Are slimming clubs worth the effort

Are slimming clubs worth the effort

If you want to lose weight, you may be tempted to join a slimming club. But is it worth the cost and effort in the long run? We take a long hard look at the evidence.

Did you catch the “Welcome to the world of weight loss” programme on BBC2 last week? It made for fascinating viewing. With unprecedented access to classes run by Weight Watchers, Slimming World and Rosemary Conley Diet and Fitness Club, director Vanessa Engle followed people over a three-month period as they tried to lose weight. The programme raised some interesting questions about the effectiveness of slimming clubs and the politics of the diet industry.

So do slimming programmes work?

That depends on how you define their effectiveness. They're generally pretty effective at helping people to lose weight. The buzz of starting a new programme, the structure of an eating and exercise plan and the support of peers and teachers all contribute to helping people shed the pounds. And it seems that commercial programmes are more effective than standard advice and support from medical professionals.

Two studies were given particular attention in the BBC2 programme. Both were recent, carried out in 2011. Their findings were as follows:

  • Publishing their research in The Lancet, Dr Jebb from the Medical Research Council Centre for Human Nutrition Research at Cambridge University, in collaboration with scientists across Europe, compared the effectiveness of commercial weight loss programmes with standard primary care interventions (i.e. advice on diet and nutrition from your GP according to national standards of best practice). After a 12-month intervention, participants following the commercial programmes had lost over twice as much weight, on average, as those receiving standard primary care (5.06 kg compared to 2.25 kg).
  • Similarly, a study published in the British Medical Journal by Dr Kate Jolly and colleagues from the University of Birmingham, compared the effectiveness of 12-week weight loss interventions. Weight Watchers, Slimming World, and Rosemary Conley were compared to a group-based dietetics programme and one-to-one counselling offered by GPs or pharmacies. It was found that, at the end of a 12-week intervention, commercial programmes achieved significantly greater weight loss than those provided by primary care services. This still held true at a one-year follow-up. Furthermore, the commercial programmes were actually cheaper to implement than the primary care ones. Of the commercial programmes, Weight Watchers was the most effective by a significant margin.

Now, the first study was actually funded by Weight Watchers, and it's certainly worth keeping in mind any vested interests when assessing these sorts of studies. But it seems that there is compelling evidence that commercial weight loss programmes offer a cost-effective route to weight loss. At least initially.

Most people aren't just interested in short term weight loss, though. They want to lose weight and keep it off for good. And that is where the effectiveness of slimming programmes has been called into question. So what evidence do we have for the long-term effectiveness of structured weight loss programmes?

Research into long-term effectiveness of slimming programmes

So what happens in the long term? Let's take Weight Watchers, since there's a fair amount of evidence pointing to the fact that it's one of the most effective weight loss programmes around. A long-term follow-up study conducted in 2007 by researchers in Pennsylvania (including the chief scientific officer of Weight Watchers) found that:

  • 1 year after successful completion of a weight loss programme, 26.5% of people were at or below their goal weight.
  • 2 years after successful completion of a weight loss programme, 0.5% of people were at or below their goal weight.
  • 5 years after successful completion of a weight loss programme, 16.2% of people were at or below their goal weight.

The exact interpretation of these data is controversial. But there's no getting away from one very simple way of putting it: Out of those people who do manage to lose weight successfully with what may well be the most effective slimming programme around, nearly 84% are over their goal weight again 5 years later. It's not a prospect to fill anyone trying to lose weight with enthusiasm.

Weight loss as an industry

In 2012, over 27 million of us in the UK were on a diet. It's a huge industry. One of the most striking parts of the BBC2 programme was an interview with Richard Samber, who was the finance director of Weight Watchers from 1968-1993. He stated that the fact that people don't keep off the weight they have lost in the long term is actually an important part of the business model on which Weight Watchers is based. Most of Weight Watcher's business comes from the 84% of clients who do put weight back and keep returning to the programme. The current chief scientific officers of Weight Watchers, Karen Miller-Kovach, denied that this was the case and said that it was not possible to sustain a business based on failure. But it's certainly food for thought: If structured weight loss programmes worked, surely the market would be d we wouldn't see the vast expansion of the industry that is occurring at the moment.

So what does work?!

Does all this mean that we just throw up our hands, admit defeat and live with obesity? No. It is possible to lose weight long-term. But it's not quick or glamorous, and it's certainly not a matter of following a one-off programme. It's a lifelong project, particularly if you have a fair amount of weight to lose in the first place. We need to change our mind sets entirely and move away from the whole idea of being on a diet. It's much more helpful to think about our overall health and our way of eating. And that isn't and never has been rocket science. As Michael Pollan puts it: “Eat food. Not too much. Mostly plants.” It might not be easy in this day and age of multiple temptations, but it's certainly simple.



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