Diets Debunked: The Weight Watchers Diet

Can Sticking With A Food-Points Budget Lead To Long-Term Weight Loss?

• WW 101|
• Does WW Work?|
• Benefits Beyond Weight Loss?|
• Where WW Goes Wrong|
• What WW Gets Right|
• Is WW Right For You?|
• A Healthy Foundation is Key|

Weight Watchers (now known as WW) has been a household name for decades, so naturally, I wanted to include it in my Diets Debunked series. I’m not necessarily for or against WW, but I want to share what the research says so you can make the most informed decision about whether it’s something you want to try.

WW gets a lot of things right. For example, there’s no extreme calorie cutting or restrictive dieting, it includes behavioral and fitness components (which are crucial for weight loss success), and it’s pretty affordable. So, if you’ve had a hard time making meaningful changes to your diet, WW could be a great jumping-off point because it provides structure, support, and guidance for making healthy lifestyle changes. 

This could be perfect if you’re looking to lose a few pounds and want to start moving toward a healthier lifestyle. However, some research (including studies completed by WW itself) indicates that for the majority of people who follow WW, weight loss isn’t significant, and long-term adherence to the program is a problem.

With this overview in mind, I want to start off with a little background on the Weight Watchers diet program.

Weight Watchers Diet 101

The Weight Watchers diet was started by Jean Nidetch in New York City in 1963 with the goal of providing group support for folks on their weight loss journey. Over the years, celebrities have endorsed the program and it continues to be quite popular. In 2018, it was renamed WW to shift the focus away from the number on the scale and toward “shifts in behavior, progress over perfection, and meeting members where they are right now” in an attempt to [1].

WW claims to have over 100 research-backed behavioral techniques delivered digitally and through coaching that help members make changes in nutrition, sleep, exercise, mindset, and general behavior [1].

On the WW program, foods are assigned a single-number point value based on six main factors [2]:

1. Calorie content/portion size
2. Added sugar
3. Saturated fat
4. Fiber
5. Protein
6. Unsaturated fat

In addition to foods with various point values, there are over 200 “zero-point” options, which you can consume liberally. Some of these include:

• Beans, peas, lentils
• Chicken and turkey breast
• Popcorn
• Eggs
• Fruit
• Fish
• Non-starchy vegetables
• Tofu
• Yogurt
•  Cottage cheese

Here’s a snapshot of how it works when you sign up for WW [2]:

1. Based on your current and desired weight, you receive a daily “points budget” that will hypothetically help you lose 1-2 pounds a week.
2. You can consume any foods to meet your daily points budget (but some foods are higher in points, so they use up your food budget more quickly).
3. You can consume an unlimited amount of “zero-point” foods.

In addition to your daily points budget, Weight Watchers gives you meal and drink recipes that are tailored to your dietary preferences, like if you’re vegetarian or vegan [3]. WW can also accommodate dietary restrictions like gluten and dairy, and offers a low-carbohydrate option with a modified list of “zero-point” foods for people with type 2 diabetes [3].

The WW program app allows you to easily track the foods you eat and your personal points, activity, and weight. It also includes a barcode scanner and restaurant search option to make grocery store shopping and eating out easier.

You can sign up for encouragement or arrange to meet up with other WW members and coaches to help you stay on track [3]. But the program also offers to match you with an in-person or virtual nutrition and behavioral coach for a monthly fee that varies based on your level of membership [3].

More recently, WW has started to offer a prescription weight-loss medication program for people who have tried diet and exercise without much success [3]. Medications are prescribed via a virtual clinic, and participants are also given the option of genetic testing for obesity genes [3].

This all seems fairly straightforward and simple, so let’s discuss what the research says about the WW diet success rate.

The Weight Watchers Diet: Does It Work?

WW seems to focus primarily on weight loss, and there’s a good amount of evidence that it may be a valid option, especially with certain dietary adjustments. For example, one meta-analysis found that overweight men who followed the WW program lost more weight after one year when compared to a control group [4]. Another showed that incorporating WW meal replacement shakes (along with dietary and behavioral support) helped participants lose an average of 14 pounds more than programs without meal replacement shakes [5].

Other positive research findings from systematic reviews and clinical trials include:

• People who followed WW for at least a year had 2.6% greater weight loss compared to people who only received nutrition education [6].
• Out of 4 popular diets and a control diet, WW was the only diet that consistently led to weight loss (7.7 to 13.2 pounds), for up to 2 years [7].
• WW led to more weight loss than Curves [8] or a behavioral weight loss intervention [9].
• Six months of three different WW plans that included fitness tracking and weekly behavioral workshops led to significant weight loss [10].

While those studies suggest WW can help you lose weight, the results may not be significant, and they may not last. Here are a few randomized controlled trials that make this point:

• When people followed one of 4 popular diets (including WW) for 2 months and then followed their own meal plan for a year, weight loss occurred across all diets, but the numbers weren’t meaningful (the WW group lost 6.6 pounds in one year) [11].
• People who followed WW lost more weight after one year compared to those who followed a do-it-yourself weight loss approach, but the amount of total weight loss was trivial [12].
• Even though WW was the only one of four diets that consistently led to weight loss (7.7 to 13.2 pounds), people tended to partially regain their weight after 2 years [7].

To summarize, evidence suggests that WW may work pretty well for some people, especially in the shorter term and with adjustments like meal replacement shakes. Considering that WW seems to focus mainly on weight loss, you may be wondering if it has any other benefits.

Are There Benefits to Weight Watchers Beyond Weight Loss?

Any time you lose excess weight, especially if it’s a significant amount of weight, you’ll likely see improvements in your mental health [13], as well as markers related to cardiovascular and glycemic health [14]. Does any evidence show that Weight Watchers improves health outside of weight loss?

Well, when people include WW’s behavioral and fitness components, the program may benefit their mental and physical health. For example, one clinical trial showed that people who lost the most weight on WW (with fitness tracking and weekly behavioral workshops) had improvements in happiness, physical fitness and function, and general health [10]. Another trial of WW with a fitness component found that participants had significant improvements in happiness, sleep, quality of life, aerobic fitness, flexibility, and blood pressure [15]. It’s important to note that the second study gave a financial incentive to complete the assessment procedures, and it was funded by WW, so it’s hard to say whether its results are reliable.

In terms of cardiovascular health, one randomized controlled trial found that people who followed WW had improved lipid levels (e.g. cholesterol) but no change in blood pressure or fasting blood sugar [11]. 

In general, you can expect improved physical and mental health from WW if it helps you lose significant excess weight. But at this point, there isn’t enough substantial evidence to show that WW can directly reduce the risk of cardiometabolic disease. 

Overall, the research we have suggests that WW may be great for short-term weight loss and related improvements in mental and physical health, but the benefits seem to wane as time goes on, and regaining lost weight may be common. Why might this be? Let’s get into where WW may go wrong for some people.

The Weight Watchers Diet: Where It Goes Wrong

Like other commercial diet plans, Weight Watchers may be helpful for creating a framework to kickstart your weight loss journey. However, there are some downsides:

1. The WW points system essentially reduces food to a number. Thinking of food only in terms of calories or fat grams or points can be tedious, time-consuming, and unfulfilling, which might make it tough to stick with long term.  
2. The WW program may take the focus off listening to your body and creating a healthy relationship with food. Research shows that tracking food as numbers can increase the likelihood that you’ll become obsessive about food or end up with disordered eating [16, 17].
3.  WW offers its own line of packaged foods that are processed, which might encourage you to consume fewer whole foods.
4. Some of the “zero-point” foods on the WW system, or foods with lower point values, may not work well for your body.
5. Unlimited “zero-point” foods could lead to overconsumption.

The WW program has tried to mitigate some of these drawbacks by changing the program over the years. For example, the name change from Weight Watchers to WW may help promote a healthier view by taking the focus away from the number on the scale. And even though the food-points system hasn’t changed, WW removed a feature that allowed you to add points to your daily budget if you exercised, drank a lot of water, or ate non-starchy vegetables. 

While this type of adding and subtracting may make sense mechanistically, it undermines the goal of listening to your body and can create disordered eating practices. To demonstrate this, someone might say, “if I run 3 more miles today, I can add extra food points.” This type of thinking can lead to an unhealthy relationship with food and exercise. And since you can choose any food, wholesome or not, you may get into a vicious cycle where you aren’t really listening to your body. Nevertheless, WW does get several things right, so let’s check those out.

The Weight Watchers Diet: What It Does Right

The WW program seems to be a valid way to get started with healthy habits if you struggle to do this on your own. Weight Watchers actually gets a lot of things right, one being the “zero-point” food options, which appear to be mostly whole, nutritious foods. Seeing as they don’t count toward your points budget, you may be inclined to consume these instead of less healthy foods, and that may improve your nutritional status overall. 

Other positive aspects of the WW diet include:

• It doesn’t push you to hit unreasonable calorie goals like some extreme weight loss plans do.
• It includes non-restrictive dieting with a wide variety of food choices (there are no off-limits foods).
• It differentiates between saturated and unsaturated fats, and makes sure you’re not completely removing fat from your diet
• It differentiates between natural and added sugar, encouraging you to consume fruit and natural sweeteners.
• It includes behavioral components to help change your mindset and habits around food.
• It promotes physical activity and workout tracking.
• It’s fairly affordable (although it may still be too expensive for some).
• It offers support groups or one-on-one sessions with a WW coach.
• The WW app is easy to use.

Some research suggests poor long-term adherence, and many people end up regaining their lost weight, but WW does have success stories. One observational study found that people who successfully lost weight and kept it off with WW tended to choose healthier foods overall, self-monitor their food intake, seek out social support, and ignore their food cravings [18]. This suggests that the behavioral components of WW are extremely important for long-term success, which is the case for any weight loss program. 

Is The Weight Watchers Program Right For You?

If you’re currently following WW and you’re seeing great results, then there’s no need to stop. But if you’re wondering if the Weight Watchers diet is right for you, consider using it as a structured launch point. You can take advantage of the behavioral components and nutrition education, and then transition into a more relaxed and sustainable way of healthy eating that will help you maintain your weight loss.

On the other hand, if you’d like to lose a significant amount of weight and keep it off, WW may not deliver on that promise. First of all, if you find the program tedious, it might be hard to stick with it long-term. Second, the WW program may not target the root causes of stubborn weight gain. 

In my experience at the clinic, poor gut health, a lack of physical activity, poor sleep habits, out-of-control stress, and inflammatory food choices are often at the root of weight gain. Without tackling these issues, lost weight will likely return. This requires making changes you can continue for the rest of your life. And let’s face it, counting food points from here on out may not be practical or feasible. 

Here are some tips for getting started on a more sustainable weight loss journey:

• Eat an anti-inflammatory diet, like the Paleo diet, which removes more potentially inflammatory foods. This may help improve your gut health and lower inflammation if you’re open to temporarily eliminating some foods from your diet. 
• Take probiotics, which are another effective strategy for improving gut health. A well-balanced gut microbiome is important for maintaining a healthy weight and your metabolic health.
• Incorporate resistance training into your routine to help improve body composition.
• Create a relaxing sleep routine that allows you to get the right amount and quality of sleep.
• Spend time in nature to help target your stress level.

To achieve your weight loss goals and maintain your desired weight, you have to create a healthy foundation. But you don’t necessarily need a commercial weight loss program to start healing your body. 

Weight Watchers or Not? Build A Healthy Foundation

Overall, WW is a diet program that reduces portions and calories without restricting any particular foods. If you’re generally healthy and would like to lose some weight without depriving yourself of any foods, this may be a great option for you. And if you take advantage of the other aspects of the program, like the exercise and behavior change strategies, you’ll probably be pretty successful. 

However, if you’ve tried to lose weight with similar programs without success, you may want to investigate possible root causes like poor gut health, too little exercise, low-quality sleep, overwhelming stress, and an inflammatory diet. 

Whichever option you choose, it’s important to remember that counting calories or food points alone may be hard to sustain and benefit from in the long run. But once you have a sustainable, anti-inflammatory meal plan, if you are diligent about physical fitness, healthy sleep habits, stress management, and getting support through strong social connections, you’re building the foundations for healthy, long-term weight loss.

If you’d like to learn more about how poor gut health and an inflammatory lifestyle may be sabotaging your weight loss efforts, check out my book Healthy Gut, Healthy You. And if you’re in need of personalized guidance, I encourage you to contact The Ruscio Institute for Functional Health.

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