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

Karen Miller-Kovach

MBA, MS, RD, Chief Scientific

0 4 .1 2 .1 2

, , , Officer, Weight Watchers International, Inc.

W hen left to lose w eight on their

• w n

m ost people do not succeed

• w n, m ost people do not succeed.

433 Participants; mean age 45 years; mean BMI 34km/ m2

1 – 0 –

• 1 –

( kg)

• 2 –
• 3 –
• 4 –

Change

= Self-help = Commercial 4

• 5 –
• 6 –

7

W eight C W eek

0 25 52 78 104

• 7 –

W

212 175 170 156 159

W eek

No. Self-help C i l

Heshka et al., 2003. JAMA, 289

211 175 176 154 150 Com m ercial

KM1

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 Move More Eat Smarter Move More Move More Helpful Habits Move More Helpful Habits Get Support Get Support

Our goal is to surround the participant w ith

inform ation tools and support in a w ay that prom otes inform ation, tools, and support in a w ay that prom otes engagem ent and drives com pliance. Both attendance at m eetings1 and online usage 2 are highly predictive f i ht l lt

• f w eight loss results.

1S Heshka et al. Journal of the American Medical Association 2003; 289 (14): 1792-1798. 2L 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

• Weight Watchers (n=100)
• Slimming World (n=100)
• Rosemary Conley (n=100)

Participants: Age: 49.5% ± 15.6 years hi i i h i h 69.3% female y y ( )

• Size Down NHS (n=100)
• Pharmacy (n=70)
• GP provision (n=70)

86.5% white British or Irish BMI = 33.5 ± 5.4

• Choice (n = 70)

Jolly K et al. BMC. 2010;10:439

W eight Loss w ith C t I t ti Comparator I nterventions

Program m e end ( 3 m th) 1 year

Mean diff. 95% CI Mean diff 95% CI Mean diff. 95% CI Mean diff 95% CI W eight W atchers

• 2 .2 4 *
• 3.45, -1.03,
• 2 .3 0 *
• 4.04, -0.55

Slim m ing

• 1 .4 1 *
• 2.64, -0.19
• 0.75
• 2.22, 0.72

W orld Rosem ary Conley

• 2 .1 8 *
• 3.52, -0.84
• 0.96
• 2.63, 0.71

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

Choice

• 1 .3 8 *
• 2.58, -0.19
• 1.03
• 2.63, 0.61

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

Percentage w eight loss

( l t l ) ( com pleters only)

Standard Care 13% 20%

Weight Watchers

20% 23% 44% 32% 14% 28% 26%

• ≥10%
• 5 - -9.9%

Weight gain/ No loss

• 0.1 - -4.9%

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/m2

• r higher to intensive multicomponent
• r 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.

Karen Miller-Kovach

MBA, MS, RD, Chief Scientific Inc.

0 4 .1 2 .1 2

, , , Officer, Weight Watchers International,