Weight Watchers: A Review Of How It Works
-An Analysis Of The Pros and Cons Of The Points System
-A Look At The Power Of Weight Watchers Support Groups
-The Limits Of A "One Size Fits All" Model For Weight Loss
-A Look At The Short Term and Long Term Success Rate
June 26th, 2012By Jason Boehm MS, CNS, MMC
(PEERtrainer Note: This article is bound to generate controversy as well as difference of opinion and experience. We present many different views on the site, and above all are committed to generating informative and science-based discussion. Please leave a comment below or feel free to contact us directly if you would like to add to this discussion from a professional or scientific standpoint. Thank you!!)
You probably have a friend who's always doing Weight Watchers. She's nowhere near her goal weight, nor does she look particularly lean or healthy. But she claims the program "works for her," and she's able to enjoy a plate of chili cheese nachos and a skinny margarita after work on Fridays because it fits into her allotted points.
If you're not familiar with the system, Weight Watchers designates every food numerical points. Similar to an allowance, you get a certain number of points to use every day based on your demographics and goal weight.
In 2010, Weight Watchers' improved that system with PointsPlus™. Rather than focus so much on calories like the old plan did, PointsPlus™ instead bases points on macronutrient content. High-fiber and high-protein foods earn fewer points, whereas carbohydrates and fats earn more.
Many experts praised the improved PointsPlus™ plan, which encourages whole, nutrient-rich foods. "PointsPlus™ is better than their old point system," says Grace Suh Coscia, acupuncturist and founder of HolisticWeightLossMethod.com, "because it's based on more foods that regulate your blood sugar, like getting more protein."
An improved point system, flexibility, and the ability to indulge in any food you want (as long as you stay within your allotted points): what's not to love about Weight Watchers?
Let's Start With The Positives
"Weight Watchers is excellent in particular in teaching you portion control," notes PEERtrainer, "and basically getting a solid set of 'training wheels' going for you."Suh Coscia agrees. "Weight Watchers is a great stepping stone for someone looking to start their journey to getting into shape for the first time," she says. "Without taking the first step, you cannot take the second step."
Group support provides a key component to Weight Watchers' success. "Weight Watchers got one part of the weight-loss equation right: accountability and personal responsibility," says Dr. Jonny Bowden, author of The 150 Healthiest Foods on Earth. "They understand that community, connection, and shared purpose are extremely important."
Studies confirm group meetings help people become more accountable for their success. One in the journal Obesity Surgery, for instance, found that people who attended group meetings lost more weight than those who didn't.
If group meetings aren't your thing, Weight Watchers also offers an online option that includes an interactive forum that helps you track points, for instance. Studies confirm these internet-based forums can be just as valuable as in-person meetings. For example, a study in the International Journal of Medical Informatics found an internet weight-loss community played a vital role in participants' weight loss efforts that clinicians, family, and friends might not be able to fill.
"In The Long Run It Has A Miserable Track Record"
U.S. News & World Report recently had 22 health experts (most of them Registered Dietitians or Medical Doctors) examine 25 diets and diet programs, which they ranked on a scale of one to five. Weight Watchers came out the winner, with the average member losing six pounds after doing the program four weeks (If you were wondering, experts ranked the Paleo diet lowest among these 25 eating plans).Longer-term weight loss on the program, however, isn't so impressive. A study in the journal Lancet found that 772 overweight and obese adults lost an average of 15 pounds over one year, or less than one pound every three weeks. Granted, that was twice as much weight loss as the group who received weight-loss advice from their doctor. Also worth mentioning: this Weight Watchers-funded study had a 39% dropout rate.
Those numbers become even less impressive after five years doing Weight Watchers: a study in The British Journal of Nutrition showed only half of lifetime members maintained at least five percent of their weight loss after that many years.
Dr. Jade Teta, co-author of The Metabolic Effect Diet, offers one explanation why Weight Watchers fails many people long-term:
"Some people master [the habit formation and social support taught in Weight Watchers], but most don't because they often bump up against biochemistry," he says. "Hunger, energy lows, and cravings are difficult sensations to overcome, and often, new habits and social support are not enough to overcome them. Bottom line is for some Weight Watchers works in the short term, but in the long run it has a miserable track record."
There Is Absolutely No Biochemical Understanding
"Weight Watchers' 'policies' on food show zero understanding of the hormonal component, metabolic abnormalities, and challenges of weight gain," says Bowden.Esther Blum, concurs. "Weight Watchers neglects the hormonal effects of food," she says. "Until people understand simple sugars are insulinogenic and make us fat, they will continue to lose weight in the form of muscle."
Nowhere does that hormonal misunderstanding become more evident than with fruit. According to Weight Watchers, all fruits are unlimited and carry zero points on the PointsPlus™ system. For someone with insulin resistance, which is most overweight people, snacking on bananas and grapes is a surefire way to stall weight loss and worse.
[PEERtrainer has created a webinar and video series with JJ Virgin, Phd, which explains how our hormones effect our body's ability to either store or burn fat, and what foods you need to eat and not eat to maximize your ability to burn fat. To be sent the webinar and video series, enter your email address below. You will need to confirm this request before you are sent the webinar]
Weight Watchers also didn't get the memo about dietary fat, which they generally categorize as good or bad but overall limit because of its high calories. One member reflects that mentality when she warned the Weight Watchers online community, "Whether good or bad, Fat is still Fat! Large amounts of fat add a lot of calories (nine calories per one gram of fat)."
Misunderstanding dietary fat leads Weight Watchers to, for instance, endorse margarine over butter. They also warn about nuts, which are "high in carbohydrates and oils and can rack up the PointsPlus™ values if consumed in excess..." Never mind that nuts have far fewer carbohydrates than fruit, which is unlimited on Weight Watchers!
They also have no issue with artificial sweeteners: "Weight Watchers has evaluated the numerous studies conducted on [artificial] sweeteners and is of the opinion that they are safe." They must have missed the study in Appetite that showed saccharin triggers insulin release and the one in the Yale Journal of Biology and Medicine that showed artificial sweeteners could spark sugar cravings.
Added sugars and trans fat are also okay in Weight Watchers' book. "The use of these ingredients is not... an all-or-nothing effect," they note. "Rather, the relationship with negative health outcomes is directly related to how much of the ingredient is used in the product." In other words, Weight Watchers espouses the familiar cliched mantra everything in moderation.
Another area Weight Watchers neglects to address is common food intolerances like wheat, dairy, and soy, which for many people can create inflammation and other problems that stall weight loss. Among their recommendations that could trigger intolerances:
- Choosing whole-grain foods whenever possible.
- Two to three servings of low-fat or non-fat milk.
- Using soy foods to replace high-fat protein foods.
And it lets you down too: you get an immediate high, but it's short-lived, and you have to have more. Just like alcoholics who should not drink since it begets more drinking, food-aholics need to avoid their trigger foods.
Yes, some say that it's OK to drink "just a little", but it's a slippery slope. One drink, one piece of bread and you are out of control. Sorry to be such a spoilsport, but you'll feel much better on an allergy-free diet."
Weight Loss, But Not Fat Loss
"Weight Watchers is about weight loss, not fat loss," says Teta. "And weight loss has been shown repeatedly to be unsustainable because you often lose muscle along with fat, which can be disastrous for your ability to maintain your new weight."According to an analysis in Consumer Reports, about 56% of the calories on Weight Watchers come from carbohydrates. Only about 20%, on the other hand, comes from protein.
"Eating inadequate dietary protein creates muscle loss," says Blum. "So although a person may lose weight, the body will spare fat and lose muscle. Even though the scales might show someone's losing weight, without enough protein that weight loss is likely coming from muscle and not fat."
You can lose weight on a carbohydrate-based diet, but it won't necessarily be fat loss. "Weight loss often results in muscle along with fat," says Teta, "which can be disastrous for your ability to maintain your new weight."
Rather than measuring lean muscle mass and fat, Weight Watchers focuses on your scale number. In other words, you don't know whether you're losing muscle or fat. "The majority of systematic approached weight loss programs focus solely on total scale weight loss versus losing actual body fat and gaining lean metabolically active muscle tissue," says Paula Owens, author of The Power of Four. "So, basically what you end up with is a thin, skinny physique with a high body fat composition."
Points, Calories... Aren't They Really The Same Thing?
In New Zealand, Weight Watchers recently came under fire for endorsing Chicken McNuggets and other McDonald's foods. "Our philosophy at Weight Watchers is that all food can be part of a healthy, balanced diet taking into account portion control and frequency," said Weight Watchers nutrition adviser Emma Stirling, justifying their decision.The McDonald's collaboration should have surprised no one, considering that Weight Watchers provides PointsPlus™ values for numerous fast food joints on its website. Want a Burger King Whopper without mayo? That'll cost you fourteen points. You can get an Arby's Roast Beef, on the other hand, for just nine points.
In other words, where those calories come from doesn't matter as much as staying within your allotted points, which proves that despite their improved points system that accounts for macronutrient status over calorie counting, Weight Watchers is essentially still a restricted-calorie diet.
"Weight Watchers' 'nutrition' information is regurgitated 1950s American Dietetic Association claptrap, with 'points' substituting for 'calories,'" says Bowden. Suh Coscia concurs: "It's still counting points," she says, "which is another word for counting calories. Counting points or calories is just that, counting."
In fact, according to that Consumer Reports analysis, the average person on Weight Watchers eats 1,450 calories a day. Blum attributes Weight Watchers' low-calorie regimen for ultimately failing most people. "Almost all people who deprive themselves of calories end up regaining the weight plus another 10 pounds," she says. "Your metabolism becomes damaged and repeated attempts at weight loss become more and more difficult."
JJ Virgin, author of the upcoming book, The Virgin Diet, echoes that same idea. "When you lower your calorie load as your key focus, your metabolism must adjust by shifting downward," she says. "This is like a cat chasing its tail. Ultimately your hunger wins out and you have to eat a normal amount of calories."
Of course you'll lose weight on a 1,450-calorie diet, at least initially. But it all goes back to losing weight and not fat, particularly if those calories come from the high-carbohydrate fast foods and processed foods that Weight Watchers allows. "While calories do count," says Virgin, "where they come from counts more and we need to focus much more on what we are eating than how much."
Blum provides a helpful example to illustrate that principle. "Weight Watchers fools people into thinking they are eating better because they are eating less," she says. "But 800 calories of Oreo cookies have a different metabolic effect than 800 calories of steak and spinach."
Other Views From MDs, RDs and Consumers:
Sara Gottfried MD, Harvard physician and author of the upcoming book, The Hormone Cure (Scribner/Simon & Schuster, 2013)
: "Weight Watchers is a great example of how 'one size fits all' just doesn't work broadly for people seeking to lose weight, particularly if you have hormone imbalances or addictive behaviors around food. While some of the 'healthy food guidelines' are effective for a select few, if you are a food addict--you'll play games.My patients, particularly those who eat to soothe stress and run high cortisol levels (the main stress hormone), will binge the moment the weigh in for the week, find their weight climbs, and the net benefit is paltry. It only works for a small subset of people who wish to lose weight permanently."
Nalini Chilkov, Cancer Expert, O.M.D (Link To Bio)
A Discussion Of Weight Watchers In Relation To A "Health Model""It is truly unfortunate that Weight Watcher's does not operate out of a health model. What does that mean? A "health model"?
What I mean is that real sustainable long term health must not only be the goal but also part of the entire process of weight loss, so that participants actually LEARN how to choose healthy foods and build a healthy body as a result of making healthy diet and lifestyle choices.
For example: A health model for weight loss teaches how to avoid artificial foods and sweeteners, (and certainly not encourage their consumption) foods that trigger inflammation, foods that increase toxic exposures.
A health model for weight loss teaches the importance of losing fat and preserving bone and muscle. Loss of muscle and bone increase risk of cachexia and bone metastasis, both life threatening processes for an advanced cancer patient.
A health model for weight loss teaches the importance of keeping blood sugar stable and well managed by eating a low glycemic diet (not a high glycemic diet with unrestricted fruit. High blood sugar fuels cancer.
A health model for weight loss included modulation of stress and stress hormones which signal fat storage and can lead to insulin resistance and pre-diabetes, another risk factor for cancer."
Debi Silber, MS, RD (Link To Bio)
: "The idea of portion control is great but it's the choices I disagree with. Learning to have less of unhealthy food choices is a short term solution at best. There's little sense of satiety so these high sugar/carbohydrate foods that are still welcomed on the program still have power over the dieter.This may work when all is going well but when life throws us a curveball, the emotional/stress eater will look towards these foods to self-medicate, with high sugar foods being the drug of choice. When these foods are eliminated instead, the dieter learns to include healthier choices while also learning healthier ways to soothe."
Joel Fuhrman, MD
: "Weight Watchers is not in the business of disease reversal, disease protection and health. It is all about weight. Participants and even leaders are poorly educated about nutritional science and women are not motivated to eat to win the war on cancer.Participants are forever maintaining their food addictions, because eating a little healthier and trying to cut back is simply a formula for failure in too many cases (the vast majority).
So they give lip service to better health and healthier eating, but this is impossible to maintain without serious attention to excellent nutrition, prevention of all deficiencies, sufficient anti-inflammatory super foods and reduction of additions and cravings that result.
That's why Weight Watchers is so successful, because people lose and then gain it back and are forever on the weight loss merry go round, so they keep needing their relatively ineffective supportive services.
Eat To Live is all about life extension and winning the war on cancer. And, once you learn it, the weight comes off permanently and you never have to diet again."
The Eat To Live Diet Explained
Consumer Comments: Taken From The Facebook Discussion Thread Below
: "I do not see Weight Watchers addressing the real issue of bio-individuality as it relates to its meals. Certainly in the "old days" our forefathers understood over time which food types were most beneficial to helping us stay strong and healthy. but that type of dietary understanding has been all but lost by the majority of the U.S. population. So if your genotype calls for a low fat diet but your currently on a low carb diet or vice a versa- this will ultimately lead to failure. And keeping in mind, that common allergen foods such as eggs, dairy, gluten, soy, corn and peanuts do not appear to be addressed by the Weight Watchers program. There better programs out there - but i must give Weight Watchers for its great marketing.""I won't argue with you on the fact that WW does allow you to eat what you want, as long as it falls within your Points+ allotment, and I'm sure that it doesn't address all of the hormonal and metabolic issues you mention, but in my 1 1/2 years on the Weight Watchers program, I have seen and heard some things differently than you report. For one, there is a large emphasis on activity and movement, to maintain and build muscle mass, so that issue is not being ignored. Second, there is also a bigger emphasis than you report on protein - it is promoted as a 'power food' and encouraged to be used over carbohydrates to sustain satiety and increase energy. Finally, they also promote the inclusion of healthy fats - in fact, there is a recommendation to include two servings a day of healthy oils as part of your Points+ allotment. To me, the focus IS on healthier eating, not just 'cramming whatever you can into your allowance' - at least, that's what I've experienced with the meetings I attend and the leader who runs them. I understand that the plan is not perfect, but, for anyone who has come to the point in their life (as I have) that they are truly committed to achieving and maintaining weight loss, it is a good start - a better start, I believe, than you have portrayed it in this article. I have lost 35 pounds and achieved Lifetime membership. I am interested in the information you provide on your site as I want to continue to become healthier in my eating, and I do think you have some great information and a good approach - just wanted to speak up on the side of Weight Watchers with some points I think were missed.
"I agree completely...but being a Weight Watchers member and doing great I have to say that the inclusion of Mc D's nuggets et al is more so that the one time I'm on a road trip and have no real options, that I can factor those horrid things into my day in the event I HAVE TO....I read your article here and then flipped thru my food journal for the last 4 days....I've eaten a ton of the following: chickpeas, spinach, chicken eggs, milk, hummus(i have a thing for chickpeas), all sorts of assorted raw veg, raspberries, blueberries and apples, almonds, lean beef, black beans, brown basmati rice, edamame, whole grain bread, ham, grapes, and one bunless chicken burger (from frozen at home not fast food)....WW allows you to factor in those bad guys for every once in a while, otherwise you eat as healthy and clean as possible....Now I know people in my meeting who just go by the points and after the meeting head to Pizza Pizza for as many slices as their points will allow...this is not working the program properly....doing that is a cop-out that causes people to lose and gain...those of us who get that that isn't going to fly use the program wisely - and when it's done that way it works...I've lost weight, gained muscle and am on my way to a happy healthy lifestyle. also, I follow the simply filling (what used to be called CORE) program....i do not have points per day but 49 pts per week for treats or higher fat items...otherwise i eat from a list of lean meats, fruit and veg and whole grains and fat free dairy"
"In 30 minutes, once a week, Weight Watchers leaders cannot teach everything about nutrition. We have to take responsibility for our actions and learn about the foods we are eating. If I think Weight Watchers is the last word on nutrition, both Weight Watchers and I are fooling ourselves. I have lost 15 lbs, I eat healthy, ride my bike 200 miles a week, do weight lifting 2x per week and never miss a Weight Watchers meeting if I can help it. Nothing is free in life and nothing is free in Weight Watchers...not even fruit and veggies. Come on. let's be sensible and responsible."
"This is a great article. WW has been one of my favored plans, specifically for the group support aspect. That is so critical. But on "how to eat", Weight Watchers, like almost EVERYONE selling a plan, feels that they have to tell you that you should be able to "indulge" once in a while. The common myth is that if we attempt to "deny" ourselves the treats completely, we are doomed to fail. This is so not true! We can retrain our brains to dislike sugar, refined flour, etc. Believe me, I am living proof of that. Thanks for the article!"
Related PEERtrainer Articles:
Is Belly Fat Different Than Other Fat, And Can It Really Be Targeted??The Science Of How To Burn Fat, And The Hormone That Drives Fat Burning
How Dr. Fuhrman Approaches The Concept Of Low Carb Dieting
5 Foods Weight Watchers Allows That Destroy Your Ability To Lose Weight
[PEERtrainer has created a webinar and video series with JJ Virgin, Phd, which explains how our hormones effect our body's ability to either store or burn fat, and what foods you need to eat and not eat to maximize your ability to burn fat. To be sent the webinar and video series, called "How To Do A Nutritional Cleanse", enter your email address below. You will need to confirm this request before you are sent the webinar]
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References:
Blom WA, et al. Effect of a high-protein breakfast on the postprandial ghrelin response. Am J Clin Nutr. 2006 Feb;83(2):211-20.
Hwang KO, et al. Social support in an Internet weight loss community. Int J Med Inform. 2010 Jan;79(1):5-13.
Jebb SA, et al. Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial. Lancet. 2011 Oct 22;378(9801):1485-92.
Just T, et al. Cephalic phase insulin release in healthy humans after taste stimulation? Appetite. 2008 Nov;51(3):622-7.
Lowe MR, et al. Weight-loss maintenance 1, 2 and 5 years after successful completion of a weight-loss programme. Br J Nutr. 2008 Apr;99(4):925-30.
Orth WS, et al. Support group meeting attendance is associated with better weight loss. Obes Surg. 2008 Apr;18(4):391-4.
Paddon-Jones D, et al. Protein, weight management, and satiety. Am J Clin Nutr. 2008 May;87(5):1558S-1561S.
Yang Q. Gain weight by "going diet?" Artificial sweeteners and the neurobiology of sugar cravings. Yale J Biol Med. 2010 Jun;83(2):101-8.
