Feb. 11, 2016 -- About 1 in 4 Americans are trying to shed some serious pounds. But exploring the world of weight loss programs can be tricky.
Digital and print ads bombard us with claims promising success and messages that sound too good to be true, leaving some doctors scratching their heads. So how do you find a healthy program that works?
It’s tough to do, a new study in the journal Obesity says. But it’s not impossible.
"It is hard for consumers and doctors to tell what is effective and reliable, especially when relying on information found only on the Internet," says Kimberly Gudzune, MD, MPH, who worked on the study and is a weight loss specialist at the Johns Hopkins University School of Medicine. "Few community weight loss programs offer services that meet at least some of the key components of widely accepted weight loss guidelines."
Program Reviews: Chewing Through the Fat
Gudzune and her colleagues reviewed web sites for nearly 200 weight loss programs in the D.C., Maryland, and Virginia areas. They included national ones like Weight Watchers and Jenny Craig, independent operators, and those supervised by doctors or offered by weight-loss surgery centers. The researchers checked to see if the programs followed medical weight loss guidelines from the American Heart Association, American College of Cardiology, and The Obesity Society.
They looked at five key areas: level of support, the diet plan, behavior strategies, exercise, and whether it recommended supplements that weren't FDA-approved for weight loss.
Gudzune says only 9% of the programs met their requirements in the key areas. The study does not name the programs. "I think it speaks to the decades of lack of regulation in this industry. [Weight loss] companies are just doing whatever they feel like. This is the reason it's so hard to find a reliable program."
"Getting information solely off Internet ads or TV commercials or from a spokesperson or the person who owns the company gives you a one-sided pitch, which is not that much dissimilar than a snake oil salesman back in the days of the covered wagons," says Marc Leavey, MD, a primary care specialist with Lutherville Personal Physicians in Maryland. "It didn't work then, and it doesn't work now, but it does make a huge amount of money for weight loss and diet business."
But that doesn't mean all programs are bogus. Leavey says that Weight Watchers, for example, "shines," and says previous surveys found it does work very well. (He has no financial stake in that company.)
Weight Watchers also consistently gets high marks from the U.S. News & World Report annual list of best diets.
The researchers hope their findings will prompt an industry facelift, so that practices are more aligned with the "great scientific evidence that we have," Gudzune says. "If the programs out there delivering services just made slight modifications, that could translate to better outcomes for people who are participating."
Cutting Through the Hype
Finding a reliable weight loss program is important. More than a third of people in the U.S. are considered obese. And it's not just adults. The CDC says 1 in 6 kids are dealing with the condition, too. Weighing too much puts you at risk for many serious health problems, including diabetes and heart disease.
"Eat less and exercise more" has always been the golden rule for dropping pounds. But how do you really accomplish that? Here are the five must-haves in a weight loss program, according to the researchers at Johns Hopkins.
1) Plenty of interaction and support. You want ongoing contact with the program's support team. Researchers recommend at least 14 sessions over 6 months. This might be in person or by phone or email. "Support is so critical in helping people through the weight loss process," Gudzune says.
2) Diet changes that are backed by science. "Things like the Paleo diet are very hot right now but haven't been studied with their effects on weight loss," Gudzune says. You want an approach that has solid evidence to support it works. This might be a low-calorie eating plan or meal replacements, or a well-studied diet for weight loss, like Atkins, she says.
3) Exercise encouragement. Opt for a program with some type of plan to get you moving more. The U.S. Department of Health and Human Services guidelines recommend 150 minutes of moderate activity (like walking) each week. You can divvy that up however you like. Keep in mind that exercise is key if you want to stay at your lighter weight once you've dropped pounds, but doctors say it's hard to lose weight with just exercise alone.
4) Behavior strategies. Your program should encourage things like weighing yourself, meal planning, or tracking your food or exercise.
5) Approved meds only. Steer clear of programs that push fat burners or other supplements that aren't FDA-approved for weight loss. The FDA offers a list of dangerous weight loss products. You can sign up for email alerts, too.
Local affiliates of national weight loss programs might not offer all five of the recommended basic things, but some do come close. A spokeswoman for Nutrisystem says their program meets 4 out of the 5 criteria listed in the new Obesity study. It doesn't offer the recommended amount of contact (14 sessions in 6 months). But the company says it offers unlimited counseling anywhere there is Internet access.
"For more than 40 years, Nutrisystem has provided what consumers need and deserve -- sound nutritional science, clinically proven results, and constant innovation to help them meet their weight loss goals," says company spokeswoman Robin Shallow. "We’re proud to help people on their weight loss journey."
Lisa Talamini, RD, senior science expert for Jenny Craig, says the company is “pleased” the study was done and that the company meets its criteria.
The research "identifies the need for more reliable information" to help doctors point their patients to effective weight loss programs, Talamini says.
Last year, a study in the Annals of Internal Medicine recognized Jenny Craig as one of the most effective weight loss programs available.
What to Ask When Choosing a Program
It might be hard to figure out if the program you're eyeing meets all those above requirements. Here are some doctor-approved questions to ask.
- What's your track record? How long has this program been around?
- Do you have any studies or statistics that show this really works?
- Who am I going to be talking to? Am I talking to a counselor who got an hour of training, or a registered dietitian or nurse, or just a salesperson?
- What will it cost? (They should be up-front about this.)
- What kind of after-support do you have? Ask them: "If I'm on this program for a period of time and I've lost some weight, do you turn me loose and say "good luck and be healthy," or do you have an ongoing program to keep me at my weight?" Leavey suggests.
- How do you balance diet and exercise? Do you have a formula, or am I on my own?
Remember, there's no a one-size-fits all weight loss program.
"It should be a program you, as an individual, can follow. Just because your brother-in-law does it, doesn't mean you can do it," Leavey says. "And, if you're going to do it, start today. Don't tell me you're going to start next month or your birthday. People who delay their start never start."
But before you begin your journey, talk to your doctor to let him know this is something you're considering. You can use him as an ally to help you narrow down your program choices. Your doctor will also make sure any diet and exercise changes are safe for you.