What has been the biggest health-effecting news thus far in 2011? A cure for some form of cancer? Declines in AIDS, TB, or malaria? Side-effect-free new drugs for schizophrenia and bipolar disorder? No, given the fact that it will actually affect multiple millions of overweight people, who might otherwise drift sooner rather than later into adult onset diabetes, knee and hip replacements, heart disease, and stroke, arguably it’s the fact that in the US, Weight Watchers International, has shifted their famed Points counting system to the “PointsPlus” program, following its adoption in Europe.
This has been much discussed in the New York Times (Gootman 2011), Time magazine (Sachs 2011), USA Today (Hellmich 2011), the Herald Sun in Melbourne, Australia (Herald Sun 2011), the Daily Mail in London (Keeling 2010), and many other publications, and actually made the cover of Environmental Nutrition (Environmental Nutrition editors 2011).
In the interest of full disclosure, I am actually a member of Weight Watchers, and at one point in my life (circa 2000) actually lost 150 pounds (which took me 10 years to gain back, although I have re-lost 35 over the last several months). Nonetheless, I own no stock in the company and expect no free membership or other payback for this blog.
Did the old points counting system not succeed?
No, it succeeded for millions of people, overwhelmingly women, although it certainly can work for men. The old Weight Watchers point scheme has generally faired at least as well, and often marginally better than other major commercially backed diet programs in a rather large number of scientific and clinical comparison studies as well as in advisories or editorials found in health related publications (Brown et al 2009, Dansiger et al 2005, Futtterman 2006, Hunt & Poulter 2007, Jolly et al 2010, Ma et al 2007, Morgan et al 2009, Scarff 2008, Truby et al 2006, Tsai & Wadden 2006. Witherspoon & Rosenzweig 2004) although some critics suggest that the evidence for most commercial programs is not particularly strong (Weaver 2005), while others argue that it is too expensive, although the most recent study figures in transportation costs to meetings, which suggests that if the overweight people were not going to meetings they would not be going anywhere, as opposed to incorporating their trip to Weight Watchers, with something likely to be necessary at least once a week, like shopping for food or going to and from work (Cobiac, Vos & Veerman 2010). To some degree this can also be overcome by participating in Weight Watchers online, albeit not all the people of modest means addressed in that study were as likely as the general populace in having personal computers or internet access.
In comparison with the purported “scientific” or “clinical” studies at unnamed “leading medical universities” vaguely alluded to in late night cable or supermarket tabloids ads for miracle pills, capsules, or “nutritional supplements” the factual basis for Weight Watchers, as well as for many of its honorable competitors, is overwhelming.
This relatively consistent positive showing by Weight Watchers is not surprising because the plan is actually based on a combination of mindful eating habits, good nutrition, upbeat group psychology, and a model for customer satisfaction and mutual support that is effective and widely admired in business circles (Tax, Colgate & Bowen 2006, Vignali & Henderson 2008) .
Basically, like many of its competitors, Weight Watchers counsels caloric restriction & portion control, encourages exercise, is forgiving of occasional backsliding, and encourages the client to rethink their eating habits and attitudes towards food, particularly in social situations or at times of stress or personal disappointment.
Weight Watcher’s genius in the caloric restriction area has been to substitute for laborious calorie counting the idea of given foods having a certain number of “points” which can be readily looked up in one of their print publications and/or online guides.
Historically on Weight Watchers, one could eat pretty much what one wanted and expect to lose weight most weeks if they adhered to their points allotment for the week. In other words, if you chose to eat half your points allotment in potato chips ------not something they would then or now recommend------you could nonetheless expect to lose weight.
Allotments were based on the client’s current weight, age, gender, and as one lost weight, the points allotment actually went down.
One could consume a somewhat greater points allotment by engaging in a wide variety of physical activities which also were assigned a Points value, which could be subtracted from an overage of food points consumed.
This is not to say that Weight Watchers has not consistently encouraged eating a wide variety of fruits and vegetables, whole grains, etc. It just did not make following that particular aspect an absolute.
Why fool around with such a winning program?
I suspect that Weight Watchers changed their Points counting system for the some of the same reasons that science textbook publishers frequently change editions: There is always some new wrinkle in science that, while not overthrowing the laws of the universe, changes things up somewhat, and new editions which incorporate these changes tend to reduce or stop resale of used textbooks already in circulation from which the publisher no longer profits, from cutting into the steady sales of new textbooks. Or as one perceptive analyst, Ruth Mortimer (2010)of Marketing Week, noted:
“A brilliant move by WeightWatchers is to make sure its eating systems are just complicated enough that its followers have to buy into the company’s products. If the diet plan was easy to follow without any guidance, why would anyone need Weight Watchers?”
What is this new science?
Weight Watchers has apparently incorporated more of the glycemic index in the Points counting scheme, but not uncritically so. A glycemic index approach is not particularly new (Bellisle et al 2007, Thomas, Elliott & Baur 2007), and certainly not a discovery unique to, or even pioneered by, Weight Watchers.
According to the Mayo Clinic:
“A glycemic index diet is a general term for a weight-loss diet that's based on choosing foods and beverages that are thought to prevent rapid increases in your blood sugar level. Glycemic index diets are based on the idea that controlling blood sugar levels leads to weight loss (Mayo Clinic staff 2011).”
The difference is that while many glycemic index diets do not have one count calories, they require the dieter to be aware of which foods have a high glycemic index (raising blood glucose levels rapidly) and generally to avoid them. Examples include white bread and spaghetti. Dieters are advised to eat more readily those foods with a moderate glycemic index rating: corn and bananas . And they are urged to eat low glycemic rating foods abundantly: these include many fruits and vegetables. Portion control is not a big feature of most glycemic index diets, as long as the portions are of low glycemic index foods.
How far is Weight Watchers going with this? In terms of points counting, members are getting a free pass on many very low glycemic index fruits and vegetables (Gootman 2010). Unfortunately for lovers of refined carbs like baked goods that are without enormous fiber content, and other higher glycemic index foods (including many potato and rice dishes), their points values have gone up. Beer, wine, and alcoholic beverages also seem to have accreted extra points.
Surprisingly, so have many juices. Orange juice is up, and so are my personal favorites, tomato juice and V-8. However, under the new PointsPlus counting scheme, if one were to eat the oranges or tomatoes or the mixed vegetables that go into V-8, instead of their juices, there would be zero, or only a very few points.
Presumably, eating the raw materials, so to speak, does not spike blood sugar levels, and there is probably a natural stomach-filling aspect to packing in those bulky, more solid foods, that inhibits eating too many of them, or perhaps forestalls the desire or ability subsequently to eat higher glycemic index foods.
And to be fair, Weight Watchers has increased the Points allotment for virtually all of their clients, so the transition should not be entirely discomfiting.
This free-for-all for many fruits and vegetables, is not entirely a departure for Weight Watchers. There have always been a fairly extensive list of foods that, in customary portions, did not count against one’s Points allotment. This included cabbage, radishes, lettuce, scallions, green and wax beans, beets, asparagus, broccoli, summer squash, spinach and zucchini, to name a few.
In a very real sense, Weight Watchers is now entirely in line with the new Food Pyramid modeled by the FDA, which as the Harvard School of Public Health Nutrition Source succinctly states (2011):
“Most people should aim for at least nine servings (at least 4½ cups) of vegetables and fruits a day, and potatoes don't count.”
Conclusions
Ultimately, the question that each overweight person must ask themselves, however, is not when they should begin a program of corrective diet and exercise, it’s when they wish to get used to having insulin shots, knee or hip replacements, heart attacks or strokes. Making the first determination is not a guarantee that the second outcome will not happen, but one improves the odds of it not happening, or not happening as soon as it might otherwise. And while handling the “new math” ProPoints plan on Weight Watchers is annoying to those of us who lost weight on the old one, it’s not as annoying as figuring out if your savings account has enough money for those copayments that will very likely come if you do nothing to change the way you eat and exercise (or don’t). And, yes, there is good science behind the change, even if this was not necessarily the sole reason the change was made.
Long term Weight Watchers adherents significantly reduce adverse triglyceride levels, decrease low density cholesterol, increase high density cholesterol, and decrease C-Reactive protein levels, considered by some a precursor or predictor of cardiovascular disease, and weight loss is probably the greatest single slower of weight-bearing joint deterioration there is, particularly in conjunction with non-jolting, non-joint-pounding exercise. It is not the only way all this can be accomplished, but it is a way that has worked, sometimes modestly, sometimes manifestly, for literally millions.
Tony Stankus, FSLA, Life Sciences Librarian, Science Coordinator & Professor
University of Arkansas Libraries MULN 223 E
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