1. Weight Watchers and Jenny Craig come out on top among commercial weight loss programs

Note: Sound bites, b-roll footage, and image available. Satellite coordinates and feed times are below. Physicians looking for an effective commercial weight-loss program for their overweight and obese patients may want to recommend Weight Watchers or Jenny Craig. According to an updated evidence review of 11 commercial weight-loss programs, only Weight Watchers and Jenny Craig showed evidence for effective long-term weight loss. The review is published in Annals of Internal Medicine.

More than one-third of U.S. adults are obese. The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians screen all adults for obesity and offer or refer overweight or obese patients to intensive, multi-component behavioral interventions for weight loss. Several commercial weight loss programs meet the recommended criteria, but their efficacy is unclear. Researchers reviewed published research to compare weight loss, adherence, and harms of 11 commercial or proprietary weight loss programs. All of the programs studied emphasized nutrition and behavioral counseling or social support components with or without physical activity. Of those, Weight Watchers, Jenny Craig, Nutrisystem, Health Management Resources, Medifast, OPTIFAST, Atkins, The Biggest Loser Club, eDiets, Lose It!, and SlimFast had trials that met inclusion criteria.

The researchers found that only Jenny Craig and Weight Watchers showed evidence that they helped people lose weight and then keep it off for twelve months or more. Other popular programs, such as NutriSystem, showed promising weight-loss results in the short-term, but additional research is needed to determine long-term results.

The author of an accompanying editorial is not surprised that highly structured programs with in-person social support, such as Weight Watchers and Jenny Craig, seem more effective but cautions that weight loss with such programs is modest and likely below patients' expectations. These unrealistic expectations may affect patients' willingness to adhere to any program.

Note: The URL will be live when the embargo lifts. For an embargoed PDF, please contact Megan Hanks. To interview the lead author, please contact Heather Dewar at hdewar@jhmi.edu or 410-502-9463.

2. Physical therapy as effective as surgery for lumber spinal stenosis

Patients with lumbar spinal stenosis (LSS) who followed an evidence-based, standardized physical therapy (PT) regimen achieved similar symptom relief and improvements in physical functioning as those who underwent surgical decompression, according to a study published in Annals of Internal Medicine.

LSS is an anatomical impairment characterized by narrowing of the spinal canal or nerve root foramen that causes pain, weakness in the lower back, buttocks, and thighs. LSS is the most often cited cause for lumbar surgery in the United States and studies comparing surgical with nonsurgical treatment of LSS have been done but outcomes are unclear.

Patients with LSS who were surgical candidates and who provided consent for surgery were randomly assigned to either evidence-based, standardized PT two times per week for six weeks or surgical decompression. After treatment, no differences were detected between the two groups with respect to relieving symptoms and improving function. Both groups began to show improvement at 10 weeks and continued to improve through 26 weeks. Improvements were maintained for both groups through the two-year follow up.

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News from Annals of Internal Medicine April 7, 2015