Because It Works

To my mind, WeightWatchers is the industry leader in performing rigorous testing of their services.? Under the leadership of?Karen Miller-Kovach, its chief scientific officer, it has sponsored several randomized control trials comparing the effectiveness of the WeightWatchers point system to other diet approaches.? For example, Miller-Kovach is a co-author of?this 2003 JAMA study (which showed that after 2-years WeightWatchers helped overweight dieters lose about 3 percent of their body mass – reducing their average weight from 207 to 201 pounds).

But I’m troubled by the current advertising campaign that accompanies the rollout of the New PointsPlus system.

The tagline “Because it works” is not well supported by the data.? (You can see the phrase in the background in?this television commercial, where the amazing Jennifer Hudson belts out “Feeling Good.”)

Miller-Kovach has been out in front promoting the new point system claiming, for example:

Our new PointsPlus program is?based on the latest scientific research and is designed to guide people to foods that are nutrient dense and highly satisfying, ensuring they will make healthful decisions, have successful weight loss and learn to keep their weight off long-term.

The WeightWatchers site helpfully has a page laying out “The Science behind thePointsPlus Program“:

The Weight Watchers approach delivers a science-based, lifestyle modification program based on 4 pillars- diet, physical activity, positive thinking skills and an environment of support.

The new?PointsPlus program does not waiver from this foundation, but rather incorporates advances in science and nutrition as it relates to weight management. It has been tested in a rigorous, independent clinical trial, and the results demonstrate it delivers significant weight loss as well as improvements in cardiovascular risk factors and eating behaviors linked with long-term weight loss and hedonistic hunger (an urge to eat when the body does not have a biologic need to). 1,2

These two footnotes (1,2) are the crucial backup for both the “because it works” claim and the claim that the PointsPlus program has been “tested in rigorous, independent clinical trials and the results demonstrate it delivers significant weight loss.”

It turns out that the two studies, which are both coauthored by Miller-Kovach, provide pretty meager support for these claims.

One?study took 132 adults with BMIs between 27 and 35 and randomized them to “1 of 2 systems for appraising food intake” (I guessing, the old points and the new points system).? Then after 12 weeks, the researchers looked to see whether there was a difference between the groups in weight loss or in self-reported measures of weight control of hedonic hunger.? The key, and to my mind alarming, results were succinctly stated:

Results: 111 subjects (99 F, 12 M) completed all Week 12 assessments.? With?no differences between conditions on any measure, analyses used the combined sample.? M % weight loss was 4.4% (S.D.=3.71).

The study of just 111 subjects seems to have found no difference on any measure between the old and the new point systems.? The average weight loss for diets after 12 weeks was 4.4 percent, which is not only modest (especially given that?most dieters regain weight between 6-24 months), but the standard deviation of 3.71 suggests that it is not even a statistically significant loss in weight.? Counter to the claims of the website, I do not believe that “the results demonstrate it delivers significant weight loss.”

The?second study which is cited seems to be just a second analysis of the same experiment (132 adults again with BMIs between 27 and 35).? Instead of looking at weight loss and self-reported measures of hunger, this study looked to see whether there were differences between the groups in “Lipid, blood glucose, blood pressure and waist circumference.”? But again, the researchers report no differences between the old and new point systems: “With no weight loss differences between conditions, analyses used the combined sample.”

So, as far as I can tell, the change to the new point system is supported by a single experiment of 132 subjects that could not find any difference in results between the two point systems.? To my mind, the campaign may mislead consumers, who are more likely to hear in the phrase “New PointsPlus, because it works” the idea that WeightWatchers made the change “because the new point system works better than the old points system.”? But the current studies don’t support this inference.? A more accurate, but less appealing tagline would be:? “New PointsPlus, because it doesn’t work any worse.”

I may be wrong about all of this.? One of the downsides of starting to teach Intellectual Property is that I find myself seeing an increasing number of?Lanham Act violations.? In fact, the new point system, by providing more dieting freedom and flexibility (the new system, for example, attributes zero points for fruit), without any worse results may be a net good.? But I fear this more subtle message is unlikely to be understood by consumers who are in the market for a weight loss plan.

(Conflict Disclosure:? I’m a co-founder of?a website and author of?a diet booklet (including a frank assessment of its limited empirical support) which might be viewed as either a substitute for or a complement to the WeightWatchers system.)


Allison

"Because it works" has been Weight Watchers tagline for a while, though, so it may well have more to do with consistency in branding while everything is being shaken up than anything else.

Put a lid on them.

Wait, how much weight should we give this Weight Watcher watcher?

Mariel

Thanks for writing about this. I did wonder why Weight Watchers changed the system, and this look into their studies contributes to the answer, I think.

I do partly disagree (like Allison) on the take you made on "Because it works". I don't think it's unreasonable to assume that a corporation would use tools like that to manipulate its audience, but at the same time we can't really be sure that was the intent. As Allison said, they could be after consistency. They could also be doing a claim for Weight Watchers in general, rather than about the efficiency of this new program as compared to the other one.

The impression I got from reading what they had Jennifer Hudson write on her blog (and what I've read from other people who seem to have WW endorsements, like Hungry Girl), the point they were trying to get across was that the new program was better in the way that it encouraged you to eat 'healthier' foods. With all the low-cal, 'fiberified' junk food that is on the market, people on WW forget that there are healthier options than a muffin.

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Eric M. Jones

As of today, NO form of addictive, obsessive, or compulsive behavior, once tamed, can even be resumed in safety.

Would that it could be...!

I have every hope that this situation will change with deeper understanding of the mechanisms of human brains and bodies. I've got my reservations in with my doctor. I'll take one of those and one of those and one of those...Oh Hell, just give me the whole case.

Megan

I would like to read your booklet, but when I use the link to Amazon, I get a message that says "The Web address you entered is not a functioning page on our site". I can't find it by searching the Kindle store, either.

Miri McDonald

I know many people that have had success on Weight Watchers and I believe it works when people stick to it. The issue is that restricting intake and exercising regularly is something Americans have a hard time doing.

People want a "secret" solution that requires no effort. That's why our country is so obese. Get rich quick. Get thin quick. People want it all without working towards it.

WW is a healthy choice for people that are serious about changing the way they eat for the long term and increasing their activity level. I think including fruits and vegetables as "free" is a great idea because most Americans don't eat nearly enough of either. Someone at my WW meeting put it quite eloquently "no one got to weight watchers by eating an entire bag of apples."

In summary, I do think WW works and we are so quick to blame corporations rather than taking accountability for being determined, disciplined, and focusing on long-term health.

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Deb

I have used the old point system successfully, but I modified it in the same way the new point system is modified. All fruits and veggies were 0 pts in my system. In a choice between a 2 pt apple and 2 pt chocolate, the chocolate would always win. but modified, the chocolate has 2 pts and the apple none, so the apple wins. and I win too

Chris

I believe people usually overeat because they are either bored or depressed or both... obesity is a psychological problem. Fat people know they eat too much, they just can't stop.

BCN

As another current weight watcher, I can say that I agree with Deb. The new pointsplus system is designed not only to help you lose weight (although my weight loss has been fairly consistent across both) but also to help train you to make healthier choices.

You likely eat a similar number of calories, but more of them come from fruit and vegetables, rather than high-carbohydrate (or processed, and high-sodium) foods.

I would think that as an economist you would like the points/pointsplus sytem. Healthier choices (such as exercise, or eating fruits and vegetables) are rewarded with a zero point debit, or a point credit, while unhealthier choices are made, in many cases, unsustainably penurious.

ACW

Agree with #1. Also I think the changes, such as they are, are more an attempt to create the impression of "new and improved" than representing any actual improvement in the system.

WW, old and new, in fact any sane and balanced diet, will work IF you are willing to make the lifestyle changes -- more exercise, fewer calories -- to maintain the loss in the long run. The beginning of the excerpt all but states this flat out. So "because it works" is still accurate; it's like Bayer Aspiring advertising that it is the purest you can buy. Sure it is, because all aspirin-only pills are (by government mandate) equal. (Excludes aspirin-plus compounds.) So Bayer's actually, accurately, telling you that its aspirin is no worse.

Looking at WW system (which I don't use, see below), this might actually work better because it has foods categorised as zero points, which enables the dieter at least sometimes to skip counting and measuring, so it doesn't feel quite so much like a "diet." (The drawback is that you can easily eat a few hundred calories of a higher-calorie fruit and still have zero new-system points.)

One reason dieters fall off the wagon is that they get tired of monitoring their food intake. Another -- more common, I think -- is that they're looking for the quick fix, and assuming they manage to achieve their goal, they go right back to their old habits, with the predictable result. So the new point system may help group #1, but nothing will help group #2 except to man up. (I think WW charges a join-up membership fee? If so, the recidivists are WW's bread and butter, so to speak, and WW should hope it doesn't work! :} )

My top weight was 175lb (I'm 5ft, so yes, that is obese for my size); I'm now 88 (slightly underweight according to the BMI tables). The pounds have been off for more than 35yrs now, with a balanced vegetarian/vegan diet and some care about when and how I eat (e.g., preparing sit-down meals with fresh, wholesome ingredients, at which I can relax and be mindful -- which is how nearly everyone ate, until very very recently in history). Works great for me; your mileage may vary.

The important point, though, is that I made the lifestyle changes. The big problem with WW's "because it works" is that the points system still isn't natural eating; you will be conscious of being on a "diet" and you will never be off a "diet."

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Ben

I believe that conflict disclosure should be placed at the start of the article.

Tristan

This is a pretty weak conflict disclosure, especially when you water it down by adding:

"which might be viewed as either a substitute for or a complement to the WeightWatchers system."

Those are pretty much the only two options (besides "no relation at all"). If you feel compelled to disclose a potential conflict of interest, don't try to down play it, the whole point of a disclosure is to let the readers judge what the potential impact might be for themselves.

di

This reminds me of the Fresh Air interview yesterday with an author who discussed another organization revolving around life change, community, and philosophy of life-AA. It is still around and popular because it works for *some* people. The problem is assuming it will work for everyone, and work for them without the addition of any other type of help.

Drill-Baby-Drill drill Team

It works until it doesn't.

If you look at most dieters long term, there is success and then rebound failures and then reruns of success and failings. IT IS YO-YO DIETING. Look at Oprah for the last 20 years.

So long term, few things work. Short term success is common, but is not sustainable. The body seeks its natural equilibrium point.

We are all a collection of Good and Bad Habits. We have to cultivate the good habits, and eliminate the bad habits. We have to eliminate the diet binge-ing and diet failings, and diet catastrophes. And just eat Rice Cakes and drink water.

Ian Kemmish

Does WW's publicity material state anywhere that the new system works "better" than the old one? if not, then why did you assume that they were claiming it was better?

IIt seems reasonable to assume that the legal community has accepted, over the years, that the old system works. If the new system's results are statistically indistinguishable from the old system's results, then the new system works too. Which appears to be all that they are claiming.

Mantonat

Having been a part of WW just before the new system and now, the important aspect of the changes is that it seems more likely to produce positive lifestyle changes. Immediately after the rollout of the new plan, it was obvious in the meetings and message boards that people simply don't know how to purchase good food and prepare meals for themselves on a regular basis. The new system emphasises vegetables and fruits, with additional small amounts of lean proteins and complex carbohydrates. It also upped the points for empty calories (alcohol and junk food) and highly processed foods. In addition to these changes, WW has always placed an emphasis on regular excercise as a way of burning calories and staying fit.

Many WW subscribers were left not knowing how to cook foods that would fall into these parameters, since so many people - even dieters - rely on packaged and processed foods. Thanfully, I enjoy cooking and have been shifting toward delicious whole vegetables, beans, and grains like quinoa to add bulk and nutrition to my diet. I think anyone will suffer if they consume primarily processed and fast foods and then decide to live on minute quantities of thoses foods. The scientific evaluation of the effectiveness of the new plan will probably eventually be determined when WW members can quit the program and maintain a healthy weight by continuing to eat and live in a manner taught by the program.

The really great thing about WW is their online point tracking system which includes an enormous database of foods as well as the ability to input your own recipes, so that you can monitor points and portion sizes of home-cooked food.

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VB in NV

Hey Ian. Are fast food ads Lantham Act violations?

http://www.thewvsr.com/adsvsreality.htm

Thanks.

norma

I love it and Jennifer Hudson is very gorgeous. She is such a class act. Weight Watchers could not have choosen a better person to lead their program. Jen is such an inspiration to millions and people respect her. She is one of the most humbled and grounded super stars of her error. She is also one of the most trusted.

Dan Kunze

WW, when you boil it down, is all about portion control, and that is a good thing. We are still served and almost expected to eat portions that only farmers and others who engage in manual labor all day should eat. The days of a full breakfast, lunch and dinner are long gone, if you sit at a desk all day and then don't exercise.

I don't have any problem with the new vs. old points system, as long as the obesity problem in the US is being attacked.

Eric M. Jones

@13--di, "...works for *some* people..."

Whoa di, sounds like you need to call your sponsor and get to a meeting.