Introduction Low-income women are disproportionately overweight or obese. The Vermont WISEWOMAN (Well Integrated Screening and Evaluation for Women Across the Nation) program, which serves Vermont women whose annual income is less than 250% of the federal poverty level, pays for members to attend 1 of 2 different evidence-based weight loss programs, Weight Watchers or Curves Complete. Purpose and Objectives We evaluated cost effectiveness of the weight-loss programs, conducted from April 2014 through March 2016, to determine which represented the best investment of WISEWOMAN program funds. Intervention Approach Vermont WISEWOMAN members who were overweight or obese during screening and who identified weight loss as a goal were invited to participate in 1 of the 2 programs on the basis of their place of residence and local Weight Watchers or Curves Complete contractual agreements with the Vermont WISEWOMAN program. Evaluation Methods Program costs and benefits were collected for a 2-year period and used to calculate the cost per participant who completed the program and the cost per participant who achieved the weight reduction goal of a 5% or more loss in body weight. Results The cost per participant achieving the weight reduction goal with Curves Complete ($8,613) was approximately 5 times the cost for Weight Watchers ($1,610). Implications for Public Health Weight Watchers, the evidence-based program with the simplest administrative structure, was significantly more cost effective than Curves Complete. Results suggest that overweight or obese low-income women aged 30 to 64 can lose 5% or more of their body weight more cost effectively through Weight Watchers than through Curves Complete.