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Commercial weight-loss programs have been compared in randomized trials to other self-help approaches with enrollment of self-referred patients, but never to standard counseling in a primary care setting with enrollment of patients identified by their own physicians.
With funding from Weight Watchers (WW), researchers enrolled 772 relatively healthy overweight and moderately obese adults (body-mass index, 27–35 kg/m2; 87% female) who were initially screened by their primary care providers in the U.K., Germany, and Australia. Participants were randomized to 12 months of free access to WW services, including weekly community-based meetings, or to standard weight-loss advice in their primary care practices.
Mean 12-month weight loss was significantly greater in the WW group than in the standard-care group (–4.1 vs. –1.8 kg for all participants; –6.7 vs. –3.3 kg for program completers). Significantly more WW participants than standard-care participants lost at least 5% of baseline body weight (about 46% vs. 23%) and at least 10% of baseline body weight (about 22% vs. 8%).
Jebb SA et al. Primary care referral to a commercial provider for weight loss treatment versus standard care: A randomised controlled trial. Lancet 2011 Sep 8; [e-pub ahead of print]. (http://dx.doi.org/10.1016/S0140-6736(11)61344-5)
Jolly K and Aveyard P. Provision of commercial weight management programmes. Lancet 2011 Sep 8; [e-pub ahead of print]. (http://dx.doi.org/10.1016/S0140-6736(11)61186-0)
Comment
Although these results are impressive, their practical effect will depend on sustainability and cost-effectiveness. The authors plan to report 18- and 24-month follow-up, and data on costs. The program used in this study costs an estimated US$480 annually; editorialists suggest that commercial weight-loss programs might be more cost-effective than primary care–based weight loss services and might be worthy of support from health insurers.