VOLUME 8 NUMBER 3 • SEPTEMBER 2011
105
SA JOURNAL OF DIABETES & VASCULAR DISEASE
REVIEW
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T
he increasing prevalence of overweight
and obesity requires effective approaches
to weight loss in primary care and com-
munity settings. Obesity and its associated
co-morbidities demand early intervention,
as the high prevalence of obesity puts pres-
sure on scarce healthcare resources. Weight
loss of 5 to 10% is associated with clini-
cally significant health benefits, including
a reduction in risk factors for diabetes and
cardiovascular disease.
The efficacy of commercial weight-loss
programmes has not been assessed in direct
comparison with standard care in primary
healthcare settings. Recent findings indicate
that commercial programmes in partnership
with primary-care providers are a robust
intervention for obesity, with commercial-
programme participants losing twice as
much weight.
In a parallel group, non-blinded, ran-
domised, controlled trial, 772 overweight
and obese adults (with at least one other
risk factor for obesity-related disease) were
recruited by primary-care practices in Aus-
tralia, Germany and the UK. Participants
received either 12 months of standard care
Commercial weight loss programmes offer clinically useful early
intervention for obesity
as per national treatment guidelines, or 12
months’ free membership to the commercial
weight-loss programme ‘Weight Watchers’.
Primary outcome was weight change over
12 months.
Of the 377 participants assigned to the
commercial programme, 230 completed
the 12-month assessment. Of the 395 par-
ticipants assigned to standard care, 214
completed the 12-month assessment. In
all analyses, participants in the commercial-
programme group lost approximately twice
as much weight as did those in the stand-
ard-care group. The mean weight change
at 12 months was –5.1 kg for those in the
commercial programme versus –2.2 kg for
those receiving standard care.
For those participants who completed
the 12 months, mean weight loss was 6.7
kg in the commercial programme versus 3.3
kg is the standard-care group. Participants
randomised to the commercial programme
were also more than three times as likely
to lose at least 5% of their body weight
compared with those receiving standard
care. The greater weight loss in participants
assigned to the commercial programme was
accompanied by greater reductions in waist
circumference and fat mass, which would
be expected to reduce the risk for type 2
diabetes and cardiovascular disease. There
was also the suggestion of greater improve-
ments in glucose and lipid metabolism in the
commercial programme participants.
Weight Watchers promotes a hypo-ener-
getic, balanced diet based on healthy eating
principles, increased physical activity and
group support. Participants are encouraged
to achieve and maintain their self-selected
weight-loss goals through weekly meetings
encompassing a weigh-in and group discus-
sion, behavioural counsellingandmotivation.
Internet-based systems enable monitoring
of food intake, activity and weight change,
as well as access to community discussion
boards, recipes and other information.
Source: Jebb SA, Ahern AL, Olson AD, Aston LM,
1.
Holzapfel C, Stoll J,
et al
. Primary care referral to
a commercial provider for weight loss treatment
versus standard care: a randomised controlled trial.
. Published online September
8, 2011 DOI: 10.1016/S0140-6736(11)61344-5.
