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How To Help People Lose Weight? Give ‘Em Free Meals and Money!

Rating

3 Star

How To Help People Lose Weight? Give ‘Em Free Meals and Money!

Our Review Summary

This smartly written blog post manages to pack more information into a tight space than many longer pieces. We wish it had spent a little more time with the evidence behind this study on weight loss programs.  For example, a MedPageToday story explained: 

  • Clinical outcomes were not evaluated. 
  • "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."
  • The editorial writer "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."
  • The researchers "acknowledged that the finding may not apply to a real-world setting because the weight-loss program was delivered at no cost. … In the current study, the participants’ average food costs would have averaged out to about $4,080 for a year, the researchers noted."
  • Additional limitations of the study included the use of participants who were likely highly motivated to lose weight, which partially explained the low dropout rate, the use of unblinded weight-loss counselors, and the use of a control intervention that would be a likely first step for individuals seeking guidance to lose weight.

Each of those is important points – and limitations that readers should have been told about – somehow – even in a short blog piece.

 

Why This Matters

As the story points out, the majority of Americans are either overweight or obese, and losing that weight can prove very difficult. Anyone who has picked up a lifestyle magazine knows how fat-fighting fads catch fire and then disappear. Solid research into what motivates people to lose weight and to keep it off is necessary to help guide public policy on a number of fronts.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story excels in this criteria where so many others fail. The story says, "The program costs about $1,600 for 12 weeks," and then it goes on to make an important comparison. "Compare that to the $19,000 to $29,000 cost of bariatric surgery, which is often reimbursed by insurers." This helps readers understand that dieting is a far cheaper approach to weight loss, and that the burden of expensive weight-loss surgeries is actually passed onto all of us in the form of higher insurance premiums. We wish the story had driven home the point more emphatically – as it alluded to in the headline and in one line in the story – that people in the trial got the intervention for free.  That’s a big leap from reality.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story does quantify the benefits of each of the plans studied. We would have liked to have seen the total number of people in each group and the highest and lowest amount of weight lost. This would have shown, for example, whether anyone in the control group lost more weight than people in the Jenny Craig face-to-face group.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

This story does not quantify the harms of either the diet plans or of obesity.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story missed an opportunity here to explore some of the limitations of the study, even though it does make note of a few of them. The study was funded by Jenny Craig, as the story points out, and it compared three different groups of people. There were so many factors going on in this study, though — counseling, the diet itself, cash payments — that it would have been nice to see some acknowledgment of the difficulty in teasing out the real triggers for the weight loss. The story talks about the program being 12 weeks long but then also says that "average weight loss was greater at one year than at the end of the study." Are we to take this to mean that people stuck with the program for a year and lost more weight? Were there people from different income groups in this study? A $25 incentive might not mean much to a high earner.

For comparison, a MedPageToday story did a far better job explaining limitations of this research.

Does the story commit disease-mongering?

Satisfactory

The story repeats the commonly cited CDC statistics on people who are obese and overweight. It does not engage in disease-mongering.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story does not quote any "live" sources, but it does make good use of an editorial that accompanied the study. It also points out that the study was finded by diet giant Jenny Craig and that the editorial writer, Rena Wing, a professor of psychiatry at Brown University called for "cost-effectiveness studies, conducted by researchers without any financial ties to the companies involved, that compare different commercial programs with each other."

Does the story compare the new approach with existing alternatives?

Satisfactory

The story says up high that "there’s not much clinical evidence on the best way to lose weight, outside of research on bariatric surgery. (True, “Eat less and exercise more” is great advice if you can manage to follow it, but public-health authorities have repeated that line until they’re blue in the face and as a population we’ve only gotten fatter.)" The study itself compared three different approaches, and the story also makes this important note: "The countervailing theory is that people value things more when they pay for them, and that the mere act of ponying up $1,600 for three months of a diet program may make you take it more seriously."

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

This is a tricky one. Because the study was funded by Jenny Craig, it seems some mention of how widespread Jenny Criag programs are would have been warranted. Absent that, the story could have said how easy it might be for the typical person to find a diet program of any sourt that would provide people once-weekly face-to-face counseling, which was the regimen that had the best results – and for free! It might seem obvious that these programs are popping up all over the place, but they are not uniformly available, especially in rural and poor areas in counties that have high concentrations of obesity. If the story had even mentioned how many Jenny Craig centers (according to the company’s website it is 565) we would have given this one a passing grade.

Does the story establish the true novelty of the approach?

Not Satisfactory

The story could have put this study into the larger context of cash payments for health incentives. This has been demonstrated to work on a number of fronts, including encouraging mothers to give birth in health centers, discouraging risky sex, and smoking cessation.

Does the story appear to rely solely or largely on a news release?

Satisfactory

This story does not rely on a news release.

Total Score: 6 of 10 Satisfactory

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