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Title: A randomized controlled trial of a commercially available weight loss program

Author
item JOHNSTON, CRAIG - Children'S Nutrition Research Center (CNRC)
item ROST, STEPHANIE - Weight Watchers International, Inc
item MILLER-KOVACH, KAREN - Weight Watchers International, Inc
item MORENO, JENNETTE - Children'S Nutrition Research Center (CNRC)
item FOREYT, JOHN - Children'S Nutrition Research Center (CNRC)

Submitted to: American Journal of Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/24/2013
Publication Date: 12/1/2013
Citation: Johnston, C.A., Rost, S., Miller-Kovach, K., Moreno, J.P., Foreyt, J.P. 2013. A randomized controlled trial of a commercially available weight loss program. American Journal of Medicine. 126(12):1143.e19–1143.e24.

Interpretive Summary: Obesity contributes to many chronic diseases, yet 80 percent of weight loss attempts are self-directed. Even when people seek medical advice for addressing obesity, there is limited evidence to support the effectiveness of primary care physicians in weight management. In 2012, the United States Preventive Services Task Force (USPSTF) recommended that physicians should screen all patients for excess weight and offer or refer those identified as obese for intensive, multi-component behavioral counseling. Commercial and proprietary weight loss programs that can be delivered in the community have been developed. However, most of these programs have limited or no efficacy data. Weight Watchers (WW) has conducted many studies on its efficacy and effectiveness. The purpose of this study was to examine the efficacy of the WW program that incorporates multiple access points compared to the self-directed approach that most Americans employ. The results of this study showed that participants enrolled in the commercially available, community-based weight loss program using 3 access points (i.e., meetings, online website, and mobile device application) lost more weight than participants in the self-help group. In terms of clinical significance, participants in the WW condition were more likely to achieve a weight loss of 5 to 10 percent of their initial body weight, which is considered to be beneficial in reducing some of the negative effects of obesity, such as high blood pressure and glucose levels. These findings suggest that the WW program is effective in promoting significant weight loss in community-based settings and a viable referral choice for clinician's patients diagnosed with obesity.

Technical Abstract: The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians refer obese adults for intensive, multi-component behavioral counseling, yet most obese Americans choose a self-help approach to lose weight. The current study examined weight loss between a community-based, intensive behavioral counseling program (Weight Watchers program) and a self-help condition. A total of 292 participants were randomized to either a Weight Watchers condition (WW) (n=147) or a self-help (n=145). Participants in the WW condition were provided with three ways to access the treatment: 1) weekly meetings, 2) WW mobile application, and 3) WW online tools. Weights were measured at baseline, 3, and 6 months. Additionally, self-report use of access modes was collected at 3 and 6 months. Participants in the WW condition significantly decreased their BMI at 6 months (F=36.7, p<.001) and were 8.0 and 8.8 times more likely to achieve a 5% and 10% reduction in weight respectively compared to those in the self-help condition. In a secondary analysis, high usage of all three access modes resulted in the greatest weight loss (p<.001). Use of the WW program yielded significantly greater weight loss than a self-help approach, suggesting it is a viable community-based provider of weight loss treatment, as recommended by the USPSTF. Further, high usage of three access modes was associated with greater weight loss results.