What is Obesity Treatment?

Commercial Weight-loss Options

There are hundreds of commercial weight-loss products and programs to choose from. It can be hard to know where to start. Commercial weight-loss products and programs not offered through a healthcare provider are called non-clinical. Non-clinical methods vary greatly and can include everything from diet books to supplements to commercial weight-loss programs that might include meal replacements. Some of these options may require you to buy and use the program’s foods or supplements. There may also be fees for professional services or devices.

Non-Clinical Weight-loss Options:

  • Support groups
  • Apps such as Lark™ and MyFitnessPal
  • Over-the-counter (OTC) medications such as alli™
  • Meal replacement systems such as Jenny Craig and Nutrisystem
  • WW
  • Health coaches
  • Meal-replacement items
  • Diet books
  • Body monitoring devices such as Fitbit Alta™ or Bodybugg™
  • Websites such as noom.com and SparkPeople.com

Equal to the number of options available in this category of weight-loss are the types of claims they make. It is important to remember that not all methods and claims are reviewed by the Food and Drug Administration (FDA). The FDA is responsible for making sure products are safe and effective. They review all medical devices as well as medications whether they are over-the-counter or prescription. They do not review supplements advertised for weight-loss or diet books.

Diet Books

Diet books have been published since the mid-19th century. While not many have been proven effective, the market for an at-home guide to weight-loss has been successful. They are easy to find, promise results and are usually very affordable.

Popular Diet Books Include:

  • The Complete Ketogenic Diet for Beginners by Amy Ramos
  • The Whole 30 (any in the series) by Melissa and Dallas Hartwig
  • The Obesity Code by Dr. Jason Fung
  • The Plant Paradox by Dr. Steven Gundry
  • The Lose Your Belly Diet by Travis Stork

How Do They Work? Diet books are fairly simple, straight forward and affordable. You select a book at a store or at the library and follow the rules. Most do not require special foods or tools. Many follow a combination of a change in diet (reducing calories, cutting out foods or food groups) paired with self-monitoring and exercise. The cost is about the same as you would have spent on food they currently eat from the grocery store.

Weight-loss: Weight-loss and management depends on your ability to follow the program outlined in the book. If you find it to be something you can easily follow, you may experience a one or two pound loss per week.

Concerns: While many diet books have some merit, most do not offer real, long-lasting lifestyle change options. The majority of people follow the plans for a month or two.

Authors of diet books are very good at putting what you want to hear into words. They make money from selling their books. If they can make a plan seem easy, quick and long-lasting; it could be a best-seller. The New York Times even has a best seller list just for food and diet books.

Following a plan from a diet book usually means that you are making lifestyle changes on your own. This can be difficult. The more weight you aim to lose and the more health concerns you are dealing with can make it harder to be successful in long-term weight management. No matter your health and weight status, it is best to talk with your healthcare provider before beginning any weight-loss plan. You can discuss the pros and cons of different plans with them.

Online/Website/App-Based Diet Programs

Similar to diet books, website and app-based diet programs come in many versions. Some are free, while some charge a fee. Some require a body-monitoring device, some do not. Some are nutritionally sound and others are not.

How Do They Work? Some websites and apps are digital versions of their programs (WeightWatchers.com) or books (Whole30.com) while others are full courses with an online support structure (noom.com). These options are popular and usually offer:

• Simple tools such as recipes, meal ideas and tips for eating out
• Workout and sleep tracking
• Food journal or calorie counting options
• Forums and discussion boards to provide support and an idea community
• Add-on options for personal counseling or prepared meal delivery

Weight-loss: Depending on your ability to follow the set program, you can experience a one to two pound weight-loss per week.

Concerns: Similar to diet books, digital-based diet programs are self-monitored. These work well for some, but are not for everyone. Most diet books and digital-based programs offer flexible options in weight-loss that allow you to shop for your own food at the grocery store, which many people prefer. As with all diet options, it is best to talk with your healthcare provider before you begin one. You may have nutritional or health needs that will not fit with all programs.

Dietary SupplementsIf you have questions about weight-loss medications, learn more with this blog post.

Dietary supplement advertisements promise some of the greatest weight-loss results. However, they have the least amount of rules and regulations when it comes to advertising and marketing claims. This makes it hard for people looking for weight-loss products that are safe and effective to know what to believe and trust.

Some facts about dietary supplements:

  • Dietary supplements are any product taken by mouth that supplement your diet. They include:
    • Vitamins
    • Minerals
    • Herbs
    • Amino acids
  • The manufacturing of dietary supplements is regulated by the FDA for safety.
  • Dietary supplements do not need to prove they perform a certain action (like weight-loss) before being sold.
  • Dietary supplements can interact with prescription medications. You need to let your HCP and pharmacist know if you choose to take them.

How Do They Work? To understand how dietary supplements work, you need to look past the marketing claims and read the ingredients. The supplements may include ingredients that claim to support weight-loss. However, you need to look at each ingredient on the list and learn how they work individually and how they work together. Doing the research can help you understand how effective a supplement might be for weight-loss. Additional guidance from the Federal Trade Commission (FTC) on this topic can be found at: Consumer.FTC.gov/Articles/0061-Weighing-Claims-Diet-Ads

It is very important to know how each supplement will work with all prescription medications you are already taking. It is best to take the product, or at least the list of ingredients, to your HCP or pharmacist to help decide if one is right for you.

Weight-loss: Weight-loss results, specifically from dietary supplements, can be hard to measure as they do not need to be proven effective to be sold. Many people take them along with other lifestyle changes such as increased exercise or weight-loss options such as a low-fat or low-calorie diet. Like all weight-loss options, a one or two-pound weight-loss per week is recommended.

Concerns: It is important to look beyond the amazing weight-loss claims dietary supplements often make. Many claim dramatic weight loss with no additional lifestyle or dietary changes. Evidence supporting these claims or on weight loss, in general, is rarely available. A quick fix endorsed by someone famous can be tempting, but adding dietary supplements without talking with your HCP can not only be costly, but potentially dangerous if it causes a reaction with your medications.

Wearable Technology

A wide range of wearable technology is available that can aid in monitoring lifestyle and dietary changes for weight-loss. Many are worn on your wrist, and they generally have options to pairing with a website or app to allow for greater information sharing and tracking.

How Do They Work? The devices are generally worn on your wrist or carried in your pocket. Through direct monitoring of your actions combined with information you input through a website or app, they can track:

• Temperature
• Heartrate
• Movement (steps, miles, flights of stairs)
• Calories burned
• Calories consumed
• Water consumed
• Sleep patterns

Weight-loss: Wearable technology alone will not result in weight-loss. These devices are meant to be used along with a weight-loss option.

Concerns: These devices cost about $100 to $250 and require an online access fee of around $7-10 per month. The benefit of wearing technology while working out is that a wearer will get a good understanding of which of their activities burn calories best. The downside is that food logging can become tiring, and the ability of technology to accurately calculate calories depends entirely on how well the wearer tracks their food consumption. In addition, not everyone wants to wear an armband or carry a device at all times.

Over-the-Counter Drugs

Currently, alli® is only over-the-counter (OTC) drug approved by the Food and Drug Administration (FDA) for weight-loss. A drug that has FDA approval means that the FDA has reviewed the product and found it to be safe and effective when used as directed. It is not recommended for children under 18 years of age or adults with a BMI below 25. It is important to talk with your HCP before taking any new medication.

How does it work? The medication alli® is a lower-dose version of the prescription drug Xenical® (orlistat). It is a capsule that is taken three times each day, before a meal that includes dietary fat. The medicine works by decreasing the amount of fat absorbed by your body, generally about 25% less. This means not only is the amount of fat absorbed decreased, so are the number of calories. The fat, calories, and nutrients not absorbed by your body are carried through your intestines as stool.

This medicine is designed to help increase the amount of weight you lose while eating a healthy diet, exercising regularly, and drinking plenty of water. The company that manufactures this drug (GlaxoSmithLine group of companies) offers a website with educational and support resources for people taking alli® at MyAlli.com.

Weight-loss: The average weight-loss for people who take alli® is about five to 10 pounds over six months. The medicine is designed to increase your weight-loss while living a healthy lifestyle. For example, if you lost five pounds through eating a healthy diet and exercise, taking alli® could increase your weight-loss by two to three pounds, resulting in a seven to eight-pound weight loss.

Concerns: People taking alli® need to make sure they are eating a healthy, balanced diet that does include some nutritional fat. The medicine will not aid much in weight loss if you are already following a very strict low-fat and low-calorie diet. Individuals using alli® on a regular basis should take a multi-vitamin as there is the potential for vitamin and mineral deficiencies as not all nutrients consumed are absorbed while taking this medication. The side effects of alli® are limited to the gastrointestinal (GI) system and commonly include gas, cramps, stool leakage, oily spotting, and gas with discharge. These side effects will decrease as you decrease the amount of fat you consume in your diet.

Commercial Weight-Loss Centers and Programs

Choosing a commercial weight-loss center or program is one of the most popular options for someone wanting to manage their weight. These options usually provide resources such as pre-packaged meals, support and more. They also traditionally use a 1,000 to 1,500 calorie-per-day diet plan, which can provide quick weight-loss results. However, as weight-loss slows down, it is easy for some people to get frustrated and discouraged or regain weight after they leave the program.

Before starting any commercial program, ask the following questions to a program representative:

  • How much, on average, do clients regain long-term?
  • What is your maintenance and follow-up program?
  • What rate of weight-loss does your program aim for?
  • Does the program emphasize balanced food choices and exercise?
  • Are you required to buy specially formulated foods or supplements?
  • What are the costs of membership, weekly fees, brand food, supplements and counseling?
  • What are the credentials of those running the program?
  • What are the health risks?

Commercial programs usually fit into one of two categories — those that use a meal replacement plan and those that do not. Here is a closer look into the two options:

Meal Replacement Plans:

  • Participants purchase and eat pre-portioned meals.
  • Faster initial weight-loss, but harder to maintain long term and once you leave the program.
  • Convenient, but can also be expensive.
  • Does not teach the basics of healthy eating and nutrition.

Non-Meal Replacement Plans:

  • Participants eat meals made at home from ingredients bought at the grocery store.
  • Slower initial weight-loss, but easier to maintain long term.
  • Costs and effort similar to traditional meal planning.
  • Teaches the basics of healthy eating and nutrition.

Commercial Weight-loss Programs that Use Meal Replacements

NUTRISYSTEM

Nutrisystem is a leading provider of health and wellness and weight-loss products and services, and has helped millions of people lose weight over the course of more than 45 years. Nutrisystem offers safe, effective and scientifically-backed weight-loss plans, with a distinguished Science Advisory Board and strong clinical studies.

Nutrisystem plans provide frozen and shelf-stable pre-packaged, portion-controlled meals and snacks delivered to your home. All Nutrisystem plans include comprehensive support and counseling options from trained weight-loss coaches and certified diabetes educators, accessible seven days a week via chat, email or telephone.

Nutrisystem features portion-controlled meals and structured reduced-calorie meal plans that are high in protein and fiber to help keep you feeling full throughout the day. All meal plans align with national guidelines for total fat, saturated fat, trans fat, sodium, carbohydrates, fiber, protein and added sugars.

All plans can be customized to specific dietary needs and preferences, including the Nutrisystem D® program for people living with type 2 diabetes or prediabetes. Once you have reached your weight-loss goal, Nutrisystem offers transition programs to help you continue to follow the portion-controlled principles of the Nutrisystem program while adding back more of your own foods.

All foods in the Nutrisystem portfolio have been reformulated to contain no artificial flavors or sweeteners and about 120 menu items are free of artificial preservatives.

How does it work? Nutrisystem plans, tailored for men and women, encourage you to consume three meals and two or three snacks per day. The plans offer about 150 items from its highly rated menu of ready-to-go and fresh frozen options. Foods are home-delivered, typically in shipments every four weeks, after you place an order online or over-the-phone. Often fruits, vegetables, lean proteins and dairy products are added to the meal plan – those you select and purchase as needed. Foods are grouped into three categories: SmartCarbs (nutrient-rich, high-fiber carbohydrates), PowerFuels (lean proteins and healthy fats) and Vegetables (non-starchy ones, which can be eaten freely). Each week, you will also get to include Flex™ meals (one breakfast, one lunch, one dinner and one to two snacks) that you either prepare on your own or have when dining out. Flex™ meals allow you to add flexibility into your program while still following the Nutrisystem meal plan guidelines.

A meal planner explains how and when to add these foods and Flex™ meals into your diet. In addition to the Nutrisystem meal plan, you are encouraged to complete three 10-minute bouts of exercise each day, known as My Daily 3. Counseling, for those who want it, is available and included with all Nutrisystem programs.

Nutrisystem offers a free tracking app NuMi as a seamless companion to the Nutrisystem program complete with a barcode scanner for easy tracking, a newsfeed offering daily tips and inspiration, and videos and recipes from The Leaf, the Nutrisystem lifestyle blog.

Weight-loss: With the recommended fruits, vegetables and dairy products, this program is considered a well-balanced approach to weight-loss. In a clinical study, participants on the Nutrisystem plan lost an average of 11.6 pounds in their first four weeks. The average results of two clinical studies on the Nutrisystem D® program showed that participants living with diabetes lost an average of 14 pounds at three months and reduced their A1C by 1.02%.

Concerns: Participants using pre-packaged meals may need additional help to learn good nutrition, which makes maintaining weight-loss difficult once they return to buying or preparing food on their own. In 2011, Nutrisystem began to address this with “transition and maintenance” plans that reduce the number of on-program meals and increase the customer’s preparing and choosing healthy meals in the proper portions. More recently, Flex™ meals were introduced into the program, providing the opportunity to teach consumers how to prepare their own perfectly portioned, balanced meals and snacks to support a lifelong healthy lifestyle. Counselors are also available throughout the program and during transition and maintenance to educate about maintaining good eating habits during program and on your own. And, Nutrisystem provides the free NuMi app to help customers continue to self-monitor their food intake and physical activity even after they have reached their weight-loss goal.

Membership is free and programs cost about $230-$350 for a 28-day package, depending on your order preferences. This does not include the additional fruits, vegetables and other food that you supplement. Although Nutrisystem claims that the full cost of eating while on the program is about 15 to 40% less than what the average American spends on food, some consumers would rather buy food week-to-week, rather than once a month. Some employers and health plans subsidize or reimburse program costs.

JENNY CRAIG

Founded 35 years ago, the Jenny Craig program is designed to provide structure and support to help members lose weight and learn how to keep it off. Jenny Craig’s program provides nutritionally-balanced menus, which include around 100 delicious entrées, desserts and snacks developed by dietitians, nutritionists, and professional chefs.

At Jenny Craig, personal support is a cornerstone of the program. Dedicated consultants who have gone through in-depth training provide one-on-one personal support and education on portion control and strategies such as utilizing Fresh and Free Additions, which helps with satiety. Jenny Craig consultants work with each member individually to identify their strengths, challenges and personal goals to create unique weekly meal and activity plans that fit individual needs. Consultants also help members implement behavioral strategies to support their success. Jenny Craig’s comprehensive approach to weight-loss is available to members either in person, in centers or by phone or video chat with Jenny Craig Anywhere. The program is backed by hard science as demonstrated by a 2010 independent two-year clinical trial published in the Journal of the American Medical Association showing that participants on the Jenny Craig program lost three times more weight than dieting on their own. Jenny Craig, based in Carlsbad, California, is one of the world’s largest weight-loss and weight management companies, with approximately 500 company-owned and franchised locations in local neighborhoods in the United States and Canada, and approximately 600 centers worldwide.

How does it work? Jenny Craig members eat six times a day. A typical menu on Jenny Craig consists of three Jenny Craig meals and three snacks per day in combination with the member’s added grocery items, such as fresh fruits and vegetables and low-fat dairy. Members can still eat their favorite foods, there is no need to eliminate any food groups. No cooking or meal prep required.

The Jenny Craig Program reflects the key recommendations of the U.S. Dietary Guidelines to achieve a healthy eating pattern and active lifestyle to reduce risk and attain a healthy weight. The menu plan is based upon the member’s caloric needs, taking into account the member’s gender, age, height, weight and level of physical activity.

The menus offer around 100 items and provide less than 10% calories from saturated fat and added sugars and 0 grams
trans-fat.

There are several program options to fit specific needs: The Classic Jenny Craig menu, Jenny Craig for type 2 diabetes, and their new Rapid Results program, which leverages the body clock’s natural circadian rhythm to help optimize metabolism and accelerate weight loss.

During the weight-loss part of the program, members follow menus that include Jenny Craig foods for seven days a week. For special events or other times when members need an alternate option, consultants offer guidance for meals on their own. When a member reaches their goal weight, they transition to their own foods with the help of their consultant, and have the option to continue with one meal/snack per day to maintain consistent calories for more successful weight maintenance through our maintenance program. Throughout the program, members meet with their consultant to utilize behavioral strategies to address challenges like emotional, social and unconscious eating and dining out as well as to build an enjoyable, active lifestyle. The program also provides recipes using Fresh and Free additions and helpful blog articles for added support.

Weight-loss: Jenny Craig is a well-balanced, scientifically proven program on which you can expect to lose one to two pounds per week on average. A 2010 independent trial, published in the Journal of the American Medical Association, demonstrated a 10% weight-loss for Jenny Craig participants at one year and seven percent weight-loss at two years. A 2015 study conducted by researchers at Johns Hopkins University and published in Annals of Internal Medicine, one of the most widely-cited peer-reviewed medical journals in the world, suggests that doctors consider recommending Jenny Craig’s weight-loss solution to their patients.

Jenny Craig was identified as one of the most effective weight-loss programs based on evidence that its participants achieved greater weight-loss at 12 months, relative to control groups. A 2014 clinical trial of people with type 2 diabetes, demonstrated a 9% weight-loss at one year with greater improvements in diabetes control and heart risk factors as compared to usual care. Jenny Craig’s Type 2 Diabetes Guide has been favorably reviewed by The American Association of Diabetes Educators (AADE).

Jenny Craig’s newest program, Rapid Results™, is a science-based innovation that leverages research on the body clock’s circadian rhythm which was awarded the 2017 Nobel Prize in Physiology/Medicine. Based on a Jenny Craig pilot study, members can lose up to 16 pounds during their first four weeks. The average weight-loss was 11.6 pounds for those who completed the study.

Concerns: From the beginning, members are learning how to incorporate healthy foods (a variety of non-starchy vegetables, reduced/nonfat dairy products, whole grains and heart healthy fats) into their menus. The daily menu is a model for learning nutritional balance, variety and moderation in food choices. For long-term weight management, it’s important to utilize the tools learned from the program and build healthy habits such as self-monitoring of food choices and behavioral strategies as well as engaging in physical activity.

Consultants are not dietitians; however, they have been trained to deliver an evidence-based program that is developed by registered dietitians as is recommended by the 2013 Obesity Guidelines. Jenny Craig offers three standard types of memberships: As You Go, Premium and Super Premium (available In Center and through Jenny Craig Anywhere). Food costs vary but are approximately $20 a day for three entrées and two snacks.

SLIM-FAST (Available in supermarkets, grocery stores and pharmacies)

Slim-Fast has been around for more than 40 years and offers relatively quick weight-loss by substituting a calorie-controlled, sweet-tasting fortified meal replacement shake or bar for some of your regular meals. The program offers online support that includes weight, diet and exercise charting, chat rooms with online buddies, chat sessions with registered dietitians, a weekly newsletter, exercise programs and meal planning.

Slim-Fast offers several plan options including Traditional, Keto, Advanced Nutrition and Diabetic Weight Loss. They also offer coffee drinks, supplements and bakery items.

How does it work? The diet plan is centered on two Slim-Fast meal replacements. One meal consists of a “Meal-on-the-Go” shake or bar and the other is a similar shake or bar combined with 200 calories of your favorite healthy foods. The third meal is a “sensible meal” of about 500 calories, with 1/2 of your plate filled with veggies, 1/4 with lean protein (such as chicken without the skin), 1/4 with starch, a salad on the side and fruit for dessert. A snack of 120 calories is also offered during the day. Fruits and vegetables (about three to five servings) are encouraged in addition to the meals and snack.

As dieters approach their weight maintenance phase, they can replace the shakes or bars with two additional “sensible meals;” however, Slim-Fast provides little instruction on transitioning from portion-controlled products back to regular foods, an omission which is likely to leave dieters struggling to maintain their weight-loss or relying on Slim-Fast products indefinitely.

Weight-loss: Overall, if followed correctly, the plan does encourage additional fruits and vegetables and it stays at or above 1,200 calories a day, leading to more balanced consumption than traditional liquid diets. Meal replacement diets such as Slim-Fast are appealing because of their simplicity and convenience. If you plan to use Slim-Fast, you should consider doing so under the supervision of a healthcare professional, who can help teach you how to transition yourself from the shakes and who can monitor you for potential complications of fast weight-loss.

Concerns: The shakes are about $1.75 and the meal replacement bars and bakery items cost about $1 to $2 each. The biggest drawback is that dieters may not receive comprehensive information about nutrition, which means that as they transition back to regular foods, which they are likely to do eventually, weight gain may be inevitable. Also, the recommended calorie level may be too low for some dieters.

WW

WW is a global wellness company and the world’s leading commercial weight-loss program. WW inspires millions of people to adopt healthy habits for real life. Through WW’s engaging digital experience and face-to-face group meetings, members follow a livable and sustainable program that encompasses healthy eating, physical activity and positive mindset.

How does it work? The WW program, WW Freestyle™, builds on the successful SmartPoints® plan and gives you more flexibility than ever before. WW Freestyle gives you the freedom to eat – without tracking or measuring – from a robust list of delicious, satisfying foods and still successfully lose weight. While everything is on the menu with WW, the WW Freestyle program features an expanded list of more than 200 zero points foods, including: eggs, corn, all fish, all seafood, skinless chicken breast, skinless turkey breast, non-fat plain yogurt, beans, peas, lentils and tofu.

As part of the new program, the SmartPoints system encourages a healthier pattern of eating and is consistent with the 2015-2020 Dietary Guidelines for Americans. The SmartPoints system translates complex nutrition information into one simple number, giving each food and beverage a SmartPoints value based on calories, saturated fat, sugar and protein. You are given a personalized Daily SmartPoints target based on your height, weight, age and gender and also receive a Weekly SmartPoints target. For even more flexibility, up to four unused SmartPoints each day automatically rollover for you to use as you wish on another day.

With more than five decades of experience in building communities and WW’s deep expertise in behavioral science, WW aims to deliver wellness for all. In addition to eating what you love, WW Freestyle helps you move more in a way that fits your lifestyle, as well as learn the skills and techniques to shift your mindset, strengthen your resilience and keep yourself motivated. Additionally, WW tools such as Connect — a social media community within its app — provides you with a safe space to talk about your journey through a community of like-minded members.

You can follow the program in-person at weekly group meetings and/or digitally. For more information, please visit
WeightWatchers.com.

Weight-loss: WW inspires and guides members toward a healthier pattern of living; by following the program, members can expect to lose one to two pounds per week. WW is one of the few programs whose ability to produce weight-loss has been clinically proven repeatedly through research studies. WW has multiple subscription options: a Monthly Pass subscription to its Meetings offering has base rate of $44.95/month and OnlinePlus has a base rate of $19.95/month (prices may vary). There is also a starter fee of $20.00 to join; applicable taxes vary by state. These two offerings include access to the WW app, which includes Connect.

Concerns: While Leaders have lived the experience (all Leaders have lost weight on WW and kept it off) and are trained in behavioral methods to support weight-loss, they are not licensed dietitians. Therefore, if there are special dietary requirements, it is always best to consult with a dietitian. Another concern is that foods that are zero in point value – which WW describes as having been selected because they have a low risk of being overeaten and form the foundation of a healthy eating pattern – can have as much as 60-230 calories in them, so it is important to eat these in moderation.

Evaluate Your Choices

There are hundreds of weight-loss programs to choose from and many have fantastic sounding claims. Chances are, those claims are too good to be true. When choosing a commercial weight-loss program, be sure to evaluate them based on what will work best for you. A good piece of advice to follow is, “The best diet is one you can stick with.”

Tips for Evaluating Commercial Weight-loss Programs. Make sure to choose a plan that:

• Promotes gradual weight-loss
• Develops permanent lifestyle changes
• Encourages exercise
• Does not exclude major food groups
• Does not label certain foods “bad” or “illegal”
• Does not make unrealistic weight-loss claims

 

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