Weight Loss Toronto

Governments should be regulating the commercial weight-loss industry to prevent Canadians desperate to shed pounds from being taken in by products and programs promoting scientifically unproven therapies, obesity doctors say.

In an editorial in this week’s Canadian Medical Association Journal, Drs. Yoni Freedhoff and Arya Sharma say there is no quick fix or magic pill for losing excess weight - or for maintaining weight loss over time.

“Although experts agree that obesity management requires long-term behavioural, medical or surgical intervention, the majority of commercial weight-loss providers manipulate vulnerable consumers with impunity, cultivating unrealistic expectations and false beliefs,” they write.

Some weight-loss programs promote the use of vitamin injections or herbal supplements, claiming they help the body burn off fat. But Freedhoff and Sharma say there is no scientific evidence based on clinical research to support those contentions.

And it’s not just clinics, but over-the-counter products, noted Freedhoff, medical director of the Bariatric Medical Institute in Ottawa.

“Certainly if you walk into any drug store … (you) will find that there are products that purport themselves to be weight-loss products that don’t necessarily have any shred of evidence to suggest that they are efficacious in treating weight management,” he said from Ottawa.

“So really we see a lot of people preying on Canadians who are concerned about their weight. And given the large percentage of Canadians who, in fact, have weight to lose, I think we need to offer them approaches that are potentially beneficial and don’t simply bilk them out of their pocket change.”

Sharma, chair of obesity research and management at the University of Alberta, said successful weight loss and maintenance depend on a number of factors, including calorie reduction, healthy food choices, regular exercise and addressing psychosocial or physiological factors that lead to overeating.

It also includes realistic goals, he said from Edmonton, noting that some off-the-shelf products and clinics promote and promise extremely rapid weight reduction.

“Obesity treatment is not about weight loss. Losing weight is easy. Treatment is keeping it off.”

Sharma said he is not against commercial weight-loss or obesity-treatment centres, many of which offer valuable help to people trying to slim down.

“We have a lot of community partners that have been accredited because the services that they are offering are in compliance with the clinical practice guidelines,” he said of the university’s obesity program, noting that those partners in Edmonton include Weight Watchers and the YMCA.

“We’re not saying just because you charge money for it, it’s a useless program. It’s not about commercial or non-commercial. It’s about the people who are making false claims and peddling things that have no scientific validity.”

“And nobody regulates these things.”

He and Freedhoff want the federal or provincial-territorial governments to require weight-loss providers to be formally accredited, so consumers can identify those providing scientifically sound services. As well, they say weight-reduction products should require regulatory approval before they can be sold, based on proper clinical testing that substantiates their effectiveness.

At his centre in Ottawa, Freedhoff said staff are all licensed to provide integrated programs that allow patients to lose no more than one to three pounds per week, with the higher limit set for those who tip the scales at a higher weight.

Shedding pounds at a more rapid clip can be medically dangerous, he said, leading to a risk of gallstones, a disproportionate loss of muscle and a greater propensity over time to regain lost weight.

“The problem is we’re really good - physicians and public health agencies and our government and the media - we’re really good at telling people they’re supposed to lose weight,” Freedhoff said. “But yet nobody is telling people where to go.”

He advises that anyone wanting to trim their waistline should speak to their doctor before embarking on a weight-management program, including asking their physicians to check out a prospective clinic or off-the-shelf product.

Diane Finegood, an obesity expert and researcher at Simon Fraser University, said the editorial raises an important issue and one that needs more discussion.

While she agreed that regulation would make it easier for consumers to choose reputable weight-loss providers, the challenge would be knowing where to draw the line on “what is sufficient evidence to allow advertising of a particular claim.”

“That’s a scary edge for this area because there aren’t a lot of proven effective weight-loss remedies,” Finegood said Monday from Burnaby, B.C.

“And when we haven’t done enough data collection to understand what works for whom and under what conditions, then do we run the risk of preventing something useful from being advertised?”