Effects of Weight Reduction Interventions by Community Pharmacists

Ahrens RA, Hower M, Best AM. J Am Pharm Assoc. 2003;43(5):583-589.

Objective

To compare a meal replacement (MR) program with a conventional reduced-calorie diet (RCD) for weight management using the pharmacy as the setting and the pharmacist as the point of contact for dietary advice.

Methods

This randomized, controlled, open-label study enrolled 95 patients. Patients were randomized to receive either a calorie-controlled meal replacement diet (MR) with 2 of the 3 main meals replaced with a liquid meal replacement shake (Slim-Fast), or a traditional reduced-calorie diet (RCD) self-selected based on diabetic exchanges. A registered dietitian reviewed the plan and was consulted as needed. Patients were followed for a 12-week period of active weight loss and an additional 10-week period of weight maintenance, for a total of 22 weeks. During the 10-week weight maintenance phase, MR patients drank 1 Slim-Fast shake per day and ate 2 sensible meals of their choice. Patients in both groups were told to self-regulate their caloric intake during the maintenance phase, with a goal of maintaining their weight loss. Patients returned every 3 weeks for follow-up with the pharmacist, for a total of 13 visits.

Results

Of the 95 randomized patients, 88 were considered eligible for comparison (by continuing through week 2 of the study). During the active weight loss phase, both the MR (n = 45) and RCD (n = 43) groups lost significant amounts of weight, with no significant difference between the groups. However, 52% of patients in the MR group compared with 32% in the RCD group lost more than 7% of their initial body weight during the first 12 weeks of the study. Both groups were able to maintain the weight loss attained during the first study period and continued to lose additional weight during the maintenance period. Significant improvements were observed in waist circumference, systolic and diastolic blood pressure, and triglyceride levels. No significant changes were seen in high-density lipoprotein cholesterol or low-density lipoprotein cholesterol levels in either group.

Conclusion

Both a meal replacement strategy and a reduced-calorie diet approach were effective methods for weight loss and weight maintenance, and pharmacists can play a role in helping patients manage their weight by virtue of a simple, easy-to-implement program requiring minimal intervention.

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