Commercial weight loss programmes are more effective and cheaper than those provided by the NHS, a study has found. Diet programmes such as Weight Watchers, Slimming World and Rosemary Conley are better at helping people lose weight than one-to-one counselling at GPs' surgeries or pharmacies, research by Birmingham University found. The research, published online in the British Medical Journal, compared the effectiveness of several popular weight loss programmes with those available on the NHS. In the study, 740 obese and overweight men and women were divided into six groups and attended either Weight Watchers, Slimming World, Rosemary Conley, a group-based NHS programme called Size Down - run by local food advisers trained by dieticians - and one-to-one counselling in a pharmacy or GP's surgery. However, the NHS programmes were no better than attending the local fitness centre when it came to weight reduction.
At one year, significant weight loss occurred in all groups apart from the GP and pharmacy based one-to-one programmes. The study found that Weight Watchers was the only programme to achieve "significantly greater weight loss" than the control group. The findings confirm those of a recent study published in the journal Lancet which found that people attending Weight Watchers lost twice as much weight after a year compared with others who were given standard weight loss advice by their doctor. The NHS programmes were also the worst attended, and the most costly to run, the researchers said. The researchers concluded: "Our findings suggest that a 12 week group based dedicated programme of weight management can result in clinically useful amounts of weight loss that are sustained at one year. DISCLAIMER: The contents of this site are for information purposes only and do not constitute medical advice. The study was carried out by researchers from the Medical Research Council Human Nutrition Research Laboratory, Cambridge; the University of Munich, Germany and the University of Sydney, Australia. One thing to note is that the trial was not blinded – the participants knew which group they were in, as did some of the researchers. The researchers say that there is an urgent need for interventions to deal with the global health problem of obesity, as excess weight accounts for 44% of the global burden of diabetes, 23% of heart disease and 7%-41% of some cancers.
Between September 2007 and November 2008, researchers recruited 772 overweight and obese adults from primary care practices in Australia, Germany and the UK. Participants were randomly assigned to receive either 12 months of free membership to Weight Watchers, or standard care, as defined in national treatment guidelines for obesity. Participants in the standard care group received weight loss advice from a health professional at their local GP surgery, based on national treatment guidelines.
As well as recording weight change, the researchers also looked at changes in fat mass, waist circumference, blood pressure and markers of cardiovascular risk.
Of the 377 participants assigned to the commercial programme, 230 (61%) completed the 12-month study. Participants on the Weight Watchers programme lost twice as much weight on average than those in the standard care group. Participants in the commercial programme also had larger reductions in waist circumference and fat mass, greater improvements in insulin levels and improved cholesterol ratios. The authors say that referring selected patients to commercial weight loss programmes providing group support and dietary advice can present a “clinically useful intervention” for managing the weight of overweight and obese people.

There were high drop-out rates in both groups (40%-50%), which may have affected the study’s results. The lack of blinding was unavoidable given the nature of the two interventions being tested.
The researchers ensured that the allocation of participants at randomisation was concealed. One aspect not addressed by this report is the cost-effectiveness of the different approaches. Finally, the study does not address a common problem with weight loss: the difficulty of keeping the weight off in the long term. With an account you can keep track of pages on the site and save them to this tab, which you can access on every page when you are logged in. These simple balance exercises can be done at home to help improve your health and mobility.
If you're not very active or not sure how to start, you may want to get the all-clear from a GP before starting. Consider doing the exercises near a wall or a stable chair just in case you lose your balance. Try to do these exercises at least twice a week and combine them with the other routines in this series to help improve strength, balance and co-ordination.
The story is based on research that found that overweight and obese adults referred to Weight Watchers lost twice as much weight over a year as those who received standard advice on losing weight at their local GP surgery. It was funded by a grant from Weight Watchers International to the UK Medical Research Council. In its story the Daily Express mentioned another commercial organisation, Slimming World, which could be misleading since this programme was not assessed by the trial. They were assigned to receive either 12 months of standard care for weight loss (as defined by national guidelines) or 12 months of free membership to the Weight Watchers commercial weight loss programme. Given the nature of the interventions being investigated, the lack of blinding was unavoidable, but it means that knowing which treatment group they were in could have unconsciously influenced participants’ motivation and therefore the amount of weight they lost. They also highlight that for overweight individuals a weight loss of 5%-10% is associated with significant health benefits. The Weight Watchers system places emphasis on a balanced diet based on healthy eating principles, increased physical activity and group support. It is not clear how often people in this group met with health professionals or how much support they received. They measured body weight, fat mass, waist circumference and blood pressure at at the start of the study and at 2, 4, 6, 9 and 12 months.
Although the researchers say that they anticipated this possibility when calculating the sample sizes needed to obtain meaningful results, the difference in drop-out rates between groups could have affected the reliability of the results.
It is possible that participants knowing which treatment they were assigned could have had an influence on results.
This means that allocation could not be influenced by the researchers or the participants, and this is an important feature of this well-designed trial.

Although the more intensive support organised by Weight Watchers (including weekly weigh-ins and group support) resulted in more weight loss than standard guideline advice from a GP, more research will be needed to assess the financial costs to achieve this extra benefit. Future studies could look at this too, particularly in people who discontinue the programme once they have achieved their target weight.
Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial. Find out why a steady rate of weight loss is safer, and more likely to produce the long-term results you want. Start by standing facing the wall, with arms outstretched and your fingertips touching the wall. Participants on the Weight Watchers programme also had greater reductions in waist size and body fat, which are both changes associated with a lower risk of cardiovascular disease and diabetes. It should be noted that in the trial, which was sponsored by Weight Watchers, participants received free access to the programme, which may mean that their behaviour was not typical of people having to pay for the course themselves. The researchers say that the sponsor had no role in the study design, data collection, data analysis, data interpretation or writing of the report. The Daily Mail included comments from an independent expert and mentioned the source of funding – a pertinent point which many other newspapers left out. The randomisation procedure (how the participants were randomly allocated to each group) was concealed from the researchers by use of an online database.
They suggest that partnerships between primary care and commercial organisations could be used to deliver weight-management programmes on a large scale, but say that prior to their study there had been few RCTs of commercial weight-loss programmes and that their effectiveness has not yet been compared with standard care. They had at least one additional risk factor for obesity-related disease, including “central adiposity” (a waist circumference of more than 88cm in women and more than 102cm in men), type 2 diabetes or mild to moderate high cholesterol (dyslipidaemia). In this research participants received 12 months of free access to weekly community-based Weight Watcher meetings, which involve weigh-ins, group discussion, behavioural counselling and motivation.
Blood samples were also taken to measure blood sugar, insulin and lipid levels at 6 and 12 months. However, the objective measurement of weight makes this less important as it does quantify the effect of these interventions. Also, as participants were given free access to the Weight Watchers programme, it is unclear from this study how having to pay to attend might affect the amount of weight lost or the chances of dropping out. Another limitation of the study is that it only lasted 12 months, and therefore does not address the common difficulty of maintaining weight loss in the long-term. They had initially recruited 1,010 potential participants but excluded 238 on the grounds of recent weight loss of 5kg or more and various health and medical disorders. Participants are also able to access internet-based systems to monitor food intake, physical activity and weight change, to join community discussion boards and to access recipes and meal ideas.

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