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Commercial Weight Loss Programs in the Management of Obesity: an Update


Purpose of Review

Comprehensive lifestyle programs are cornerstones of obesity management, but clinician referrals may be limited by program availability. Commercial weight loss programs may be an alternative, but clinicians may be unaware of their efficacy and safety. This review describes the evidence for commercial programs, particularly 12-month weight loss, among individuals with obesity.

Recent Findings

Several programs are concordant with evidence-based recommendations (i.e., lower-calorie diet, increased physical activity, and behavioral strategies). Among the guideline-concordant programs, National Diabetes Prevention Program, WW, Jenny Craig, Medifast, and OPTIFAST have demonstrated 12-month weight loss efficacy and safety. While other programs show promise, more evidence is needed before clinician referral may be recommended.


Clinical practice guidelines support referrals to commercial weight loss programs that have peer-reviewed evidence to support their efficacy and safety. Clinicians should consider the available evidence, patient preference, and cost when considering referrals to these programs for weight management.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2013;2014(129):S102–38.

    Article  Google Scholar 

  2. Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, et al. Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320:1163–71.

    Article  PubMed  Google Scholar 

  3. Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity. Endocr Pract. 2016;22(Suppl 3):1–203.

    Article  PubMed  Google Scholar 

  4. Brauer P, Gorber SC, Shaw E, Singh H, Bell N, Shane ARE, et al. Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care. CMAJ. 2015;187:184–95.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bloom B, Mehta AK, Clark JM, Gudzune KA. Guideline-concordant weight-loss programs in an urban area are uncommon and difficult to identify through the Internet. Obesity. 2016;24:583–8.

    Article  PubMed  Google Scholar 

  6. Key National DPP Milestones. Accessed at on March 30, 2020.

  7. Medicare Diabetes Prevention Program (MDPP). Accessed at on March 30, 2020.

  8. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.

    Article  CAS  PubMed  Google Scholar 

  9. Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1677–86.

    Article  PubMed Central  Google Scholar 

  10. Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. Lancet Diabetes Endocrinol. 2015;3:866–75.

    Article  CAS  PubMed Central  Google Scholar 

  11. Gudzune KA, Doshi RS, Mehta AK, Chaudhry ZW, Jacobs DK, Vakil RM, et al. Efficacy of commercial weight-loss programs: an updated systematic review. Ann Intern Med. 2015;162:501–12.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gudzune KA, Clark JM. Commercial weight loss programs. In: Wadden TA, Bray GE, editors. Handbook of Obesity Treatment. 2nd ed. New York: Guilford Press; 2018. p. 480–91.

    Google Scholar 

  13. Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, et al. Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. JAMA. 2014;312:923–33.

    Article  CAS  PubMed  Google Scholar 

  14. Jolly K, Lewis A, Beach J, Denley J, Adab P, Deeks JJ, et al. Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten up randomised controlled trial. BMJ. 2011;343:d6500.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Gorin AA, Lenz EM, Cornelius T, Huedo-Medina T, Wojtanowski AC, Foster GD. Randomized controlled trial examining the ripple effect of a nationally available weight management program on untreated spouses. Obesity. 2018;26:499–504.

    Article  PubMed  Google Scholar 

  16. • Thomas JG, Raynor HA, Bond DS, Luke AK, Cardoso CC, Foster GD, et al. Weight loss in Weight Watchers online with and without an activity tracking device compared to control: a randomized trial. Obesity. 2017;25:1014–21. RCT reporting outcomes for Weight Watchers Online program.

    Article  PubMed  Google Scholar 

  17. • Ahern AL, Wheeler GM, Aveyard P, Boyland EJ, Halford JCG, Mander AP, et al. Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial. Lancet. 2017;389:2214–25. examining duration of participation in WW and how it influences long-term weight loss outcomes – suggests that continued engagement with WW to 52 weeks is beneficial for weight loss and weight loss maintenance, which may be a key counseling point for clinicians.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Yancy WS Jr, Shaw PA, Wesby L, Hilbert V, Yang L, Zhu J, et al. Financial incentive strategies for maintenance of weight loss: results from an internet-based randomized controlled trial. Nutr Diabetes. 2018;8:33.

    Article  PubMed  Google Scholar 

  19. Yancy WS Jr, Shaw PA, Reale C, Hilbert V, Yan J, Zhu J, et al. Effect of escalating financial incentive rewards on maintenance of weight loss: a randomized clinical trial. JAMA Netw Open. 2019;2:e1914393.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Marrero DG, Palmer KN, Phillips EO, Miller-Kovach K, Foster GD, Saha CK. Comparison of commercial and self-initiated weight loss programs in people with prediabetes: a randomized control trial. Am J Public Health. 2016;106:949–56.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Palmer KNB, Sasha C, Phillips EO, Krish A, Foster GD, Finkelstein E, et al. The two-year outcomes and cost-effectiveness of a commercial weight loss program for the prevention of type 2 diabetes among people with prediabetes. Endocrinol Diabetes Obes. 2018;1:6.

    Article  Google Scholar 

  22. Rock CL, Flatt SW, Pakiz B, Taylor KS, Leone AF, Brelje K, et al. Weight loss, glycemic control, and cardiovascular disease risk factors in response to differential diet composition in a weight loss program in type 2 diabetes: a randomized controlled trial. Diabetes Care. 2014;37:1573–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Chaudhry ZW, Doshi RS, Mehta AK, Jacobs DK, Vakil RM, Lee CJ, et al. A systematic review of commercial weight loss programmes’ effect on glycemic outcomes among overweight and obese adults with and without type 2 diabetes mellitus. Obes Rev. 2016;17:758–69.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Donnelly JE, Goetz J, Gibson C, Sullivan DK, Lee R, Smith BK, et al. Equivalent weight loss for weight management programs delivered by phone and clinic. Obesity. 2013;21:1951–9.

    Article  PubMed  Google Scholar 

  25. Shikany JM, Thomas AS, Beasley TM, Lewis CE, Allison DB. Randomized controlled trial of the Medifast 5 & 1 plan for weight loss. Int J Obes. 2013;37:1571–8.

    Article  CAS  Google Scholar 

  26. Moldovan CP, Weldon AJ, Daher NS, Schneider LE, Bellinger DL, Berk LS, et al. Effects of a meal replacement system alone or in combination with phentermine on weight loss and food cravings. Obesity. 2016;24:2344–50.

    Article  CAS  PubMed  Google Scholar 

  27. Beavers KM, Nesbit BA, Kiel JR, Sheedy JL, Arterburn LM, Collins AE, et al. Effect of an energy-restricted, nutritionally complete, higher protein meal plan on body composition and mobility in older adults with obesity: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2019;74:929–35.

    Article  CAS  PubMed  Google Scholar 

  28. • Ard JD, Lewis KH, Rothberg A, Auriemma A, Coburn SL, Cohen SS, et al. Effectiveness of a total meal replacement program (OPTIFAST Program) on weight loss: results from the OPTIWIN study. Obesity. 2019;27:22–9. RCT demonstrating the efficacy of OPTIFAST.

    Article  PubMed  Google Scholar 

  29. Allen JK, Stephens J, Dennison Himmelfarb CR, Stewart KJ, Hauck S. Randomized controlled pilot study testing use of smartphone technology for obesity treatment. J Obes. 2013;2013:151597.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Laing BY, Mangione CM, Tseng CH, Leng M, Vaisberg E, Mahida M, et al. Effectiveness of a smartphone application for weight loss compared with usual care in overweight primary care patients: a randomized, controlled trial. Ann Intern Med. 2014;161(10 Suppl):S5–12.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Jospe MR, Roy M, Brown RC, Williams SM, Osborne HR, Meredith-Jones KA, et al. The effect of different types of monitoring strategies on weight loss: a randomized controlled trial. Obesity. 2017;25:1490–8.

    Article  PubMed  Google Scholar 

  32. Toro-Ramos T, Lee DH, Kim Y, Michaelides A, Oh TJ, Kim KM, et al. Effectiveness of a smartphone application for the management of metabolic syndrome components focusing on weight loss: a preliminary study. Metab Syndr Relat Disord. 2017;15:465–73.

    Article  CAS  PubMed  Google Scholar 

  33. Chin SO, Keum C, Woo J, Park J, Choi HJ, Woo J, et al. Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity. Sci Rep. 2016;6:34563.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Michaelides A, Raby C, Wood M, Farr K, Toro-Ramos T. Weight loss efficacy of a novel mobile Diabetes Prevention Program delivery platform with human coaching. BMJ Open Diabetes Res Care. 2016;4:e000264.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Michaelides A, Major J, Pienkosz E Jr, Wood M, Kim Y, Toro-Ramos T. Usefulness of a novel mobile Diabetes Prevention Program delivery platform with human coaching: 65-week observational follow-up. JMIR Mhealth Uhealth. 2018;6:e93.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Hildebrandt T, Michaelides A, Mackinnon D, Greif R, DeBar L, Sysko R. Randomized controlled trial comparing smartphone assisted versus traditional guided self-help for adults with binge eating. Int J Eat Disord. 2017;50:1313–22.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sepah SC, Jiang L, Peters AL. Long-term outcomes of a web-based Diabetes Prevention Program: 2-year results of a single-arm longitudinal study. J Med Internet Res. 2015;17:e92.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Sepah SC, Jiang L, Ellis RJ, McDermott K, Peters AL. Engagement and outcomes in a digital Diabetes Prevention Program: 3-year update. BMJ Open Diabetes Res Care. 2017;5:e000422.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Castro Sweet CM, Chiguluri V, Gumpina R, Abbott P, Madero EN, Payne M, et al. Outcomes of a Digital Health Program With Human Coaching for Diabetes Risk Reduction in a Medicare Population. J Aging Health. 2018;30:692–710.

    Article  PubMed  Google Scholar 

  40. Mitchell NS, Dickinson LM, Kempe A, Tsai AG. Determining the effectiveness of Take Off Pounds Sensibly (TOPS), a nationally available nonprofit weight loss program. Obesity (Silver Spring). 2011;19(3):568–73.

    Article  Google Scholar 

  41. Community Preventive Services Task Force. Combined diet and physical activity promotion programs for prevention of diabetes: Community Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2015;163:465–8.

    Article  Google Scholar 

  42. Program Eligibility. Accessed at on March 30, 2020.

  43. Finkelstein EA, Kruger E. Meta- and cost-effectiveness analysis of commercial weight loss strategies. Obesity. 2014;22:1942–51.

    Article  PubMed  Google Scholar 

  44. Finkelstein EA, Verghese NR. Incremental cost-effectiveness of evidence-based non-surgical weight loss strategies. Clin Obes. 2019;9:e12294.

    Article  PubMed  Google Scholar 

  45. IBISWorld. Weight loss services in the U.S. industry market research report 2019. Accessed at Accessed March 11, 2020.

  46. Arterburn LM, Coleman CD, Kiel J, Kelley K, Mantilla L, Frye N, et al. Randomized controlled trial assessing two commercial weight loss programs in adults with overweight or obesity. Obes Sci Pract. 2019;5:3–14.

    Article  CAS  PubMed  Google Scholar 

  47. Heymsfield SB. Meal replacements and energy balance. Physiol Behav. 2010;100(1):90–4.

    Article  CAS  PubMed  Google Scholar 

  48. Mehta AK, Doshi RS, Chaudhry ZW, Jacobs DK, Vakil RM, Lee CJ, et al. Benefits of commercial weight-loss programs on blood pressure and lipids: a systematic review. Prev Med. 2016;90:86–99.

    Article  PubMed  PubMed Central  Google Scholar 

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This work received no direct funding support. ML is supported by a training grant from the National Heart, Lung and Blood Institute (T32HL007180-44). KAG was supported from a grant from the National Institute for Mental Health (P50MH115842). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Correspondence to Marci Laudenslager.

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KAG is a paid consultant for Eli Lilly Inc.

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Laudenslager, M., Chaudhry, Z.W., Rajagopal, S. et al. Commercial Weight Loss Programs in the Management of Obesity: an Update. Curr Obes Rep 10, 90–99 (2021).

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  • Weight reduction programs
  • Obesity
  • Review
  • Treatment outcome