Fewer than one in 10 websites gave enough information to suggest the programs they promoted followed widely accepted medical guidelines for weight loss by including things like regular in-person meetings, daily food and activity tracking, calorie reduction and increased exercise, the study found.
Some options looked better once researchers picked up the phone to get more information. Among the subset of programs that agreed to phone interviews, researchers rated 19 percent as high quality based on their meeting guidelines for weight loss, up from just 6 percent when the businesses were evaluated only based on their websites.
“Weight-loss programs that follow the expert guidelines exist, however, they are few and far between,” said senior study author Dr. Kimberly Gudzune of Johns Hopkins University School of Medicine in Baltimore.
“To identify these programs, patients will need to be proactive and call to verify that the components offered meet the recommendations before signing up,” Gudzune added by email.
To see how well weight loss programs lived up to standards set by medical groups such as the American Heart Association, American College of Cardiology and The Obesity Society, Gudzune and colleagues evaluated 200 programs within a 10-mile radius of 17 primary care clinics in Washington, D.C., Maryland and Virginia.
They also randomly selected 80 of these programs for a telephone interview, and just 52 (65 percent) agreed to participate.
Of all the programs examined based on their website information and phone interviews, researchers found that physicians supervised some programs, while others were affiliates of national commercial weight-loss programs like Jenny Craig and Weight Watchers. Some programs were affiliated with a bariatric surgery program and others operated independently.
Overall, only 17 percent of these options met minimum guidelines for frequency of in-person meetings or clinician appointments – 14 sessions within six months – researchers reported in the journal Obesity.
Most of the programs specified dietary changes but didn’t elaborate on what type of eating habits participants would be encouraged to adopt.
Just over half of the programs encouraged participants to keep daily logs of food and exercise, recommended because studies have linked this habit to more successful weight loss.
For exercise, just 3 percent of the programs included the minimum recommended goal of 150 minutes a week of moderate to vigorous intensity physical activity. Many more – 57 percent – described exercise as part of their program.
In addition, 34 percent of the programs endorsed the use of weight-loss supplements, which often lack scientific proof of safety or effectiveness. By contrast, only 15 percent of the programs reported prescribing diet drugs approved for use by U.S. drug regulators.
Because of the limited geographic reach of the study, it’s hard to say how much the results might reflect what consumers would encounter across the U.S., particularly in rural communities, the authors note. The analysis Phenq was limited to programs with in-person components, so the findings also don’t apply to alternatives delivered only via the Internet or by phone.
Even so, the findings suggest that consumers should do their homework before shelling out for a local weight-loss program, the authors conclude. In addition, U.S. regulators should encourage companies to provide more complete and accurate details online to help consumers comparison shop and avoid places that don’t follow medical recommendations for weight loss, the authors argue.
Even before paying for weight loss services, consumers can do a lot on their own for free, noted Dr. Anne McTiernan, a researcher at Fred Hutchinson Cancer Research Center in Seattle who wasn’t involved in the study.
Patients can start by recording everything they eat and drink, using pen and paper or one of many free online tracking tools, McTiernan said by email. This should help people identify “low-hanging fruit,” the high-calorie items that aren’t filling or nutritious like sugary sodas and juices, alcohol and coffee loaded with too much cream and sweetener.
As for exercise, walking is a great start that requires no gym membership or expensive equipment.
“You don’t need to spend a lot of money to lose weight,” McTiernan said.