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For overweight and obese women, a commercial weight-loss program -- Jenny Craig -- resulted in a greater number of pounds shed through two years compared with usual care, a company-sponsored randomized controlled trial showed.
The average amount of weight lost was 16.3 pounds with an in-person center-based program and 13.7 pounds with a phone-based program, according to Cheryl Rock, PhD, RD, of the University of California San Diego, and colleagues.
That compares with 4.4 pounds with usual care (P<0.001 for the intervention effect), they reported online in the Journal of the American Medical Association.
The corresponding percentages of weight lost were 7.9%, 6.8%, and 2.1%.
Although clinical outcomes were not evaluated, Rena Wing, PhD, of Brown University in Providence, R.I., noted in an accompanying editorial that the amount of weight loss achieved in the study has been shown to improve cardiovascular risk factors.
But, she said, the findings likely represent a best-case scenario, and obese patients enrolling in a similar program outside of a clinical trial setting will probably not achieve comparable results.
Wing cited a cohort study of Jenny Craig participants that showed that just 7% of enrollees completed a full year of the program. In contrast, 92.1% of the participants in the current study were available for the two-year follow-up.
Because the program was delivered free-of-charge in the randomized trial, cost may explain the difference in adherence, she said, noting that such programs may be worthwhile healthcare investments if they can be provided at no cost to the participants.
"Given the epidemic of obesity and the availability of commercial weight-loss programs," Wing wrote, "cost-effectiveness studies should be conducted to evaluate the costs relative to the benefits in terms of improvements in patient health and quality of life, reductions in the need for medications, and prevention of obesity-related illnesses."
The Jenny Craig program involved in-person center-based or phone-based one-to-one weight loss counseling over the entire two-year period. Behavioral goals were a lower-calorie, healthy diet aided by the inclusion of free, prepackaged foods seven days a week during the initial weight-loss phase and increased physical activity. There were weekly one-to-one contacts with a counselor, who was instructed to deliver the program as it would be to a paying customer. There was no charge to the participants.
Usual care included two individualized counseling sessions -- one at baseline and one at six months -- with a dietetics professional, in addition to monthly contacts by email or phone.
All participants received $25 for each clinic visit.
Overall, 446 overweight or obese women (BMI from 25 to 40) ages 18 to 69 were assigned to the center-based program (169 patients), the phone-based program (164 patients), or usual care (113 patients).
At one year, women in the three groups lost 10.9%, 9.2%, and 2.6% of their body weight, respectively (P<0.001 for the intervention effect). The loss was attenuated at two years by 27% in the intervention groups and 17% in the usual care group (P=0.003).
The proportion of patients who maintained at least a 5% weight loss was significantly greater with the intervention by two years.
Participants in the intervention groups had a significantly lower C-reactive protein level (1.9 versus 2.4 mg/L) and leptin concentration (29.5 versus 32.7 ng/mL) at two years (P<0.05 for both).
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