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Want to try the latest fad diet? Just ask your local pharmacist

Welcome to the tenth and final instalment of The science behind weight loss, a Conversation series in which we separate the myths about dieting from the realities of exercise and nutrition. Here, Dr Rachael…

Too many pharmacists legitimise celebrity-endorsed fad diets and misleading weight-loss products. Ell Brown

Welcome to the tenth and final instalment of The science behind weight loss, a Conversation series in which we separate the myths about dieting from the realities of exercise and nutrition. Here, Dr Rachael Dunlop, Researcher and Communications Officer at the Heart Research Institute, outlines the uncomfortable relationship pharmacists often have with fad diets and weight loss products:

As Australia becomes fatter we’re all looking for that magic bullet diet pill – and the weight loss industry knows this all too well.

So what’s the best way to market your latest weight loss miracle? Why not team up with one of Australia’s most trusted professions, pharmacists, to lend some legitimacy and boost your brand?

Wander into just about any pharmacy and you’ll find at least one type of weight loss product. Options include meal-replacement bars, appetite-control shakes, fat-trapping or dissolving pills, diet coffee and teas, detox kits, magic oral sprays endorsed by Kim Kardashian, onsite counselling and expensive genetic tests.

Kim Kardashian promotes Quick Trim. www.chicagofabulousblog.com

Yet, it’s certainly not rocket science to figure that if you replace a normal meal with a low calorie shake or pill, you will lose weight. In other words if you reduce your caloric intake, you will burn fat stores. Simple, right?

Such is the concept behind most detox diets, which feature heavily in many pharmacies and tend to be marketed after Christmas when we’re all feeling guilty for over indulging.

The Lemon Detox diet is one of the most popular in this range and is sold through many pharmacies. It’s also endorsed by some A-list celebrities including Beyonce Knowles and Mariah Carey as well as some not-so-A-list ones like Tania Zaetta.

The diet involves a strict regime based on a concoction of maple and palm syrup, lemon juice and cayenne pepper washed down with litres of water. Along with other drinks included in the diet, such as a laxative tea and “sea salt water”, these products are supposed to work as a meal replacement.

Even to those of us who aren’t dieticians, it seems pretty obvious you’re going to lose weight if you stick to this regime, but how long can anyone last on such a diet? As the old saying goes, if it looks too good to be true it probably is.

This was the case for the manufacturers of the Lemon Detox Diet, who were caught making unsubstantiated nutritional claims and providing medical advice in their advertising and product information last year.

Beyonce Knowles says she uses the lemon detox diet. Dohkoedi

The NSW Foods Authority issued the manufacturers Pure Natural Health Pty Ltd with two penalty notices, fined them $1320 and placed them on the name and shame list.

But as a spokesperson for Choice observed at the time, ”The fines are not even a slap on a wrist for the company that claims to be selling 12,000 cans of this product a month.“ It retails for close to $90 a pop.

And these actions don’t seem to matter, as you can still find the diet in just about every chemist and health-food store.

If you’re looking for something a bit more “sciencey” and have about $1600 to spare, why not try the new kid on the block, MyGene. Currently being rolled out in pharmacies across Melbourne, this product markets itself with lashings of scientific terminology in its literature, but when you boil it down, it’s really just another meal replacement program with a DNA test at the beginning.

MyGene claims to determine your “weight loss phenotype” by analysing variations in 26 different genes associated with fat and carbohydrate metabolism. The don’t reveal which genes (and don’t specify why not), nor do they provide any evidence that this approach is effective for weight loss.

Although there are plenty of scientific references on their website, none of the papers address the concept that “your genes are making you fat”. And they don’t cite any published studies examining the success, or otherwise, of diet programs tailored to your genetic profile.

Increased activity and reduced calorie intake is the only weight loss formula that’s proven to work. Andy in NYC

That’s not to say their program doesn’t work – it probably does. It’s a weight management plan, guided by health-care professionals, and includes branded weight-loss shakes, nutritional supplements and physical activity.

It’s interesting to note that MyGene is endorsed by the Pharmacy Guild of Australia and, like several other recent partnerships, this has caused some controversy, especially since the program was branded a gimmick by experts.

This is the same Guild that earned the scorn and outrage of pharmacists and consumers alike for the recent Blackmores supplement up-sell scheme (or Coke-and-fries-gate) which was subsequently dropped like a hot potato.

In a time when obesity is increasing and leading a rise in diabetes and heart disease, it’s important that we are aware of the health implications that our lifestyles bring.

But in the quagmire that is the diet industry, pharmacists would be better served if they offered clear and simple advice on effective ways to lose weight, instead of confusing the issue with celebrity-endorsed products and sophisticated but misleading marketing.

Weight loss is hard enough as it is.

This is the tenth and final part of our series The science behind weight loss. To read the other instalments, follow the links below:

Part One: Diets and weight loss: separating facts from fiction
Part Two: Want to set up a weight loss scam? Here’s how…
Part Three: Feel manipulated? Anxious? Tune out the hype and learn to love your body
Part Four: Food v exercise: What makes the biggest difference in weight loss?
Part Five: An online tool to help achieve your weight-loss goal (no, it’s not a fad diet)
Part Six: Ignore the hype, real women don’t ‘bounce back’ to their pre-pregnant shape
Part Seven: Quick and easy, or painful and risky? The truth about liposuction
Part Eight: Weight loss and the brain: why it’s difficult to control our expanding waist lines
Part Nine: Are diet pills the silver bullet for obesity?

Join the conversation

44 Comments sorted by

  1. Guy Hibbins

    Clinical evaluator of therapeutic goods at Monash University

    I think that it is fascinating that people are willing to blame their genes for their obesity when obesity has exploded in the past 30 years whereas the human genome has probably changed less than 0.5% in the past 30,000 years.

    See Neanderthals 'distinct from us' http://news.bbc.co.uk/2/hi/science/nature/7886477.stm

    There are those who confidently assert that obesity runs in families. It does but then obese people tend to have obese pets as well.

    See Heuberger R, Wakshlag J. Characteristics of ageing pets and their owners: dogs v. cats. Br J Nutr. 2011 Oct;106 Suppl 1:S150-3.

    It has been said that even if genetics loads the gun in relation to obesity, it is environment which pulls the trigger, so our genes are not our fate.

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    1. avid health

      fitness expert

      In reply to Guy Hibbins

      Hi Guy.

      Excellent point. It's silly to blame an individuals genetic make for the obesity crisis because as you pointed out, our genome has not changed that much for thousands of years. However, it's important to understand more about 'what's going on behind the scenes' in trying to provide the most appropriate recommendations. So whilst we certainly shouldn't be blaming our genes, we shouldn't be ignoring them either.

      Garry Jennings, CEO of the Baker IDI, wrote an interesting article for the conversation…

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    2. Guy Hibbins

      Clinical evaluator of therapeutic goods at Monash University

      In reply to avid health

      Well no our environment is not our fate, but the food industry spends a lot of money in the hope that people will consume their products.

      I recently read a book by David Kessler, a former head of the US FDA and the former Dean of two leading US medical schools, Yale and UCSF. His book, The End of Overeating, decribes in great detail how food technologists manipulate the fat, sugar and salt contents of food (described in the industry as the Three Points of the Appetite Compass) to unnaturally high…

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    3. avid health

      fitness expert

      In reply to Guy Hibbins

      WOW. That sounds like a far fetched conspiracy theory however with all the pushing and shoving behinds the scenes it would surprise me.

      There was an interesting commentary in the New England Journal of Medicine talking about the USA dietary guidelines and how almost all of the evidence is from observation, small interventions and epidemiology.

      http://www.nejm.org/doi/full/10.1056/NEJMp1107075

      Situation is no better here in Australia.

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    4. Guy Hibbins

      Clinical evaluator of therapeutic goods at Monash University

      In reply to avid health

      Well the US Military report Too Fat to Fight is hardly secret. It was launched with considerable publicity last year.
      You can read it at http://cdn.missionreadiness.org/MR_Too_Fat_to_Fight-1.pdf

      Kessler's book is similarly available on Amazon and has been well reviewed.

      In relation to the dietary guidelines, it is worth noting that the fat content of the diet both here in Australia and in the US is at a much higher level than it was a century ago, and this does have implications for disease…

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    5. avid health

      fitness expert

      In reply to Guy Hibbins

      It's been a long time since the last National Nutrition Survey's (NNS) was conducted. The last one was conduct 15 years ago in 1995-1996 and a lot could have changed since then.

      I'm not disagreeing that a higher level of fat in the diet, particularly trans and saturated fats, have implications for disease patterns however, as pointed out in the paper in the NEJM, often the general recommendation is to decrease fat which is often associated with recommendations or a natural tendency to increase dietary…

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    6. Guy Hibbins

      Clinical evaluator of therapeutic goods at Monash University

      In reply to avid health

      I think that it is quite true that we do not know the current percentage of calories from fat in the Australian diet through an updated national nutrition survey. However, if international experience is any guide, the percentage will have increased not decreased since 1995.

      This would correlate with the size of the snack food aisles in the supermarkets and rise of fast food.

      In relation to the China Study, it was the largest and most ambitious study of its type ever undertaken and it generated…

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  2. Shane Nixon

    logged in via Facebook

    Just a couple of days ago read an article (link below) that reported a study that found that even people carrying a gene linked to obesity can't blame their genes for being fat. They'd only be slightly heavier than people without the gene.

    http://www.abc.net.au/news/2011-11-02/am-fat-genes/3614296

    Also a couple of days ago, I was in my local pharmacy and they had a display at the front of the store with one of those expensive detox diet thingies (around $90 each) and they only had a couple of boxes left. Someone is certainly making a lot of money from that junk.

    Excellent article Dr Rachie.

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  3. Martin Spencer

    PhD student at University of Melbourne

    Hi Dr Rachie!

    The debasement of the business of the pharmacist occurred long ago. Any number of creams and cures for aging were smuggled into the store like the disgraceful contraband that they are. My local pharmacy offers, along side doctor prescribed medications, a whole stock of pseudoscientific trash, a blackmarket of crap that is not just silly but actually dangerous due to their inaction against any illness.

    The selling of false cures and snake oils alongside actual medicine should be banned by the state government. While I would not normally be in favour of state 'protection' of fools against the consequences of their mistaken beliefs (i think that it is much better to rely on free expression and debate than censorious parliamentary decrees) in this case there is an affront to the healthcare responsibilities of the pharmacist.

    -Martin

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  4. Doug Cotton

    IT Manager

    Some of the "arguments" in both the article and the comments are similar to the attempts at debunking the use of nutritional supplements for just about anything from extending life and reducing risk of disease to weight loss, youthful skin etc.

    It is important to remember that there is in fact a wealth of scientific studies supporting numerous benefits of various supplements, including some for weight loss.

    Until about six or seven years back, Swinburne University in Melbourne ran a post graduate…

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    1. Martin Spencer

      PhD student at University of Melbourne

      In reply to Doug Cotton

      Doug, I had a quick look at the products you are talking about and found the reference lists. In the case of the first product there were 5 references, only 2 of which related to the medicinal properties. One was "unpublished analysis" and the second was a poster. In the case of the second product you mention there was a long list of reference to high level and respectable journal papers, however, none that I checked were a reference to any kind of clinical trial, the single requirement for scientific…

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    2. Doug Cotton

      IT Manager

      In reply to Martin Spencer

      Martin, your quick look was far too quick I suggest. For the dual plant extract here is a summary of one trial (not the only one) ...

      In this key human clinical study using these plant species, 60 obese adults were recruited and divided into two groups. One arm of 30 patients functioned as the placebo while a second group of 30 patients received the two plant extracts. Both groups followed a 2,000 calorie-a-day diet and were asked to walk 30 minutes five days a week.(50)

      After eight weeks the…

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    3. Martin Spencer

      PhD student at University of Melbourne

      In reply to Doug Cotton

      Doug, please just provide me with just one reference to one clinical trial. I know the massive amount of text you just copied and pasted is not published because published papers don't tend to include exclamation points after their observations. In fact, exclamation points tend to occur in lying advertising hype.

      The key reference here (reference 50) is to a poster and is of no value at all.

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    4. Doug Cotton

      IT Manager

      In reply to Martin Spencer

      Calorie restriction (CR) is probably the most well-established method for slowing the aging process. Weight loss is an obvious result, but CR is difficult to achieve with humans. See http://www.lef.org/protocols/lifestyle_longevity/caloric_restriction_01.htm?source=search&key=cr%20mimetic%20formula

      Certain nutrients have been shown to mimic CR, the most effective being included in the formula. I quote just one paragraph, for example, and the associated references:

      “Other plant-derived polyphenolic…

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    5. Doug Cotton

      IT Manager

      In reply to Martin Spencer

      If you don't wish to believe that the clinical study referred to and presented at Experimental Biology 2011, Washington, DC. April 10, 2011 actually took place and had the results indicated then that is your prerogative - and maybe one day your life could depend on whether you believe such or not.

      I chose to believe the evidence for antioxidants at the age of 30 and, in more recent times, the evidence for reducing the rate of rapid aging which the vast majority of the population suffers. Microbiologists say we should live to 120 years and clearly most are aging too quickly to reach such an age. But that's another topic.

      So far, at the age of nearly 66 (with a 5 year old son as my sixth child) I believe I made a correct decision and may already owe my life to such.

      Good luck my friend with your skepticism.

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    6. Martin Spencer

      PhD student at University of Melbourne

      In reply to Doug Cotton

      This is getting a bit silly and repetitive isn't it. As an 'IT manager' I thought you might understand the benefits of using links rather than massive copy and paste efforts. I am still waiting for one single reference/link to one clinical trial of either of the two products you are spruiking. Although many of the references above are to the biomolecular effects of certain chemicals none describe any clinical trial.

      Reference 136 shows that the chemical helps yeast. If I were yeast I would be getting pretty excited right now.

      In the hope of getting something valuable you should enter the scientific name of the active ingredient into the journals article database at 'pubmed.org'. Company websites are likely to bog down any genuinly interested person with hype.

      In the hope of making a return to sanity I will now only engage with future discussion around A LINK, to ONE SINGLE, PEER REVIEWED PAPER, describing a CLINICAL TRIAL. Have a nice day.

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    7. Martin Spencer

      PhD student at University of Melbourne

      In reply to Doug Cotton

      If you are desperate and are willing to try anything that anyone says with very flimsy evidence then there are about another million potions out there that you shouldn't risk not taking.

      Many people also recommend prayer, drinking your own urine, ascetic isolation, sacrificing animals, and so on. Can you risk your health by being skeptical of these interesting ideas?

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    8. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Martin Spencer

      There appears to be an awful lot of Gish Galloping going on in this thread. I have to agree with Martin here Doug, you have copy/pasted a lot of text some referring to in vitro studies in cells and animals but no large scale clinical trials.

      Also that last block of text appears to be directly copied from a review. Is this the case? I note by the sequence of numbered references.

      I can Gish Gallop too but it doesn't change the fact that you don't appear to have any clinical evidence for your claims.

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    9. Doug Cotton

      IT Manager

      In reply to Rachael Dunlop

      The trial has been conducted, but is as yet unpublished. Here is more thereon ...

      "Searching for natural interventions that would effectively inhibit fat accumulation (adipogenesis) and enhance fat burning (lipolysis), scientists evaluated more than a thousand plants for evidence that would meet this criteria.

      Two plants whose extracts demonstrated significant biological effects were:

      1.Sphaeranthus indicus flower (S. indicus)
      2.Mangosteen fruit (Garcinia mangostana).

      Control adipocyte cells…

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    10. Doug Cotton

      IT Manager

      In reply to Martin Spencer

      I base my decisions on clinical trials, but in some instances, knowing and trusting the integrity of an organisation such as the Life Extension Foundation founded in 1980, I am prepared to act on as yet unpublished trials which they report in advance. Experience has shown that such trials do all soon get published anyway.

      Yes I do take quite a few supplements as you can read at http://slower-aging.com

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    11. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Doug Cotton

      "Control adipocyte cells not treated with S. indicus display lipid accumulation.

      Adipocyte cells treated with S. indicus inhibited fat accumulation"

      This is not a clinical trial! It's in vitro cell culture studies which whilst useful for elucidating the mechanism of action of a particular compound/drug cannot be extrapolated to whole animals.

      And where are these results? You say they are not published (which BTW technically in science excludes you from saying it has been shown/done in actual fact). You refer to photographs but without us seeing the data we can make no meaningful conclusions from your statements. You refer to cells that were treated but we don't know what concentrations, controls, methodology was used etc

      Without the data, your claims are simply that. Statements.

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    12. Martin Spencer

      PhD student at University of Melbourne

      In reply to Doug Cotton

      It can be comforting to place your faith and trust in an outside force or institution of some kind. But never forget that your critical faculties are there to be used, and sometimes the "Life Extension Foundation" might get it wrong.

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    13. Doug Cotton

      IT Manager

      In reply to Rachael Dunlop

      A clinical study such as described with 60 people and such significant results is good enough for me.

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    14. Doug Cotton

      IT Manager

      In reply to Rachael Dunlop

      Have it your way. It's starting to work well for me already and, perhaps with my life at stake, I was not prepared to wait for some editor to find space. Maybe that's already planned, I don't know. I don't believe the studies are some sort of fabrication that woud not pass peer-review.

      One could say it has been "published" by the Life Extension Foundation, having been endorsed by their Chairman in whom I have the utmost confidence.

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    15. Martin Spencer

      PhD student at University of Melbourne

      In reply to Doug Cotton

      "One could say it has been "published" by the Life Extension Foundation, having been endorsed by their Chairman in whom I have the utmost confidence."

      There comes a point where what someone says begins to be self discrediting. This point has certainly been reached with this last statement.

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    16. Martin Spencer

      PhD student at University of Melbourne

      In reply to Doug Cotton

      While we are on the topic of 'life extension corporation', their own description of their 'achievements' can be found here:
      http://www.lifeextensionfoundation.org/accomplishments_01.htm

      The document has lists many occasions where 'Life Extension' claimed to know something years in advance of the published scientific record. This is actually a massive indictment of the morals of this group. If they knew something then they should publish the data and provide the benefits to all. 'Announcing it' and then selling it as products on their website is the worst kind of behaviour. If the products work, then they have cost the lives of many people who might have benefited from the publication of the research, if the products don't work then they are ripping people off. I happen to think that if the products actually work then this is much worse than if the products don't work, but as i said, both instances are bad.

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    17. avid health

      fitness expert

      In reply to Martin Spencer

      So who's winning this battle against 'wrong' or 'right'? Doug's intentions are in the right place and I'm not sure he deserves the hammering your handing out. I agree though, that the scientific standard of the studies that he is referring to is not that great.

      @Martin Spencer, you said

      "I strongly suggest that these two products are NOT as you say: "based on solid scientific research". If you wish to loose weight and live longer, try making some permanent lifestyle changes like riding to work…

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    18. Doug Cotton

      IT Manager

      In reply to Martin Spencer

      What a wishy-washy argument, Martin - and Rachael. You both have not 1% of the knowledge and experience I have had with the Life Extension Foundation. You didn't even get their name right, Martin - which is important because they are a non-profit organisation, not a "corporation."

      What control are they supposed to have over when a paper gets published?

      One of the points they make is that countless lives are often lost due to long delays in acceptance by the medical profession - even of things like penicillin. Yes, sometimes because of their connections, they publish results of studies which have not yet found space in the journals - but that, in my opinion, can only serve to save lives and improve quality of life for many.

      It's your choice to read, understand and accept the research on natural medicine, some of which has found a place in postgraduate university courses, or to reject same. It's your life.

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    19. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Doug Cotton

      Doug, haha! You accuse us of having a "wishy-washy" argument but you provide "evidence" published on a website which is not even peer reviewed?

      I read a lot of published data on natural medicine. I'm an editor of a journal which publishes such research and participate in the peer review process of such and also write my own articles on Alt. Med.

      "What control are they supposed to have over when a paper gets published?"

      They submit it and wait a couple of months for the outcome. It's part of standard scientific procedure. Not difficult.

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    20. Doug Cotton

      IT Manager

      In reply to Martin Spencer

      Extremely rarely - and if so they are the first to admit it.

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  5. avid health

    fitness expert

    Hi Rachael.

    There is no questioning that there are a lot of fad diets out there and that it's important to have some good science to support the use of such programs in the pharmacy.

    Regarding your closing remarks....

    "But in the quagmire that is the diet industry, pharmacists would be better served if they offered clear and simple advice on effective ways to lose weight, instead of confusing the issue with celebrity-endorsed products and sophisticated but misleading marketing.

    Weight loss is…

    Read more
    1. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to avid health

      Excuse me for answering in text but I'm about to get on a plane...

      "As long as there is no risk of harm and support attached to the program (like the program you mentioned above with dietitians) some of these programs may provide the consumer with the incentive they need to change their lifestyle behaviours"

      "In my opinion, and there is a lot of good research to support this, a multi-component individualised approach will be the most effective, and until we have 'clear' evidence on what is the…

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    2. avid health

      fitness expert

      In reply to Rachael Dunlop

      It's fine Rachael. I don't mind you answering in text.

      I can understand the skepticism in this area because a) obesity is a very exploited area as far as commercial activities are concerned and b) there are many companies offering products and programs and making false and completely unsupported claims (e.g. clinically proven and so on). Actually, the grandfathering of therapeutic goods onto the ARTG have created a significant issue in this area.

      I do agree with your views and opinion on programs…

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    3. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to avid health

      That was kinda my point - that a GP can refer them to someone who is best suited to deal with their problem. Indeed I mentioned this earlier in my response where I said GP/dietitian/personal trainer.

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    4. avid health

      fitness expert

      In reply to Rachael Dunlop

      Hi Rachael.

      I missed that point in your last comment because you suggested "consulting a GP who is better positioned to advise people on the best course of action, whether that be diet, exercise or surgical intervention". There was no mention of a dietitian or exercise physiologist (not sure about personal trainer).

      In my opinion, due to the lack of formal training of some GP's in the areas of diet and physical activity, a GP may do more harm than good. In my opinion and from my own experience…

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    5. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to avid health

      Avid Health,

      In my previous comment I said; "So, whilst there is probably no harm in this component of the programme ...... Wouldn't a person achieve just as much by seeing a GP/dietitian/personal trainer for much less?...".

      I don't think it helps to make generalisations when it comes to the usefulness of GPs with respect to weight loss. What about people who are obese, maybe have Type II diabetes or high blood pressure? Isn't there a place for them to see a GP before they even embark on a weight…

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    6. Doug Cotton

      IT Manager

      In reply to Rachael Dunlop

      Interesting points made by both of you. All I'd like to add is that I suggest that the majority of professionals involved are all contributing in one way or another to helping overcome the obesity epidemic. I don't think it is something that can be handled well within a brief consultation with a pharmacist, but he may put people onto effective medication or other products. He does, after all, have an incentive to sell something.

      My point is that not every member of the public will even think of going to a pharmacist, doctor or nutritionist for weight loss advice. This is where we inevitably have to face the fact that many will perhaps only respond to effective advertising, usually on TV.

      Whatever the product or service you buy, if it's advertised on TV you can expect to be paying a loading to cover advertising costs. If consumers don't do the research themselves and find "unadvertised" products or services, they should not complain about such loadings.

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  6. kurt bruce

    marketer

    I never buy anything diet or weightloss related without checking the reviews on it.www,poundsgoodbye.com They rate the top 5 diet products an my personal favorite is the 1st one on the list.

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