Efficacy of Commercial Weight-Loss Programs

Abstract

Background Commercial or proprietary weight loss programs are popular obesity treatment options; however, their efficacy is unclear. Purpose To compare weight loss, adherence, and harms of commercial or proprietary weight loss programs to control/education or behavioral counseling among adults with overweight and obesity. Data sources MEDLINE and Cochrane Database of Systematic Reviews from inception to November 2014; references identified by programs Study selection Randomized controlled trials (RCT) of ≥12 weeks duration; prospective case series ≥12 months (harms only) Data extraction Two reviewers extracted information on study design, population characteristics, interventions, and mean % weight change, and assessed risk of bias. Data synthesis We included 39 RCTs. At 12 months, Weight Watchers’ participants achieved at least 2.6% greater weight loss than control/education. Jenny Craig resulted in at least 4.9% greater weight loss at 12 months as compared to both control/education and counseling. Nutrisystem participants achieved at least 3.8% greater weight loss at 3 months than control/education or counseling. Very-low-calorie programs (HMR, Medifast, Optifast) resulted in at least 4.0% greater short-term weight loss than counseling, but some attenuation of effect occurred beyond 6 months when reported. Atkins achieved 0.1–2.9% greater weight loss at 12 months than counseling. Results for SlimFast were mixed. We found limited evidence to evaluate adherence or harms for all programs and weight outcomes for other commercial programs. Limitations Many trials had short durations (<12 months), high attrition, and lacked blinding. Conclusions Clinicians could consider referring patients with overweight or obesity to Weight Watchers or Jenny Craig. Other popular programs such as NutriSystem show promising weight loss results; however, additional studies evaluating long-term outcomes are needed. Primary funding source None. Registered with PROSPERO (CRD42014007155).

Obesity Education Strategies for Cancer Prevention in Women’s Health

“…Overall, studies have consistently shown a modest weight loss with commercial weight-loss programs. A 2015 systematic review of 45 studies on the efficacy of commercial weight-loss programs found a 2.9% greater weight loss with Weight Watchers and 4.9% with Jenny Craig compared to control education (no intervention, printed material only, or health education in less than 3 sessions) at 12 months [64]. Other programs that focus on low-calorie meal replacement including Health Management Resources, Medifast, and OPTIFAST and the self-directed Atkins diet similarly achieved greater weight loss than control education but these studies used short-term follow-up of 6 months or less.…”

“…Other programs that focus on low-calorie meal replacement including Health Management Resources, Medifast, and OPTIFAST and the self-directed Atkins diet similarly achieved greater weight loss than control education but these studies used short-term follow-up of 6 months or less. Other self-directed diets including SlimFast have had mixed results [64]. In a randomized trial of multiple diets, all diet groups achieved a statistically significant change in baseline weight at 1 year following enrollment and there was no difference among the diet groups.…”

“…Because most weight-loss programs have included components of nutritional and behavioral counseling with or without physical activity, determining which component has the biggest impact on weight loss is difficult to assess. Furthermore, few studies have included long-term weight loss greater than 12 months [64]. Additional research is needed to further determine the safety of the many weight-loss programs.…”

Gastrointestinal traits: individualizing therapy for obesity with drugs and devices

“…3 These commercial programs incorporate group sessions (eg, Weight Watchers) or more expensive 1-on-1 counselling.…”

The Role of Commercial Weight-Loss Programs

“…In this issue, Gudzune and colleagues reviewed the evidence on the efficacy of commercial weight-loss programs that focused on nutrition and incorporated behavioral counseling or social support components, regardless of whether physical activity was emphasized (4). Of the 32 programs they identified, they found clinical trial data on only 11, and a minority of the 45 relevant trials lasted 12 months or longer.…”