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Efficacy of commercial weight-loss programmes

Many people with type 2 diabetes need to lose weight, and some will attend commercial weight-loss programmes. Weight loss has clear benefits, but healthcare professionals can be reluctant to recommend such commercial programmes owing to lack of evidence on their efficacy. In a new paper, researchers in the US searched for randomised controlled trials on these programmes and concluded that clinicians could consider referring overweight or obese patients to Weight Watchers or Jenny Craig (the latter no longer available in the UK). These had the best-quality evidence of efficacy, although additional studies evaluating long-term outcomes are needed.

by Colin Kenny, GP, Dromore

Sixty-four per cent of the UK adult population is overweight or obese, something that is an important predictor for the risk of diabetes and hypertension. In this American paper, researchers analysed data from 4200 studies and concluded that only a few studies offered high-quality evidence. Only 11 of 32 major commercial weight-loss programmes marketed in the US, it was found, have been rigorously studied. Researchers only included studies where there was a clinically significant weight loss of at least 5%. An important caveat is that these trials were not diabetes specific.

The investigators found consistent evidence supporting the long-term efficacy of Weight Watchers and Jenny Craig (the latter no longer available in the UK). Very-low-calorie dietary approaches can result in substantial short-term weight loss, but caution remains owing to potential risks and the lack of evidence supporting sustained long-term weight loss. The findings remind us as healthcare professionals that we should only refer people with diabetes to those commercial programmes that have a substantial body of evidence showing a consistent, long-term effect.

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