Weight Loss Programs

Low-carb diets

Our research uncovered both advocates and detractors for low-carbohydrate (low-carb) diets such as the South Beach diet, the Atkins diet, and to a lesser degree, the Zone diet, which all restrict carbohydrates. Although it makes for dense reading, the best research can be found on the website of the North American Association for the Study of Obesity, where editors summarize nearly every major scientific study of low-carb diets (including Atkins) from the 1970s. In a format that's slightly easier to digest, the Journal of the American Medical Association has a 2007 comparative study of Atkins, Dean Ornish, the Zone and LEARN diets, and another 2005 comparative study of Weight Watchers, Atkins, Dean Ornish and the Zone diets, while the New England Journal of Medicine has an in-depth one-year study of Atkins.

Ultimately, the scientific community is split on the low-carb craze. Vehement detractors include the American Heart Association, which expresses concerns that a diet high in protein and fat and low in nutrient-rich fruits and vegetables can contribute to osteoporosis, heart disease, kidney stones, liver problems and diabetes. Dr. Dean Ornish, who has his own diet plan, also continues to insist that low fat is crucial to lowering overall cholesterol. Atkins proponents, however, assert that the diet is healthy, and studies do show that low-carb diets can help lower cholesterol. In the latest 2007 American Medical Association study, Atkins dieters lost the most weight, and secondary outcomes, like lipid profiles, triglycerides and blood pressure, were comparable to or more favorable with Atkins than the other diet groups, including Ornish's diet plan. With statistics like that, there's about as much evidence in favor of low-carb diets as against.

On the other hand, there is an abundance of sound research showing the profound benefits associated with high carbohydrate intake, including optimal mental functioning, muscle glycogen saturation, enhanced fat burning, protection against protein and muscle breakdown and improved immune function, which contravenes the wisdom passed onto dieters from the Atkins, Zone and South Beach Diet regimes.

Many medical experts say that low-carb diets are safe at least in the short term, except for people with kidney disease. The fact is, there are no long-term studies to date (longer than two years) that chart the effects of a low-carb or very low-carb diet on an individual's overall health.

The popularity of low-carb diets has led to an explosion in low-carb manufactured products. It should be mentioned that a majority of today's nutrition bar manufacturers make low-carb claims they can't back up by evidence. Of the 30 low-carb bars tested by an independent testing organization, ConsumerLab, 18 were improperly labeled, including the Atkins Advantage nutrition bar. Half the bars contained more carbohydrates than listed. Many companies make the low-carb claim by not including the polydextrose and glycerine, both complex carbohydrate sweeteners, in their carbohydrate count. The FDA recently ruled that these and other sweeteners such as xylitol must be included in the count of total carbohydrates, and bars that contain these sweeteners cannot be labeled as low-carb.

There's evidence that the tide is turning in favor of reducing overall consumption of carbohydrates. According to researchers who conducted clinical trials at the American Heart Association, substituting protein (half from plant-based sources) or monounsaturated fats for 10% of dietary carbs can reduce the chances for heart disease. The United States Department of Agriculture released a new version of its food pyramid in April 2005. Changes include a more favorable view of healthy fats, like those found in olive oil and fish. It also encourages reducing refined carbohydrates, such as white bread and pasta, in favor of whole grains – the net effect to the body is less carbohydrates. While it will be some time before the scientific community agrees on the long-term effects of the Atkins Diet and other low-carb plans, more informal studies show that reducing net carbohydrates, even if not following the Atkins diet, can help in losing weight. In a Consumer Reports survey, over 50 percent of those who'd maintained their weight loss for more than five years report that cutting back on carbohydrates is a component of their success.

At ObesityResearch.org, researchers theorize that one reason Atkins dieters are successful is that by heavily restricting carbohydrates, overall caloric consumption is reduced enough to promote weight loss. Indeed, in all the top eight diets profiled in Consumer Reports' latest report, the average daily caloric consumption among them all was almost identical. In every study we found, caloric consumption and weight loss between low-carb groups and low-fat groups was about equal past the six-month mark. In a 2005 study published in The Journal of American Medicine, researchers studied four groups of dieters over the course of a year. One group followed the Atkins diet, while the others were divided between the Weight Watchers, Zone and Dean Ornish plans. While the Atkins group lost more weight initially, the groups had nearly equal weight losses at the end of the one-year study period. The bottom line is that results from Atkins after a year are about the same as with other diets.

The South Beach Diet has not been studied in a clinical setting as far as we could tell. That may be due to the fact that it is a close cousin of Atkins minus the emphasis on meat, or it could be the fact that its nutritional advice does not appear to hold up in the scientific community. Experts in one of the medical studies warned against any long-term diet that limits the intake of fruit, legumes and vegetables. The South Beach Diet Phase 1 does not permit any fruit at all; however, past Phase 1, the restrictions are lifted. The one South Beach review (Tufts University School of Nutrition and Science Policy) takes the diet book to task for its misleading medical and nutritional information and contradictions.

The Zone diet (*est. $12 for the book) takes a page from the Atkins playbook in that carbs are still largely restricted. To stay in the Zone, each meal must consist, in calories, of 30% fat, 30% protein and 40% carbohydrates, which exceeds the carb amount permitted on Atkins or South Beach diet plans, but is lower than permitted on most conventional diet programs. The Zone permits many fruits but eliminates nearly all grains except oatmeal. Research indicates that the Zone is a decent diet to fight off obesity and disease, if you are already at or near your goal weight, but it may not work as well for significant weight loss. This diet draws mixed reviews from nutrition experts.

Weight loss success rates: Improving your odds

You've lost the weight, but can you keep it off? The bad news is, according to well-publicized studies, 95% of all dieters who lose weight will gain it back in five years or less. Weight Watchers scores impressive marks in this regard. In one of their studies of participants, half of all dieters who reached their goal weight were still at least 5% lighter after five years (to be fair, this study involved Weight Watchers participants who succeeded in the program and did not include data for drop-outs). A Consumer Reports survey turned up some more encouraging statistics. Close to 25% of respondents to the magazine's survey said they had lost at least 10% of their total body weight and kept it off for a year. For a 200-pound person, that's at least a 20-pound weight loss -- a significant health benefit. What's more, over 80% of the successful dieters told Consumer Reports they did it on their own, creating their own exercise and meal plans.

This reinforces the views of other weight loss experts. Reviews say that the best diet programs are flexible and sustainable, and that a successful plan must be adaptable to the individual. That's why experts favor Weight Watchers, which allows for two important elements that really help people lose weight -- flexibility and support.

Repeated studies show that the more continuous the support provided and the more tailor-made that support (ideally, human interaction), the more weight was shed and stayed off. A 2007 study by the North American Association for the Study of Obesity comparing a self-help eDiets program to a therapist-led structured behavioral weight loss program showed that those dealing with a real person lost more weight. A 2003 study by the American Medical Association concluded almost the same thing: at every point during the study, weight loss in the in-person support group was greater than that of the self-help group.

Whichever eating plan you choose, weight loss experts say to avoid diet pills and diet fads -- like eating baskets of grapefruits or gallons of cabbage soup. While reviews say no one diet plan is successful for everyone, some approaches are generally regarded by reviewers and experts as either useless, dangerous or both. Any approach that promises quick weight loss should be avoided. You might lose water weight easily but you gain it back just as quickly. Diets that ignore the importance of exercise, especially strength building, are liable to result in loss of muscle rather than body fat. That can make it even harder to lose weight in the future and put you at an increased risk if you regain weight.

Experts say the best routes to sustainable weight loss are based on solid nutritional advice, exercise, accountability and support. In the Consumer Reports survey, successful dieters listed physical activity as their most important weight loss strategy. The number two strategy cited was individual counseling and guidance. Face-to-face support is cited by the Journal of the American Medical Association as a key component to maintaining weight loss over time.

Best weight loss programs

If you're looking for a healthy weight loss program with in-person group support, reviewers recommend Weight Watchers over all others. This plan is reasonably priced (*est. $20 to join and $9 per week) , and you pay as you go, without any major up-front expenses. Better yet, if you successfully reach your goal weight and stay there for six weeks, you can continue as a Lifetime Member and get maintenance support for free.

In addition to lay reviewers, Weight Watchers has a proven track record that is backed up by medical studies. The program is flexible and can accommodate special dietary needs, but encourages eating selections from all the food groups, as well as reducing fat, increasing fiber, eating plenty of fruits and vegetables and getting enough water and calcium. Since you're eating real foods from the beginning, reviews say, you also learn about appropriate food choices and portion sizes.

Weight Watchers dieters have been extensively studied and found to be more successful than dieters following other programs, as reported in The Wall Street Journal. Two recent medical studies by JAMA and the BBC found that dieters following the Weight Watchers diet were more likely to stick to their diet and continue losing weight long-term than those on more extreme plans. Weight Watchers produces a line of prepackaged food that can be incorporated into the program, but members are not required to buy the food, unlike some other well known diet plans like Jenny Craig and NutriSystem.

If you're not interested in cooking your own meals, two reviews recommend Slim-Fast (*est. $40 per week for shakes and bars) for being nutritionally sound and easy to use. The Slim-Fast products do not need to be mail-ordered since they're available in most supermarkets and pharmacies. Reviewers point to Slim-Fast as an option for people who don't have the time or inclination to prepare healthy meals. In one sense it's a good choice for those on the go, but the plan is not very flexible or variable and has a very high dropout rate over time. Also, while the shakes are technically healthy, this method of consumption doesn't help you develop better long-term eating habits. Medifast (*est. $300 per month for shakes, bars, soup and oatmeal) is also recommended in two reviews, but it should be noted that this plan is indicated for people who are very overweight, with 75 pounds or more to lose.

Experts concur that vegetarians are already healthier overall than the rest of the population, but if you are a vegetarian/vegan in need of a diet plan, or a carnivore looking for a vegetarian diet, the Dean Ornish Diet (*est. $10 for the book) has been extensively studied. It was originally developed to prevent heart disease back in the 1980s. In terms of weight loss and nutrition, the Ornish Diet stacks up against the newer diets, but it may not be the most fun and flavor-filled diet. Menus rely on vegetables, fruits and legumes, with very low fat and sugar. Most dairy, olives, nuts and processed foods are to be avoided. While it's possible to eat a vegetarian diet on Weight Watchers or Jenny Craig or, with more difficulty, the South Beach Diet, the Ornish diet is the only diet formulated with all-vegetarianism in mind, and in that sense, the easiest diet for a vegetarian/vegan to undertake without a major diet adjustment.

A newer diet to enter the fold, which gets top marks wherever it's profiled, is Volumetrics, based on the book The Volumetrics Eating Plan (*est. $11 for the book) . Formulated by a nutritionist with superb credentials, Volumetrics is designed around people's desire to eat more food. The diet makes use of foods that offer more volume per calorie, which makes you feel like you are eating more. People find the foods they can eat large quantities of while still losing the pounds. Vegetarians can be easily accommodated. The plan includes cooking strategies to reduce fat, and suggests that meals begin with a low-calorie soup or salad before the main course, which is intended to take the edge off hunger and make you feel fuller so you eat fewer calories.

It was surprising to find very little coverage of the Mediterranean Diet (*est. $8 for the book) , which goes by a variety of names, considering how long it's been around in one form or another­­. The Sonoma Diet (*est. $15 for the book) is one that did receive a mention in one review. This diet has received a lot of press in recent years for its focus on the consumption of grains and "good" fats -- monounsaturated fats like olive oil, nuts and oily fish, along with red wine as a preventive of heart disease, which are features that turned up in many diets in our research. But, according to their website, the American Heart Association is not ready to endorse this diet.

If your physician has already prescribed a specific diet, but you want some in-person group support, experts say the nonprofit Take Off Pounds Sensibly (TOPS) program is a good choice. TOPS is a nonprofit weight loss club that's been around since 1948. It's inexpensive (*est. $24 to join and $5/month for chapter dues), and since its members all have their own prescribed diets, it doesn't endorse any plan in particular. As a member, you get to attend weekly meetings and lectures, participate in weigh-ins and receive other enticements to help you lose and maintain weight. You can search for a local chapter through their website (http://www.tops.org/).

Although we did not see Curves for Women compared to any other weight loss program, this business is one of the fastest-growing franchises in the United States. Curves for Women is an exercise-based weight loss program that revolves around a 30-minute aerobic/weights circuit. Although Curves suggests a modified low-carb eating plan, you're not pushed to follow it; the real emphasis is on regular exercise and periodic weigh-ins, along with incentives like rewards for frequent attendance and attaining weight loss goals. The initial enrollment fee is steep (*est. $150), and the monthly fee is about $30. There is no prepackaged food and no counseling or group meetings.

The American Council on Exercise surveyed the Curves program in 2005. The study measured the overall fitness level of fifteen Curves members, tracking their heart rate and oxygen consumption during a 30-minute Curves workout. The disappointing news is that ACE says that the average calorie burn was a mere 184 calories -- that's maybe half of a candy bar. The advantage to Curves is its low intimidation factor, especially for women self-conscious about going to a gym. Participants like the social aspect, and experts say this kind of aerobic activity is a health benefit, even if participants don't lose much weight from the Curves workout alone. The danger from "reward" eating is high, however, since participants may believe they burned more than 184 calories per session.

Jenny Craig is a popular program, no doubt because high-profile celebrity spokespersons like Valerie Bertinelli and Kirstie Alley have gone from fat to fit on the diet. The program is not recommended often in reviews and is much more expensive than Weight Watchers (*est. $200 to $350 to join, plus roughly $90 per week for food, which is a required purchase). Jenny Craig provides support through meetings with counselors. Though counselors receive some training, they aren't dieticians, nor do they have any other medical qualifications.

Jenny Craig's program relies on prepackaged food (*est. $90 per week). Experts, including those polled by Health magazine, say the nutrition behind the meals seems sound, but that dieting using prepackaged meals is expensive and unlikely to help you keep off the weight, since you never learn to cook for yourself or make healthful decisions on foods and portion sizes. Jenny Craig has not yet been the subject of a major clinical study.

LA Weight Loss receives criticism for the high cost of its supplements, bars and snacks, which are the heart of its program. The cost will vary depending on how much of the vitamins and food you buy, but members are required to pay a registration fee (*est. $375 per year) up front, plus weekly food costs of about $28. The company has previously settled a false advertising claim in New York for advertising a cost of $7 per week. LA Weight Loss counselors are paid a commission on the products they sell.

Weight loss online programs

Support has long been a large component of Weight Watchers, with weekly meetings and weigh-ins, but we were surprised to find that some researchers say online weight loss support works just as well as face-to-face meetings. In a study published on the website of the North American Association for the Study of Obesity, researchers split a group of 255 healthy overweight and obese adults into two groups. Both groups first participated in a six-month behavioral weight loss program. One group then received one-on-one counseling, while the other group received online and e-mail support. At the end of 18 months, the groups had achieved nearly identical weight loss. Most research, however, points to in-person programs resulting in more weight loss than online programs.

When it comes to maintaining weight loss, a recent year-long study published by the New England Journal of Medicine finds that face-to-face meetings are definitely superior to Internet-based support. Still, online weight loss support is certainly a viable option, and it is more convenient for many people. It also enables shy people to ask questions and receive encouragement while avoiding the public nature of a group-support situation. Online support is also cheaper. The top-rated eDiets starts at about $4.50 per week (as of January 2008).

eDiets is the subject of several scientific studies, and it's highly rated by several sources as the best diet website. eDiets offers a variety of features at a low cost ($4.50 per week for the cheapest programs, cancel at any time after initial 13 weeks without paying a termination fee) . eDiets provides support for a number of approaches to dieting along with individualized eating plans, counseling, chat rooms and informational resources. Members choose from a wide variety of diet plans, including Atkins, the Mayo Clinic Diet, Slim-Fast and a dozen others, including vegetarian options. Users are not limited to any one diet. Dr. Phil's Diet and the Zone used to be included, but were recently dropped.

eDiets also has both peer groups/mentors and expert registered dietitians for 21 different diet plans, and more than a dozen healthy living plans for those with special health needs, such as Type 2 Diabetes or Hypoglycemia. Access to the message boards costs an extra $2 per week. The site provides personalized meal plans, shopping lists, recipes and help with fast-food choices. Individualized fitness plans can be designed on site. One of the advisors is Oprah Winfrey's personal trainer, Bob Greene. The site contains elements of what experts find to be crucial in designing a plan to fit your lifestyle and preferences. On the downside, eDiets is a busy-looking website with lots of links and too many ads. Many of the recommendations for eDiets from other websites are suspect, as eDiets promotes a generous affiliate program; these seemingly impartial websites tout eDiets' virtues in order to get viewers to click through to eDiets to join a program. We also read complaints about unwanted e-mails and trouble with cancelling. Many supplemental elements also cost extra, and eDiets is not very up front about telling you that some of the fitness program add-ons cost an extra $2 to $5 per week.

eDiets also offers a range of prepared foods (*est. $275 per week). At this cost level, Jenny Craig's foods actually look cheap. The difference is that the eDiets prepared line of foods is not a required purchase on any eDiets plan, and instead of being frozen, fresh meals are sent overnight via FedEx. In the rankings of five popular weight loss delivery plans by Epicurious magazine reflecting flavor, nutrition, convenience, portion size, variety and similarity to real food, eDiets scored the top spot while Jenny Craig's frozen meals scored next to last.

eDiets is the largest diet website, but it's not the only one. DietWatch.com (*est. $3 per week) offers four diet plans, including a low-carb plan and a vegetarian plan. The WebMD Weight Loss Clinic (*est. $5 per week) receives very favorable press. For those who want the trusted Weight Watchers name but want to do it online, they can join up with WeightWatchers.com (*est. $4.25 per week) .

Not all the online programs cost money. PEERtrainer.com is a relatively new addition to the bunch, providing free support in small groups and teams. The site also offers daily logs for meals, workouts, and goals. Calorie-Count.com, owned by About.com, has 650,000+ members and offers similar user-support forums. This site also has a growing database of nutrition labels from commercial foods, along with online logs and trackers. (Note that About.com and ConsumerSearch are both owned by The New York Times Company.)

Important Features: Weight loss plans

It should go without saying that simply attending group meetings does not make you lose weight; you have to follow the program. In several of the reviews we found, experts comment on the importance of persistence in achieving weight loss. It's also important to be realistic in your expectations, experts say. Most women aren't built to be a size six or weigh 105 pounds, and most men aren't destined to have a 30-inch waist. The focus should be on improving your health and fitness -- losing body fat, not just weight -- and not on numbers alone.

A tendency to gain weight isn't a problem that can be cured with a few weeks of dieting. Experts say you should only lose about a pound a week to avoid potentially dangerous "crash diet" health problems, so prepare to be in for the long haul. To lose weight in whichever program you choose, a reduction in caloric intake is critical.

All diets, whatever their name, must reduce the number of calories a person consumes and/or increase the amount of calories he burns. In a comparison among the most common diets (Atkins, Ornish, Zone, Jenny Craig, Weight Watchers, South Beach), the daily caloric intake for each was found to be nearly identical.

Most of the diets currently on offer have considerable overlap with each other; they just focus on different things to get you to eat the right foods. Weight Watchers purports to let you choose whatever foods you wish to eat, and this is true. You can eat whatever you want, but if you wish to stay within your daily points allowance successfully until you reach your goal weight, you'll quickly learn that fruits, vegetables and whole grains – basically, low glycemic-index foods -- contain the fewest points. Coincidentally, low glycemic-index foods are also the ones that have the highest fiber content and give you a feeling of fullness faster and longer. So, in effect, a balanced Weight Watchers regime becomes the Low Glycemic Index Diet, Dr. Phil's advice for sensible eating or Volumetrics. Focus on fish as your protein source and rice for your carbs, and you've got the Japanese Women Don't Get Fat Diet. Cut out the meats and reduce the fat somewhat and you have the Dean Ornish Diet. Up the fat and reduce the carbs by a little and you're in the Zone. In the pH Diet (*est. $10 for the book), eaters seek out high pH foods. Foods with the highest pH levels are generally fruits and vegetables. Whole grains are higher in pH than refined grains. This sounds again like a balanced Weight Watchers Plan or Sonoma Diet meal. Avoid low pH foods like meat, and you're back to the Dean Ornish regime once more.

Marketing gurus know you won't pay for the obvious, so each successful diet must have a twist to make it seem especially unique from every other diet out there, when in reality, most of the diets (apart from the low-carb diets) are actually very similar to one another.

This knowledge should make the choosing of a diet regime (or the construction of your own self-made diet) all the easier. Since all diets work in essentially the same way of restricting your caloric intake, all you need to do is choose the diet with the right types of nutritious foods you already have an affinity for that will leave you feeling satisfied. Call these foods energy-dense (Volumetrics), high-response cost, high-yield (Dr. Phil), low glycemic load foods (Low Glycemic Index Diet) or caloric restriction with optimal nutrition foods (Ray Walford's Longevity Diet) – they're all the same. For any diet to work successfully, the dieter must feel full while eating a smaller number of calories.

No one said it's going to be easy, even after you pick the right diet that fits your preferences. Retraining one's body to eat better foods and less of them takes time. And you can't let up even after you lose weight. Relapse to your old habits, and you'll relapse to your old figure. Maintenance is accomplished by regular and vigorous exercise, in addition to limiting calories and regular appointments with your scale. If you want to be among the successful few who keep the weight off, you have to develop healthy eating and exercise habits and keep them up for a lifetime.

Overall, here's what the experts say to look for in a weight loss program:

• Use the type of weight loss program you're most comfortable with. Some folks prefer group support, while others would rather have individual attention. In case you're still smarting from some decades-old humiliation in gym class, don't worry about group weigh-ins; these programs want you to keep attending, and they know better than to shout out embarrassing numbers. Many programs offer a choice of formats, including group, home, work or Internet-based options.

• The diet should be based on real foods. A regime that uses proprietary manufactured foods such as shakes, bars or packaged mini-meals is okay in the short term, but it will probably not help you establish healthy long-term eating habits. Such foods are convenient and they can be effective weight loss tools, but ultimately you will need to learn to cook healthful meals for yourself. Plans like Slim-Fast are effective for short-term weight loss, but in one review, surveys show the dropout rate to be higher for Slim-Fast than for other diet plans.

• Avoid diet pills. Research shows that diet pills don't work. (See the companion ConsumerSearch report on diet pills .) Diet pills, which do not need FDA approval, can interact with other drugs you may be taking, posing a real hazard. Some merely act as a diuretic, which can make you prone to dehydration.

• Fad diets aren't healthy. Some plans ask you to avoid specific kinds of food. That's not necessarily bad; a vegetarian diet can be very healthy as long as you substitute other proteins such as legumes or low-fat dairy products for meat. But watch out for diets in which you subsist on cabbages and grapefruits, or that encourage you to steer clear of all carbohydrates or all fats. A balanced diet with protein and complex carbohydrates, plenty of fruits and vegetables, a decent amount of fiber and not too much fat is what most people need in a good long-term eating plan.

• Make sure the program is flexible. Is your plan adaptable for vacations, quick commuter meals or socializing? Can it accommodate meals you can serve to or adapt for your family, or do you have to prepare two complete meals, one for yourself and one for everyone else?

• A healthy lifestyle should be encouraged. Good programs recognize that exercise is essential to weight loss. Some also include help with other elements of a healthy lifestyle, such as stress management, recognizing psychological or situational triggers for overeating, or developing an appropriate body image.

• Continuing support is important. The best programs continue to offer encouragement even after you reach your goal weight.

• Understand the pricing structure. Is there a large up-front fee, or is the program "pay-as-you-go"? Are there required purchases of food or supplements that add to the price?

Before undertaking any weight loss program, you should consult with your health care provider. Also, according to the IRS, some weight loss expenses are deductible as a medical expense on your taxes. There are quite a few restrictions, and you must prove through your doctor that you are at significant medical risk in order to claim a deduction. Membership and counseling costs are deductible, but food costs are not.

Our Consensus Report shows how many times products are top-ranked by reviewers included in our
All The Reviews Reviewed chart.

# of Picks	Model (with Retailer Links)	Price
7	Weight Watchers	(*est. $9 per week after $20 initiation fee)
5	eDiets.com	(*est. $4.50 to $12 per week, depending on options)
4	Atkins	(*est. $16.50 for the softcover revised edition)
3 each	Zone, South Beach, Volumetrics
2 each	Slim-Fast , Medifast, Dean Ornish , Sonoma Diet , and "doing it on your own" with no particular formal plan
1 each	Dietwatch.com , Take Pounds Off Sensibly (TOPS), NutriSystem , Jenny Craig, Burn The Fat

Weight Watchers is most often recommended in scientific studies and by editors at large. eDiets is the most frequently recommended online dieting resource, and several reviewers/editors recommend the increasingly popular Volumetrics diet. The Zone and Dean Ornish diets are compared side by side with Atkins in three major medical studies and compared with both Atkins and Weight Watchers in two of those studies, giving them perhaps more credibility than their peers with the same number of picks. Some reviews recommend alternatives to commercial weight loss programs entirely, such as working with a registered dietician, a free hospital program or simply doing it on your own. One review completely condemned most weight loss programs' failure to step up to the plate and perform numerous randomized trials and instead suggested the diet conscious seek help from their own doctors.

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