Do Popular Weight-Loss Programs Work?

As the Affordable Care Act (ACA) places greater emphasis on obesity, pharmacists should stand ready to help patients manage their weight.

Under the ACA, health plans must cover obesity screenings and counseling. Pharmacists can provide these screenings, help patients develop long-term weight-management goals, and also offer education on weight management.

But they may also direct patients to popular commercial weight-loss programs.

After testing the effectiveness of these programs in a comprehensive study, Kimberly Gudzune, MD, MPH, assistant professor at the Johns Hopkins University School of Medicine, spoke with Pharmacy Times about how pharmacists can use this evaluation to help their patients.

“When pharmacists discuss weight loss with their patients, I think that it is important for them to consider all the available options,” Dr. Gudzune said. “Some important aspects that they may want to consider would be whether the program has scientific evidence to prove that it works, as well as the costs, structure, and time commitment required with the program.”

She highlighted Jenny Craig and Weight Watchers as programs that have demonstrated in multiple scientific studies that they can lead to significant weight loss and have long-term efficacy.

Dr. Gudzune’s study examined the amount of weight typically lost, adherence to the program, and harms of commercial programs compared with control groups that received either behavioral counseling or education, printed materials, and fewer than 3 counseling sessions with a health care provider. The researchers studied randomized, controlled trials (RCTs) lasting at least 12 weeks and prospective case series at least a year in duration.

At the 1-year mark, Jenny Craig produced at least 4.9% greater weight loss than the control programs, and Weight Watchers saw at least 2.6% greater weight loss.

Weight Watchers, Jenny Craig, and Nutrisystem “dominate” the weight-loss services industry, the researchers said. Weight Watchers can sustain significant weight loss beyond 1 year, and it is 1 of the cheapest options available to patients. While Jenny Craig is more expensive than Weight Watchers, it has also resulted in greater weight loss than education and counseling participants, including diabetics.

In a shorter time span, Nutrisystem produced at least 3.8% greater weight loss at 3 months than the control programs, and very low-calorie programs such as Medifast and OPTI-FAST had at least a 4% greater short-term weight loss than counseling. However, the effect grew weaker beyond 6 months.

Overall, Weight Watchers and Jenny Craig showed evidence of having the most long-term efficacy, but more research and RCTs may be needed to prove Nutrisystem’s long-term efficacy. Very low-calorie diets can provide fast results for patients, but evidence is lacking on their long-term weight loss potential.

“Although our results have implications for clinical practice, we also believe that this evaluation is critical to policymakers, health insurers, and employers. Because the ACA is likely to increase obesity screening, having an actionable plan that addresses weight management is critical,” the researchers concluded.

“I hope that pharmacists use this information when they talk with patients to determine what weight loss strategy might best suit their needs,” Dr. Gudzone told Pharmacy Times.