Free isn't always better and government rarely is. Commercial weight loss programs are more effective and cheaper than primary care based services led by specially trained staff, finds a study published in BMJ today.
Almost a quarter of the population of England are now classified as obese. Evidence shows that commercial weight management services can be effective, but the effectiveness of obesity management in primary care is still unclear. So researchers at the University of Birmingham compared the effectiveness of several commercial weight loss programs of 12 weeks' duration with primary care led programs and a control group.
A total of 740 obese and overweight men and women took part. Follow-up data were available for 658 (89%) participants at the end of each 12-week program and 522 (71%) at one year.
The programs included in the analyses were Weight Watchers; Slimming World; Rosemary Conley; a group-based dietetics program; general practice one to one counseling, pharmacy one to one counseling; or a choice of any of the six programs.
A control group was provided with 12 vouchers enabling free entrance to a local leisure (fitness) centre.
All programs achieved significant weight loss after 12 weeks, with the average weight loss ranging from 4.4 kg (Weight Watchers) to 1.4 kg (general practice provision). The primary care programs were no better than the control group at 12 weeks.
At one year, statistically significant weight loss occurred in all groups apart from the one to one programs in general practice and pharmacy settings. However, Weight Watchers was the only program to achieve significantly greater weight loss than the control group.
All groups showed some increase in physical activity, although the smallest increase was in those allocated to the general practice program.
Attendance seemed to be an important factor; the highest attendance rate was in Weight Watchers and the lowest for the primary care programs. The primary care programs were also the most costly to provide.
"Our findings suggest that a 12 week group based dedicated program of weight management can result in clinically useful amounts of weight loss that are sustained at one year," say the authors.
They add: "Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective."
In an accompanying editorial, nutrition experts Helen Truby and Maxine Bonham at Monash University in Australia say: "Lighten Up shows that there is no simple solution to the obesity epidemic."
They believe that the NHS should be mindful of the level of investment needed to develop its own expert workforce to manage complex obesity, and it can gain much information from commercial companies in how to deliver what consumers want.