A new study from Johns Hopkins University shows that only two programs, Jenny Craig and Weight Watchers, are supported by substantial data that proves them to be more effective than on-your-own dieting or outside counsel.
The investigators found that of 32 major commercial weight-loss programs marketed nationwide, only 11 have been rigorously studied in randomized controlled trials. And from these studies, they say they found only two programs are supported by gold-standard data showing that participants, on average, lost more weight after one year in these programs than people who were either dieting on their own, got printed health information, or received other forms of education and counseling sessions.
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Moreover, they wrote that results in those programs were generally “modest, ” with participants losing on average between 3 and 5 percent more than the studies’ control groups of nonprogram participants. Because of the way weight loss is generally tracked in research, the team did not gauge the average number of pounds lost in each program, Gudzune says.
Because the majority of weight-loss programs have never been studied in randomized clinical trials, the researchers say, they ended up with 39 trials covering 11 programs: HMR, Medifast, OPTIFAST, Atkins, SlimFast, Biggest Loser Club, eDiets and Lose It!. Included were three high-intensity programs – Weight Watchers, Jenny Craig and NutriSystem – which incorporate goal setting, self-monitoring, nutritional information and counseling.
“Clinicians could consider referring patients who are overweight or obese to Weight Watchers or Jenny Craig. Other popular programs, such as NutriSystem, show promising weight-loss results, but additional studies evaluating long-term outcomes are needed, ” according to the published report.
Health benefits of weight loss
“We want people to experience the health benefits of weight loss — lower blood pressure, cholesterol and blood sugar, and lower risk of developing diseases like diabetes, ” says Jeanne Clark, M.D., M.P.H., the Frederick Brancati, M.D., M.H.S., Endowed Professor of Medicine, director of the Division of Internal Medicine and a study co-author. “Those benefits are long-term goals; losing weight for three months, then regaining it, has limited health benefits. That’s why it’s important to have studies that look at weight loss at 12 months and beyond.”
Based on their analysis of the studies, the researchers found Jenny Craig and Weight Watchers were backed by clinical trials that lasted 12 months or longer and showed program participants had a greater weight loss than nonparticipants. “Given these findings, ” the authors write, “it may be reasonable for clinicians to refer patients to Weight Watchers or Jenny Craig.” NutriSystem also produced more weight loss at three months than counseling or education alone, but the authors were unable to find any long-term trials of that program. Participants in the very-low-calorie meal replacement programs lost more weight than nonparticipants in trials lasting from four to six months. But the authors found only one long-term study, which showed no benefit from such a program at 12 months. The authors noted that very-low-calorie programs also carry higher risks of complications, such as gallstones.
Programs based on the Atkins diet — high in fat, low in carbohydrates — also helped people lose more weight at six months and 12 months than counseling alone. The approach “appears promising, ” the authors write.
No definite conclusions could be made about Slim-Fast and the Internet-based programs.
The researchers also tallied the costs of the commercial programs, which ranged from zero for Web-based weight-loss apps to between $570 and $682 per month for programs that require clients to buy replacement meals.
Two-thirds of U.S. adults are overweight or obese, and nearly two-thirds of adults say they have tried to lose weight. Weight-loss programs were a $2.5 billion-per-year business in 2014, and the industry is expected to grow. Federal matching funds provided by the Affordable Care Act make obesity screening and counseling available to people covered by federal health insurance exchanges and some Medicaid recipients. Some private insurers may phase in similar coverage. As a result, physicians across the country will be referring more patients to weight-loss services in coming years, the Johns Hopkins experts say.
