The commercial weight loss program can outperform the DIY approach

The commercial weight loss program can outperform the DIY approach

According to new data published recently in Open JAMA Network.

In a randomized clinical trial that included nearly 400 adults from Canada, the United States and the United Kingdom, participants who were assigned to WW, formerly known as Weight Watchers, lost twice as much weight as those who were trying to lose weight on their own. The WW group also had a greater reduction in weight circumference and were more likely to achieve a 5% weight loss.

Dr. Lesley Lutes

“Research shows that a majority of diets do not result in weight loss that can be sustained over time because they are simplistic, one-size-fits-all approaches to promoting initial weight loss,” the author said. study, Lesley Lutes, PhD, MSc, a professor of psychology and director of the Obesity and Wellness Research Center of Excellence at the University of British Columbia, Kelowna, Canada, said Medscape Medical News.

“Unfortunately, due to the quick fix, restrictive recommendations, and treatment of obesity as a simple ‘eat less and exercise more’ approach, people are doomed in the long run,” a- she declared. “As a result, they miss out on essential health benefits, such as reduced risk of diabetes and heart disease, that can come from even modest weight loss (3% to 5%) that is sustained in time.”

“A real test”

Given the high global prevalence of obesity, people need accessible and effective treatment options to manage their weight and multiple comorbid conditions, the study authors wrote. Guidelines from professional medical societies recommend behavioral treatment in these programs to guide participants, and while in-clinic programs appear to be effective, they are often limited in scope due to time, training, and financial constraints.

Commercial weight management programs may offer an effective solution, given their greater accessibility and lower costs, the study authors wrote, but few have been rigorously evaluated. The research team chose to study WW because it meets the US Preventive Services Task Force criteria for behavioral treatment and has been shown to help participants safely achieve modest and sustained weight loss.

The researchers conducted a one-year parallel group randomized clinical trial from June 2018 to November 2019 at the University of North Carolina at Chapel Hill in the United States, at the University of British Columbia in Kelowna in Canada and at the University of Leeds in Great Britain. They primarily focused on weight change at 3 months and 12 months for 373 participants (272 women), as well as health outcomes and quality of life measures.

Study participants had a BMI between 25 and 45 (mean BMI, 33.8). About 38% of participants were aged 53-75, 22% 44-52, 20% 35-43, and 21% 18-34. About 28% belonged to underrepresented racial and ethnic groups.

Participants were randomly assigned to either a commercial weight loss program or a DIY weight loss program. In the DIY group, participants received information about common weight loss approaches available to the public, including diet tracking and self-monitoring apps, meal plans and physical activity recommendations. These participants were left to fend for themselves.

In the commercial program, participants signed up for free on WW and were encouraged to attend weekly workshops, which included a private weight assessment and discussions of successes, problem-solving challenges and health-related topics. weight loss and behavior change. They also had access to the WW app for food intake, physical activity, online chats with trainers and an online peer community.

Notably, the WW program now includes simplified requirements for food self-monitoring, which means that over 200 foods do not need to be tracked by being weighed and measured. Instead, the program automatically assigns point values ​​for certain foods and aims for partial logging of food intake, which is designed to reduce the burden of self-monitoring.

Although WW funded the study, Lutes said, the research team insisted the company was not involved in the data and said they would present the results whether the program worked or not. Additionally, WW sites in the United States and Canada did not know who their typical clients were compared to those enrolled in the study, and after participants were randomized, study personnel were changed so that ‘they did not know the treatment condition.

“It was a real test of the program, in the real world, without interaction or influence,” Lutes said. “It allowed us to draw clear, confident and authoritative conclusions based on the results.”

Current analyzes

At the end of the study, retention rates were 89% for the WW group and 96% for the DIY group.

At 3 months, participants in the commercial program had an average weight loss of 3.8 kg (about 8 lbs), compared to 1.8 kg (4 lbs) in the DIY group.

At 12 months, those in the commercial program had an average weight loss of 4.4 kg (nearly 10 lbs), compared to 1.7 kg (about 4 lbs) in the DIY group.

Overall, 40.7% of participants in the commercial program achieved weight loss of 5% of their body weight at 3 months, compared to 18.6% of those in the DIY group. At 12 months, 42.8% of those in the commercial group achieved 5% weight loss, compared to 24.7% in the DIY group.

Lutes and his colleagues are currently analyzing additional results from the trial, including treatment uptake and any differences between people or groups based on format, modality and treatment items. Lutes is also interested in understanding the interplay between mental and physical health.

“Most people who participated in weight loss studies have already been weeded out if they had depression, anxiety, or another serious mental health condition because they were determined not to do as well in the treatment. We didn’t do that in this study,” she said. said. “I hope we will be able to make clear recommendations about the potential benefits of treatment, regardless of mental health barriers or challenges.”

“An encouraging observation”

“Although this study was funded by the commercial weight loss company and may be at risk of bias…the weight loss results are encouraging and not surprising,” said Bradley Johnston, PhD, associate professor of nutrition at Texas A&M University and Adjunct Professor. at McMaster University, said Medscape Medical News.

Dr. Bradley Johnston

Johnston, who was not involved in this study, is also director and co-founder of NutriRECS, an independent group of international clinical, nutrition and public health experts. In 2020, he and his colleagues conducted a review of randomized trials of 14 popular diet programs and found that many programs lead to short-term weight loss and better health outcomes. But at 12 months, these results largely disappear.

“While most randomized controlled trials evaluating interventions for weight loss programs experience regression to the mean (dieters begin to regain early weight loss), participants in this commercial program lost more than weight at 12 months than at 3 months, an encouraging finding,” he said. said.

Johnston also expressed optimism about the trial incorporating participant-reported measures of well-being, including happiness, sleep quality and overall health-related quality of life. Although the only statistically significant change is quality of life specific to self-esteem, he noted, the average change between these measures could be important to the public, even if the numbers are not statistically significant.

“Either way, the authors should be applauded for measuring the outcomes that matter most to the average person looking to improve their health and outlook while losing weight,” he said. “My personal view is that all future clinical trials should measure quality of life elements such as self-esteem, anxiety, sleep quality and food satisfaction, and government funding agencies should avoid funding trials. weight loss programs that neglect to measure these critical outcomes for clinical decision-making.”

The study was funded by WW International. Several authors reported receiving grants from WW during the study, and three authors were employees or shareholders of WW during the study. The full list of disclosures can be found with the original article. Johnston reported no relevant financial relationships.

JAMA Netw Open. Published online August 16, 2022. Full text

Carolyn Crist is a health and medical journalist who reports on the latest studies for Medscape, MDedge, and WebMD.

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