title: Efficacy of commercial weight-loss programs: an updated systematic review.
abstract: BACKGROUND
  Commercial and proprietary weight-loss programs are popular obesity treatment options, but their efficacy is unclear.
  
  
  OBJECTIVE
  To compare weight loss, adherence, and harms of commercial or proprietary weight-loss programs versus control/education (no intervention, printed materials only, health education curriculum, or <3 sessions with a provider) or behavioral counseling among overweight and obese adults.
  
  
  METHODS
  MEDLINE and the Cochrane Database of Systematic Reviews from inception to November 2014; references identified by program staff.
  
  
  METHODS
  Randomized, controlled trials (RCTs) of at least 12 weeks' duration; prospective case series of at least 12 months' duration (harms only).
  
  
  METHODS
  Two reviewers extracted information on study design, population characteristics, interventions, and mean percentage of weight change and assessed risk of bias.
  
  
  RESULTS
  We included 45 studies, 39 of which were RCTs. At 12 months, Weight Watchers participants achieved at least 2.6% greater weight loss than those assigned to control/education. Jenny Craig resulted in at least 4.9% greater weight loss at 12 months than control/education and counseling. Nutrisystem resulted in at least 3.8% greater weight loss at 3 months than control/education and counseling. Very-low-calorie programs (Health Management Resources, Medifast, and 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 resulted in 0.1% to 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.
  
  
  CONCLUSIONS
  Many trials were short (<12 months), had high attrition, and lacked blinding.
  
  
  CONCLUSIONS
  Clinicians could consider referring overweight or obese patients 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.
  
  
  BACKGROUND
  None. (
  CRD4201-4007155).
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Gudzune
authors.forename: Ruchi S
authors.initials: RS
authors.lastname: Doshi
authors.forename: Ambereen K
authors.initials: AK
authors.lastname: Mehta
authors.forename: Zoobia W
authors.initials: ZW
authors.lastname: Chaudhry
authors.forename: David K
authors.initials: DK
authors.lastname: Jacobs
authors.forename: Rachit M
authors.initials: RM
authors.lastname: Vakil
authors.forename: Clare J
authors.initials: CJ
authors.lastname: Lee
authors.forename: Sara N
authors.initials: SN
authors.lastname: Bleich
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Clark
mesh_terms: D031204:Caloric Restriction / Q000379:methods*; D003376:Counseling; D004038:Diet, Reducing / Q000379:methods*; D006801:Humans; D009765:Obesity / Q000178:diet therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic; D016896:Treatment Outcome; D015431:Weight Loss
references.citation: J Am Diet Assoc. 1991 Dec;91(12):1582-4
references.pmid: 1960353
references.citation: Br J Gen Pract. 2014 Mar;64(620):e128-36
references.pmid: 24567651
references.citation: Obes Res. 2001 Nov;9 Suppl 4:284S-289S
references.pmid: 11707555
references.citation: J Am Pharm Assoc (2003). 2003 Sep-Oct;43(5):583-9
references.pmid: 14626750
references.citation: Public Health Nutr. 2009 Jun;12(6):799-807
references.pmid: 18647427
references.citation: JAMA. 2003 Apr 23-30;289(16):2083-93
references.pmid: 12709466
references.citation: Am J Hypertens. 2013 Mar;26(3):416-23
references.pmid: 23382493
references.citation: JAMA. 2007 Mar 7;297(9):969-77
references.pmid: 17341711
references.citation: J Med Internet Res. 2012;14(2):e57
references.pmid: 22555246
references.citation: J Med Soc N J. 1979 Mar;76(3):175-9
references.pmid: 286061
references.citation: Eat Behav. 2011 Jan;12(1):60-3
references.pmid: 21184975
references.citation: Diabetologia. 2005 Jan;48(1):8-16
references.pmid: 15616799
references.citation: Nutr J. 2007;6:12
references.pmid: 17592648
references.citation: Circulation. 2014 Jun 24;129(25 Suppl 2):S102-38
references.pmid: 24222017
references.citation: BMJ. 2011;343:d6500
references.pmid: 22053315
references.citation: BMC Public Health. 2010;10:669
references.pmid: 21047432
references.citation: J Gen Intern Med. 2013 Jan;28(1):12-7
references.pmid: 22618582
references.citation: Eur J Clin Nutr. 2005 Mar;59(3):411-8
references.pmid: 15674301
references.citation: Qual Life Res. 2009 Apr;18(3):281-9
references.pmid: 19212822
references.citation: N Engl J Med. 2003 May 22;348(21):2082-90
references.pmid: 12761365
references.citation: Clin J Am Soc Nephrol. 2012 Jul;7(7):1103-11
references.pmid: 22653255
references.citation: Public Health Rep. 2010 Jul-Aug;125(4):596-604
references.pmid: 20597460
references.citation: Am J Med. 1994 Oct;97(4):354-62
references.pmid: 7942937
references.citation: Am J Med. 2000 Sep;109(4):282-7
references.pmid: 10996578
references.citation: Obesity (Silver Spring). 2013 Dec;21(12):2589-95
references.pmid: 23418103
references.citation: Arch Intern Med. 1992 May;152(5):961-6
references.pmid: 1580722
references.citation: JAMA. 2007 Nov 7;298(17):2028-37
references.pmid: 17986696
references.citation: Nutr J. 2010;9:11
references.pmid: 20222968
references.citation: Obesity (Silver Spring). 2014 Sep;22(9):1942-51
references.pmid: 24962106
references.citation: Obes Res Clin Pract. 2009 Aug;3(3):I-IV
references.pmid: 24345585
references.citation: J Nutr. 2004 Aug;134(8):1894-9
references.pmid: 15284372
references.citation: Am J Med. 2013 Dec;126(12):1143.e19-24
references.pmid: 24135513
references.citation: BMJ. 2006 Jun 3;332(7553):1309-14
references.pmid: 16720619
references.citation: Obesity (Silver Spring). 2006 Jul;14(7):1219-30
references.pmid: 16899803
references.citation: Int J Obes (Lond). 2005 Dec;29(12):1445-51
references.pmid: 16172619
references.citation: Obes Res. 2004 Jun;12(6):1011-8
references.pmid: 15229342
references.citation: N Engl J Med. 2008 Jul 17;359(3):229-41
references.pmid: 18635428
references.citation: Nutr Diabetes. 2013 Mar 18;3:e63
references.pmid: 23507967
references.citation: Obes Res. 2001 Nov;9 Suppl 4:341S-347S
references.pmid: 11707563
references.citation: Am J Clin Nutr. 2004 Sep;80(3):560-8
references.pmid: 15321793
references.citation: Ann Intern Med. 2004 May 18;140(10):769-77
references.pmid: 15148063
references.citation: Obes Res. 2000 Aug;8(5):399-402
references.pmid: 10968732
references.citation: Am J Clin Nutr. 1991 Apr;53(4):854-8
references.pmid: 2008863
references.citation: Int J Obes (Lond). 2007 Aug;31(8):1270-6
references.pmid: 17325684
references.citation: Diabetes Care. 2013 Aug;36(8):2225-32
references.pmid: 23690533
references.citation: J Obes. 2013;2013:151597
references.pmid: 24392223
references.citation: JAMA. 2014 Sep 3;312(9):923-33
references.pmid: 25182101
references.citation: J Nutr Health Aging. 2010 Jun;14(6):461-6
references.pmid: 20617289
references.citation: Diabetes Care. 2014 Jun;37(6):1573-80
references.pmid: 24760261
references.citation: JAMA. 2014 Feb 26;311(8):806-14
references.pmid: 24570244
references.citation: Obesity (Silver Spring). 2013 Apr;21(4):673-80
references.pmid: 23404824
references.citation: Am J Clin Nutr. 1999 Feb;69(2):198-204
references.pmid: 9989680
references.citation: Lancet. 2011 Oct 22;378(9801):1485-92
references.pmid: 21906798
references.citation: Ann Intern Med. 2010 Aug 3;153(3):147-57
references.pmid: 20679559
references.citation: J Am Heart Assoc. 2013 Dec;2(6):e000152
references.pmid: 24351700
references.citation: Obesity (Silver Spring). 2007 Apr;15(4):939-49
references.pmid: 17426329
references.citation: JAMA. 2003 Apr 9;289(14):1792-8
references.pmid: 12684357
references.citation: JAMA. 2005 Jan 5;293(1):43-53
references.pmid: 15632335
references.citation: Postgrad Med. 2009 Sep;121(5):113-8
references.pmid: 19820280
references.citation: Postgrad Med. 2011 Sep;123(5):205-13
references.pmid: 21904103
references.citation: Diabetes Care. 1994 Jun;17(6):602-4
references.pmid: 8082533
references.citation: BMC Public Health. 2010;10:439
references.pmid: 20663185
references.citation: Ann Intern Med. 2005 Jan 4;142(1):56-66
references.pmid: 15630109
references.citation: Int J Obes (Lond). 2012 Apr;36(4):614-24
references.pmid: 21673653
references.citation: J Am Coll Nutr. 2009 Apr;28(2):159-68
references.pmid: 19828901
references.citation: Int J Obes (Lond). 2007 Feb;31(2):292-8
references.pmid: 16755283
references.citation: Eur J Clin Nutr. 2002 Mar;56(3):264-70
references.pmid: 11960302
references.citation: Obes Res. 1998 May;6(3):208-18
references.pmid: 9618125
references.citation: Diabetes Care. 2009 Jul;32(7):1147-52
references.pmid: 19366978
references.citation: Int J Cardiol. 2006 Jun 16;110(2):212-6
references.pmid: 16297472
references.citation: J Clin Endocrinol Metab. 1998 Jan;83(1):214-8
references.pmid: 9435444
references.citation: Lancet. 2009 Nov 14;374(9702):1677-86
references.pmid: 19878986
references.citation: Eur J Clin Nutr. 2014 Jan;68(1):64-70
references.pmid: 24129359
references.citation: J Gen Intern Med. 2013 Jan;28(1):3-5
references.pmid: 22956417
references.citation: Int J Obes (Lond). 2014 Feb;38(2):279-84
references.pmid: 23736359
references.citation: JAMA. 2010 Oct 27;304(16):1803-10
references.pmid: 20935338