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 Doctors might prioritize these options when talking to patients
about commercial weight loss programs, at least until other types of
diets, like Nutrisystem or SlimFast, have produced substantial
evidence of consistent long-term results, the experts conclude.
“We’re not necessarily excluding any of these programs,” said lead
author Dr. Kimberly Gudzune of The Johns Hopkins University School
of Medicine in Baltimore, Maryland.
“We’re trying to highlight the ones that do have the scientific
evidence proving that they do work to lose weight and keep it off,”
Gudzune told Reuters Health by phone. “For others it is unclear,
they may show short term weight loss with no long term results, or
in the long term people start to begin to regain the weight.”
Gudzune and her co-authors reviewed evidence in support of Weight
Watchers, Jenny Craig, Nutrisystem, Health Management Resources,
Medifast, OPTIFAST, Atkins, SlimFast, The Biggest Loser Club, eDiets
and Lose It!
These programs emphasize dietary change or meal replacement and
behavioral counseling or social support, but do not necessarily
address physical activity.
Gudzune and her team selected 45 dietary trials, including 39
randomized controlled trials comparing the diets to a control group,
completed between 2002 and 2014. Many were sponsored by the
commercial programs themselves.
In six trials, by the one-year mark, people on Weight Watchers had
lost almost three percent more of their initial body weight than did
people in control groups. But they did not lose any more weight on
average than people in comparison groups who had access to
behavioral counseling consultations with providers, which would also
encourage weight loss.
Three trials found that people on Jenny Craig had at least 4.9
percent greater weight loss maintained at the one-year point
compared with people in a control group or those in a behavioral
counseling group.
Three trials found that people using Nutritystem had at least 3.8
percent greater weight loss compared to control or counseling at the
three-month point, but no trials continued a full year.
Similarly, programs which require very low calorie intake, like
Health Management Resources, Medifast and OPTIFAST, did demonstrate
more weight loss after three months than a control or counseling
group, but effectiveness seemed to diminish beyond six months, the
authors write in the Annals of Internal Medicine.
“While obesity continues to be a significant health risk in the
U.S., our program provides the personal support and behavioral
strategies that lead to healthy lifestyle change and can provide an
effective solution for clinicians,” Monty Sharma, CEO and president
of Jenny Craig, told Reuters Health in a statement. “We are
gratified that this independent study in a reputable journal has
prioritized us as a weight loss solution for patient referrals and
that the review showed that Jenny Craig is one of the most effective
long-term weight loss solutions.”
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Trials of the Atkins diet found between 0.1 and 2.9 percent greater
weight loss than counseling after one year, but potential harmful
side effects and drop-out rates from the program were rarely
reported, the authors write.
A representative for the Atkins diet disputes these conclusions.
“What the study does show is that any clinician recommending a
weight loss program with a cost is going to help people lose weight
but at a premium price,” Colette Heimowitz, vice president of
nutrition and education at Atkins Nutritionals, told Reuters Health
in a statement. “Atkins is 100 percent free and its efficacy is
proven with more than 80 independent clinical studies.”
SlimFast trial results were mixed, and there was little evidence for
weight outcomes for other programs.
Weight Watchers and Jenny Craig may be among the most effective
programs because they are highly structured and often include
in-person social support, according to Dr. Christina C. Wee of Beth
Israel Deaconess Medical Center and Harvard Medical School in
Boston.
But weight loss with these programs is modest and likely below
patients' expectations, which may make it harder for patients to
stick with, and pay for, the programs long-term, Wee wrote in an
editorial accompanying the new results.
“Medically we hope people achieve and sustain 3 to 5 percent weight
loss from their starting weight,” and people on Jenny Craig and
Weight Watchers did meet that goal, Gudzune noted.
The trials in the review were not designed to pit the diets against
each other and determine why one works better than another, she
said, but the review should help doctors and patients discuss
whether or not a commercial diet program is a good choice, and if
so, which one to try.
In addition to evidence of effectiveness, people should consider
varying costs and time commitments, she said.
“There is no one-size-fits-all solution for this,” Gudzune said.
SOURCE: http://bit.ly/1i46lF7
Annals of Internal Medicine, online April 6, 2015.
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