fat, there is a great book called 'Sweet Poison - why sugar makes us fat' by David Gillespie (Viking, 2008). It explains clearly why so many people are putting on so much weight and provides some simple ideas for stopping the weight gain cycle. The book provides detailed information about the reasons why we get fat, so that you'll know what to ask before you buy into a diet program.