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Commercial Programs or Self-Help for Weight Loss?

Average weight loss was significantly greater with a commercial program, but the range of weight change was large with either intervention.

How should clinicians guide patients who ask about joining commercial weight-loss programs? In this study, investigators at 6 academic research centers sought to determine the effectiveness of a commercial program run by Weight Watchers International, which initiated and supported the investigation. A total of 65 men and 358 women (BMI, 27-40; age range, 18-65) were randomized to a self-help intervention or to a Weight Watchers program. During the 2-year study, the self-help group underwent 2 short counseling sessions with nutritionists and received self-help resources. The commercial-program group received food, activity, and behavior-modification plans, which were promoted at hour-long weekly meetings.

At 1 year, the self-help group had lost a mean of 1.3 kg, with a return to baseline weight at 2 years. The commercial-program group had lost a mean of 4.3 kg at 1 year and 2.9 kg at 2 years. Although mean weight loss was significantly greater in the commercial-program group at each of 4 checkup visits, the range of weight change was large in both groups. At 2 years, some individuals had large weight losses (maximal losses of 23 and 26 kg in the commercial-program and self-help groups, respectively), whereas others had alarming gains (maximal gains of 21 and 30 kg, respectively). At 2 years, 52% of the commercial-program group and 29% of the self-help group had a BMI that was at least 1 unit below baseline (an amount defined as significant by the Institute of Medicine).

Comment: Despite the randomized, prospective methodology, the results of this study may not be generalizable to other commercial weight-loss programs, especially those using liquid formulas or unbalanced diets. In addition, the actual average loss seems modest, given the intensity and cost of the commercial program. Thus, the question of cost-effectiveness looms large, and we are no nearer to being able to predict what will work for a given individual.

— Ann J. Davis, MD

Published in Journal Watch Women's Health June 4, 2003

Citation(s):

Heshka S et al. Weight loss with self-help compared with a structured commercial program: A randomized trial. JAMA 2003 Apr 9; 289:1792-8.

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