0 4 .1 2 .1 2 Karen Miller-Kovach MBA, MS, RD, Chief Scientific , - PowerPoint PPT Presentation

0 4 .1 2 .1 2 Karen Miller-Kovach MBA, MS, RD, Chief Scientific , , , Officer, Weight Watchers International, Inc.

W hen left to lose w eight on their ow n ow n, m ost people do not succeed. m ost people do not succeed 433 Participants; mean age 45 years; mean BMI 34km/ m 2 KM1 1 – ( kg) 0 – -1 – Change -2 – -3 – -4 – 4 W eight C -5 – = Self-help -6 – = Commercial W -7 – 7 W eek W eek 0 25 52 78 104 No. 212 175 170 156 159 Self-help 211 175 176 154 150 C Com m ercial i l Heshka et al., 2003. JAMA, 289

Slide 2 KM1 Would probably change out for similar slide from the IMCT as it's more current Karen Miller-Kovach, 5/16/2013

Com m unity-Based W eight Loss: W eight Loss: How W eight How W eight W atchers W orks

I ntensive, m ulti-com ponent, com m unity-based w eight-loss com m unity-based w eight-loss intervention supports healthy w eight loss w eight loss. Our 4-Way Approach Our 4-Way Approach Our 4-Way Approach Eat Smarter Eat Smarter Move More Move More Move More Move More Helpful Habits Helpful Habits Get Support Get Support

Our goal is to surround the participant w ith inform ation inform ation, tools, and support in a w ay that prom otes tools and support in a w ay that prom otes engagem ent and drives com pliance. Both attendance at m eetings 1 and online usage 2 are highly predictive of w eight loss results. f i ht l lt 1 S Heshka et al. Journal of the American Medical Association 2003; 289 (14): 1792-1798. 2 L Zukley, V Nguyen, A Summers, J Brosnahan, J Lowndes, T Angelopoulos, J Rippe. Obesity 2007; 15 (Suppl 9): A221.

UK Policy NICE guidance helps NICE guidance helps health and social care professionals deliver the best possible care based on the best based on the best available evidence Self-help, commercial and community settings p, y g ● Primary care organisations and local authorities should recommend to patients, or consider endorsing, self help commercial and community weight self-help, commercial and community weight management programmes only if they follow best practice.

The Evidence: Com m unity-Based Program s Are Program s Are Scalable and Scalable and Effective in the UK

Lighten Up Trial RCT involving 6 interventions vs leaving people RCT involving 6 interventions vs. leaving people to lose weight on their own (12 leisure centre vouchers) for 3 months Participants: 69.3% female • Weight Watchers (n=100) • Slimming World (n=100) Age: 49.5% ± 15.6 years • Rosemary Conley (n=100) y y ( ) 86.5% white British or Irish hi i i h i h • Size Down NHS (n=100) BMI = 33.5 ± 5.4 • Pharmacy (n=70) • GP provision (n=70) • Choice (n = 70) Jolly K et al. BMC. 2010;10:439

W eight Loss w ith Comparator I nterventions C t I t ti Program m e end 1 year ( 3 m th) Mean diff. Mean diff. 95% CI 95% CI Mean diff Mean diff 95% CI 95% CI -3.45, -1.03, -4.04, -0.55 W eight -2 .2 4 * -2 .3 0 * W atchers -2.64, -0.19 -0.75 -2.22, 0.72 Slim m ing -1 .4 1 * W orld -3.52, -0.84 -0.96 -2.63, 0.71 Rosem ary -2 .1 8 * Conley Size Down -0.26 -1.39, 0.86 , -1.37 -2.99, 0.26 , GP 0.76 -0.55, 2.08 0.30 -1.32, 1.91 Pharmacy -0.02 -1.43, 1.38 0.45 -1.11, 2.01 -2.58, -0.19 -1.03 -2.63, 0.61 Choice -1 .3 8 * *p<0.05 - Jolly et al British medical Journal 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 .

The Lancet Trial The Lancet Trial Primary objective • • To examine the differences in weight loss at 12 months between GP referral to a To examine the differences in weight loss at 12 months between GP referral to a community-based weight loss program (Weight Watchers) and standard management in primary care (as informed by national guidelines) across three countries. Secondary objectives • To investigate number of subjects losing 5% or 10% of baseline weight in each group group. • To investigate changes in a number of indicators of metabolic risk – including waist circumference, body composition, blood pressure, blood glucose, lipids etc. Jebb et al. The Lancet. 2011 Oct 22; 378(9801): 1485-92 .

Participants identified by family doctors, then assigned to doctors then assigned to treatment group Standard Care W eight W atchers Total ( N ( N= 3 9 5 ) 3 9 5 ) ( N ( N= 3 7 7 ) 3 7 7 ) ( N= 7 7 2 ) ( N 7 7 2 ) Gender Female - N (%) 338 (86) 330 (87) 668 (86.53) Male - N (%) 57 (14) 47 (12) 104 (13.47) 48.2 ± 12 46.5 ± 13.5 47.39 ± 12.9 Age – years 86.5 ± 11 86.9 ± 12 86.7 ± 11.5 W eight - kg 31.3 ± 2.6 31.5 ± 2.6 31.4 ± 2.6 1.66 ± 0.08 1.66 ± 0.09 1.66 ± 0.08 Height - m 38.2 ± 7.4 38.6 ± 6.7 38.4 ± 7.1 % Fat m ass 99.9 ± 9.3 100.0 ± 9.2 99.9 ± 9.2 W aist – cm

Percentage w eight loss ( ( com pleters only) l t l ) Standard Care 0 13% Weight Watchers 0 0 20% 20% 44% 14% 23% 32% 26% 28% - ≥ 10% -0.1 - -4.9% -5 - -9.9% Weight gain/ No loss

W eight W atchers on Referral: An observational study of w eight change am ong adults referred to W eight W atchers by the NHS • Based on data from 29,326 referrals, 58% completed a 12 week course of Weight Watchers meetings • Median weight loss in completers was 5.2kg Median weight loss in completers was 5.2kg • 55% of completers achieved weight loss of 5% or more, with 12% losing 10% or more of initial weight • Of all courses initiated, 33% resulted in weight loss of 5% or more of baseline weight, with 7% resulting in weight loss of 10% or more Ahern AL, Olson AD, Aston LM, Jebb SA. Weight Watchers on prescription: an observational study of weight change among adults referred to Weight Watchers by the NHS. BMC Public Health 2011;11:434.

USA Policy The USPSTF recom m ends screening all adults for obesity. Clinicians should offer or refer patients with a body mass index (BMI) of 30 kg/m 2 or higher to intensive multicomponent or higher to intensive, multicomponent behavioral interventions. Grade: B Recom m endation. Preventive Services Covered Under the Affordable Care Act Under the new rules, a Non-Grandfathered Plan must provide benefits Under the new rules, a Non Grandfathered Plan must provide benefits for and prohibit the imposition of cost-sharing requirements (including co-payments, co-insurance or deductibles) with respect to items or services that have in effect a rating of “A” or “B” in the current recom m endations of the United States Preventive Services Task recom m endations of the United States Preventive Services Task Force (Task Force) with respect to the individual involved.

0 4 .1 2 .1 2 Karen Miller-Kovach Inc. MBA, MS, RD, Chief Scientific , , , Officer, Weight Watchers International,