In a head-to-head contest pitting a pair of psychologist-led "behavioral weight loss" programs against a 48-week membership to Weight Watchers, a new study found that subjects participating in the ubiquitous commercial program stuck with their regimen longer and shed more pounds.
Compared with people who met regularly with a professional counselor, those assigned to Weight Watchers were more likely to lose at least 10% of their body weight by the 48-week mark. On this measure, Weight Watchers also bested a hybrid program that researchers had expected to be the most effective — a 12-week introductory course led by a clinical psychologist to jump-start subjects' weight loss, followed by 36 weeks of Weight Watchers.
The study, published Tuesday in the journal Obesity, suggests that physicians scrambling for ways to counsel overweight and obese patients may be best served by referring them to well-established commercial programs with a track record of working.
Each year, about 1.3 million members spend some $5 billion on Weight Watchers products and services and attend more than 45,000 official meetings around the world.
The other weight loss programs tested in the study were led by health professionals trained in nutrition and behavior management. By contrast, Weight Watchers meetings are led by peer counselors — men and women who have lost significant amounts of weight in the program and then become mentors to others in the same struggle.
The study, led by a researcher from Baruch College in New York City, involved 141 people, mostly women, who were overweight or obese and was conducted without financial assistance from Weight Watchers International. Its findings echo the results of two clinical trials published last year — one in the British Medical Journal that was conducted by the United Kingdom's National Health Service and another in the journal Lancet that was sponsored by Weight Watchers.
"Weight Watchers really can produce clinically meaningful weight loss for a lot of people," said study leader Angela Marinilli Pinto. "It can be very convenient for people to access, and professional programs don't always have that convenience and accessibility."
Pinto said the research team was surprised by how much better subjects fared using Weight Watchers alone than when they combined it with a 12-week course that Pinto led.
On average, those on Weight Watchers shed slightly more than 13 pounds after 48 weeks, while those in the combined program lost slightly less than 8 pounds. Those who spent all 48 weeks with the professional counselors lost slightly less than 12 pounds on average — an amount that was judged to be statistically indistinguishable from those who used only Weight Watchers.
The researchers found that Weight Watchers subjects attended more meetings, used the program's electronic tools more frequently and were more likely to see the study through to its end than were those in the other two groups. In all, 37% of people in the Weight Watchers group lost 10% of their body weight, compared with 15% of those in the combination-therapy group and 11% of those who didn't use Weight Watchers at all.
The findings come as physicians are preparing for an all-out fight against obesity that places them on the front lines.
In November 2011, Medicare said it would reimburse doctors who provide their obese patients "intensive behavioral counseling" to lose weight. And in June, the U.S. Preventive Services Task Force recommended that physicians routinely screen their adult patients for obesity and refer those who have too many extra pounds to "intensive, multicomponent behavioral interventions" designed to get them to lose weight. Under the Patient Protection and Affordable Care Act, Medicare and most private insurers would be required to cover the full cost of those interventions.
These changes are prompting doctors to consider whether and how they can profitably deliver such services to their obese patients. The American Assn. of Clinical Endocrinologists has acknowledged that physicians will need more and better training in nutrition and obesity care and will have to build teams that include nutritionists and other professionals to help.
"We can provide this service, but we're not optimized for it right now," said Dr. Jeffrey Mechanick, president-elect of the AACE and a clinical professor of medicine at Mount Sinai School of Medicine in New York.
That may place greater pressure on the weight loss programs already available in the communities where the nation's 78 million obese people live. The federal task force cited only one — a diabetes prevention program offered at a small number of YMCA sites nationwide — as meeting its standards of effectiveness.
Karen Miller-Kovach, chief scientific officer for Weight Watchers International, said the company should be considered equally worthy of insurance reimbursement. In Britain, the National Health Service has paid to send obese patients to Weight Watchers since 2005.