Should doctors just put patients on Weight Watchers?
An Australian study has found it could be more economically effective for the heathcare system to fund patients' participation in commercial diet programs like Weight Watchers than for GPs to provide standard care.
Researchers from the University of Sydney projected the health outcomes, costs and offsets of treating the 7.8 million Australians over the age of 20 who are overweight or obese between 2015 and 2025.
Should doctors just refer patients to Weight Watchers?
The team projected outcomes for the group considering three treatment alternatives: if the group received standard care from their GP for one year, if they received a referral to a one-year Weight Watchers program, and if there was no intervention.
The study's results, published in journal Obesity and using weight loss data from a 2011 Lancet paper comparing GP care to the Weight Watchers program, found the Weight Watchers option would result in 60,445 averted cases of obesity in 2025, 2311 more than if patients had been put into standard care.
Sharyn Lymer, lead author of the study and research fellow at the University of Sydney's Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, said this was a "conservative" comparison of the efficacy of commercial weight loss programs compared to standard care, noting that the GP care in this modelling exercise probably exceeded the average.
"[Participants in the Lancet study] had an average of ten visits to their doctor for follow-up and advice over a 12-month period," she said. "That's not necessarily the standard care that a person with obesity would receive in Australia."
In addition, researchers found paying for the commercial program for patients was $82 million cheaper than standard care over the 10-year period, with an estimated saving to the healthcare system of over $17 billion compared with no intervention at all.
However, neither method resulted in Australia meeting its World Health Organisation target of zero increase in obesity rates by 2025.
The study's authors advocated for government funding or Medicare subsidies for commercial weight loss programs proven to be cost-effective ways of managing obesity.
"Something like Weight Watchers only offers a small amount of weight loss, but it provides an additional therapy for doctors to offer and, if we scale it, that has potential population benefits," Lymer explained.
"Part of our message is around equity of access. By offering commercial weight loss programs through Medicare, the people who can least afford these programs as could gain access to them, and the savings that we would experience in the healthcare system by needing to treat fewer people with obesity… [it] would offset."
Dr Michelle Celander, director of program and science at Weight Watchers Australia and New Zealand, said she agreed with the authors adding that commercial weight loss programs could play an "important role" in partnering with health practitioners.
"Medicare referral to Weight Watchers has the potential to create real and scalable behaviour change in Australia," she said.
"Health professionals are facing an increasing number of patients with obesity in need of treatment. Access to the Weight Watchers program through Medicare would provide patients with increased support options for creating sustainable lifestyle changes outside of the doctor’s office."
Weight Watchers does not offer any form of low-income subsidy for its programs. When asked if they would consider this to increase community access, Dr Celander said the company is "looking at ways to make wellness more accessible".
According to the Royal Australian College of General Practitioners' Health of a Nation report, released on Wednesday, 45 per cent of GPs consider obesity to be the health issue that provides them with the greatest concern for Australia’s future.
Although commercial weight loss programs are not subsidised by Medicare, they are a popular option for people who are told by their doctor to lose weight.
Heather McCarthy, a stay-at-home mum from the Gold Coast, joined the Weight Watchers program after her doctor said her she would need to lose weight to avoid being at risk of developing diabetes.
When the 33-year-old next saw her doctor a few months later, she had lost 10kg. McCarthy said her doctor was "so pleased" by the results, they told her to "keep going".
"When I saw her a year later, I’d lost 26kg," she recalled, adding the weight loss had helped to control her polycystic ovarian syndrome symptoms, and her mental health also improved.
Other international studies have considered how private weight loss companies can interact with state healthcare systems.
In 2017, researchers at the London Borough of Bromley's Department of Public Health found a third of people at risk of type 2 diabetes who were referred to a Weight Watchers program by their GP avoided developing the condition. Unlike the University of Sydney study, this research was partly funded by Weight Watchers.
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