Background Commercial or proprietary weight loss programs are popular obesity treatment options; however, their efficacy is unclear. Purpose To compare weight loss, adherence, and harms of commercial or proprietary weight loss programs to control/education or behavioral counseling among adults with overweight and obesity. Data sources MEDLINE and Cochrane Database of Systematic Reviews from inception to November 2014; references identified by programs Study selection Randomized controlled trials (RCT) of ≥12 weeks duration; prospective case series ≥12 months (harms only) Data extraction Two reviewers extracted information on study design, population characteristics, interventions, and mean % weight change, and assessed risk of bias. Data synthesis We included 39 RCTs. At 12 months, Weight Watchers’ participants achieved at least 2.6% greater weight loss than control/education. Jenny Craig resulted in at least 4.9% greater weight loss at 12 months as compared to both control/education and counseling. Nutrisystem participants achieved at least 3.8% greater weight loss at 3 months than control/education or counseling. Very-low-calorie programs (HMR, Medifast, Optifast) resulted in at least 4.0% greater short-term weight loss than counseling, but some attenuation of effect occurred beyond 6 months when reported. Atkins achieved 0.1–2.9% greater weight loss at 12 months than counseling. Results for SlimFast were mixed. We found limited evidence to evaluate adherence or harms for all programs and weight outcomes for other commercial programs. Limitations Many trials had short durations (<12 months), high attrition, and lacked blinding. Conclusions Clinicians could consider referring patients with overweight or obesity to Weight Watchers or Jenny Craig. Other popular programs such as NutriSystem show promising weight loss results; however, additional studies evaluating long-term outcomes are needed. Primary funding source None. Registered with PROSPERO (CRD42014007155).

OBJECTIVE -There is a concern that an "epidemic of obesity" is occurring in Western societies. One consequence of obesity is that type 2 diabetes may develop. Presumably, a great increase in body weight would continue in people with diabetes and may be accelerated due to pharmacological treatment. In this retrospective study, we tested the hypothesis that the weight gain in a diabetic population is greater than that in the general population.RESEARCH DESIGN AND METHODS -Data were obtained from the records of 205 adult men who have attended a diabetes clinic for Ն5 years. Their weight and glycohemoglobin at the last visit were compared with the initial visit data. The subjects were categorized according to treatment modalities. The mean follow-up was 9.4 years (range 5-23).RESULTS -For the group as a whole, the mean increase in body weight was 0.23 Ϯ 0.2 kg/year. BMI or initial age had little effect on the rate of weight gain. Treatment regimen used did have an effect on weight change. In subjects treated with insulin, with or without oral agents, body weight increased at a rate of 0.44 Ϯ 0.1 kg/year. In subjects treated with metformin or metformin and a sulfonylurea, there was a mean loss in weight, i.e., Ϫ0.24 Ϯ 0.09 kg/year, and with sulfonylureas alone weight increased by 0.42 Ϯ 0.2 kg/year. CONCLUSIONS -The men treated with insulin alone or insulin combined with oral agents gained weight at a rate comparable with that reported for the general population, i.e., the weight gain was not extraordinary. Metformin treatment resulted in a modest loss of weight. Diabetes Care 29:493-497, 2006

Our objective was to compare the effect of commercial weight-loss programs on blood pressure and lipids to control/education or counseling among individuals with overweight/obesity. We conducted a systematic review by searching MEDLINE and Cochrane Database of Systematic Reviews from inception to November 2014 and references identified by the programs. We included randomized, controlled trials ≥12 weeks duration. Two reviewers extracted information on study design, interventions, and mean change in systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, and total cholesterol and assessed risk of bias. We included 27 trials. Participants’ blood pressure and lipids were normal at baseline in most trials. At 12 months, Weight Watchers showed little change in blood pressure or lipid outcomes as compared to control/education (2 trials). At 12 months, Atkins’ participants had higher HDL-c and lower triglycerides than counseling (4 trials). Other programs had inconsistent effects or lacked long-term studies. Risk of bias was high for most trials of all programs. In conclusion, limited data exist regarding most commercial weight-loss programs’ long-term effects on blood pressure and lipids. Clinicians should be aware that Weight Watchers has limited data that demonstrate CVD risk factor benefits relative to control/education. Atkins may be a reasonable option for patients with dyslipidemia. Additional well-designed, long-term trials are needed to confirm these conclusions and evaluate other commercial programs.

Objective We examined the glycemic benefits of commercial weight-loss programs as compared to control/education or counseling among overweight and obese adults who had or who were at increased risk for type 2 diabetes mellitus (T2DM). Methods We searched MEDLINE, Cochrane Database of Systematic Reviews, and references cited by individual programs. We included randomized controlled trials (RCTs) of ≥12 weeks duration. Two reviewers extracted information on study design, population characteristics, interventions, and mean changes in hemoglobin A1c and glucose. Results We included 18 RCTs. Few trials occurred among individuals with T2DM. In this population, Jenny Craig reduced A1c at least 0.4% more than counseling at 12 months, Nutrisystem significantly reduced A1c 0.3% more than counseling at 6 months, and OPTIFAST reduced A1c 0.3% more than counseling at 6 months. Among individuals at increased risk for T2DM, few studies evaluated glycemic outcomes, and when reported, most did not show substantial reductions. Discussion Few trials have examined whether commercial weight-loss programs result in glycemic benefits for their participants, particularly among individuals at increased risk of T2DM. Jenny Craig, Nutrisystem, and OPTIFAST show promising glycemic lowering benefits for patients with T2DM, although additional studies are needed to confirm these conclusions.

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BackgroundObesity affects cancer risk and treatment outcomes. Preventing weight gain may prevent some cancers, improve cancer outcomes, reduce cancer recurrence and increase cancer-related survival. We performed a systematic review to identify strategies to prevent weight gain in individuals with or at risk for breast cancer.FindingsWe included 2 studies from 27,879 citations. In premenopausal women at risk for breast cancer, a low fat diet prevented weight gain at 12 months. Among women with breast cancer, effective strategies to prevent weight gain included low-fat dietary counseling with self-management techniques. One trial reported on cancer outcomes, mortality and adverse events. Low-fat dietary counseling wilth self-management techniques lowers the risk breast cancer relapse by 24% compared with less intensive counseling with maintenance of nutritional status goal. There was no difference in overall mortality and no adverse events were observed.ConclusionLimited evidence suggests that women with or at risk for breast cancer may successfully employ dietary and exercise strategies to prevent weight gain for at least one year. Low fat dietary counseling may improve cancer outcomes in women with breast cancer. Future studies should confirm these findings and evaluate the impact of weight gain prevention on cancer incidence, recurrence and survival.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-2-277) contains supplementary material, which is available to authorized users.

BackgroundObesity is common in the U.S. and many individuals turn to commercial programs to lose weight. Our objective was to directly compare weight loss, waist circumference, and systolic and diastolic blood pressure (SBP, DBP) outcomes between commercially available weight-loss programs.MethodsWe conducted a systematic review by searching MEDLINE and the Cochrane Database of Systematic Reviews from inception to November 2014 and by using references identified by commercial programs. We included randomized, controlled trials (RCTs) of at least 12 weeks duration that reported comparisons with other commercial weight-loss programs. Two reviewers extracted information on mean change in weight, waist circumference, SBP and DBP and assessed risk of bias.ResultsWe included seven articles representing three RCTs. Curves participants lost 1.8 kg (95%CI: 0.1, 3.5 kg) more than Weight Watchers in one comparison. There was no statistically significant difference in waist circumference change among the included programs. The mean reduction in SBP for SlimFast participants was 4.5 mmHg (95%CI: 0.4, 8.6 mmHg) more than that of Atkins participants in one comparison. There was no significant difference in mean DBP changes among programs.ConclusionsThere is limited evidence that any one of the commercial weight-loss programs has superior results for mean weight change, mean waist circumference change, or mean blood pressure change.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3112-z) contains supplementary material, which is available to authorized users.

ObjectiveTo characterize weight-loss claims and disclaimers present on websites for commercial weight-loss programs and compare them to results from published randomized controlled trials (RCT).MethodsWe performed a content analysis of all homepages and testimonials available on the websites of 24 randomly selected programs. Two team members independently reviewed each page and abstracted information from text and images to capture relevant content including demographics, weight loss, and disclaimers. We performed a systematic review to evaluate the efficacy of these programs by searching MEDLINE and Cochrane Database of Systematic Reviews, and abstracted mean weight change from each included RCT.ResultsOverall, the amount of weight loss portrayed in the testimonials was extreme across all programs examined (range median weight loss 10.7 to 49.5 kg). Only 10 out of the 24 programs had eligible RCTs. Median weight losses reported in testimonials exceeded that achieved by trial participants. Most programs with RCTs (78%) provided disclaimers stating that the testimonial's results were non-typical and/or giving a range of typical weight loss.ConclusionWeight loss claims within testimonials were higher than results from RCTs. Future studies should examine whether commercial programs' advertising practices influence patients' expectations or satisfaction with modest weight loss results.