1. “Some of us are big, fat liars.”
Currently, more than one in three American adults over 20 is obese — up from roughly one in four 20 years ago. And millions of other people are currently carrying more weight than they’d like this time of year, thanks to the annual holiday overeating ritual.
Many Americans experience not only health problems but also guilt and shame over these added pounds. And that’s why weight loss — an industry of diet companies, weight-loss supplement manufacturers, diet book authors and obesity doctors — is big business. Companies that focus on weight-loss programs (think Nutrisystem and Weight Watchers) raked in $2.4 billion last year; sales of supplements — many of which promise weight loss — add as much as $14 billion. And doctors now perform hundreds of thousands of bariatric surgeries a year to help patients lose weight.
The bottom line: For many, our extra weight is a source of cash. And to get that cash, some companies are willing to stretch the truth of what their products will do.
According to the most recent data from the Federal Trade Commission, roughly 15% of weight loss ads contain false claims or false information. Already this year, the FTC has fined three companies about $34 million over deceptive advertising claims. Among the cited companies is the marketer of Sensa, a product that consumers sprinkled on their food to help them lose weight, which will pay $26.5 million to settle charges of false-advertising because, according to the FTC, the company “deceived consumers with unfounded weight loss claims and misleading endorsements.” (Sensa says that “the settlement includes no admission of wrongful conduct.”)
“There is little evidence that pills and supplements can help you lose a lot of weight,” says Mary Engle, the director of the advertising practices division at the FTC.
What’s more, some of the biggest players in the industry have accused each other of deception. In 2010, Weight Watchers (the largest provider of weight loss services in the U.S., with more than 43% market share) sued Jenny Craig in U.S. District Court in New York over its ads that said that “Jenny Craig clients lost, on average, over twice as much weight as those on the largest weight-loss program.” Weight Watchers claimed that no major clinical trial was done that proved this statement and that those assertions were false and misleading. The two companies reached a settlement: Jenny Craig, though it admitted no wrongdoing, agreed to never again publish, broadcast or disseminate the ad in any form. In a statement issued at the time, Jenny Craig said, “We challenge Weight Watchers to compete directly with us in a head-to-head clinical trial.”
To be sure, the majority of weight-loss ads are relatively honest, and there are some diet supplements that work. Still, the amount of misinformation in this industry is high, experts say. Engle says that to avoid fraudulent weight-loss products, consumers should be on the lookout for labels that promise quick action (like losing 10 pounds in 10 days), and labels that use words like “guaranteed” or “scientific breakthrough.” She also cautions against using creams or patches that promise to help with weight loss.
2. “Dieting is making you fat.”
While the point of a diet is to lose weight, often the reverse happens: We end up fatter than when we started. “Diets don’t work long-term,” says psychotherapist and eating coach Karen R. Koenig, who has written five books related to weight loss. In one of the most definitive reviews of studies on the issue, researchers at the University of California, Los Angeles, found that people who diet typically lose 5% to 10% of their starting weight in the first six months, but between one-third and two-thirds of them — depending on the study — end up regaining more weight than they lost within four to five years. Traci Mann, now a professor of psychology at the University of Minnesota and an author of the study, says she thinks the re-gaining figure may actually be much higher. The results, she says, are skewed by methodological bias in some studies and the fact that in many cases, only studies with solid weight-loss results published their findings.
Part of the reason for this is that many dieters can’t keep themselves from eating forbidden foods for long, and when they do, they binge, taking in a ton of calories at one time, Koenig says. “If diets actually worked, we wouldn’t have to go on so many of them,” says psychologist Alexis Conason, a researcher at the New York Obesity Nutrition Research Center. Rather than going on short-term diets, experts say, people should opt for a long-term eating plan that will help them cut calories and eat healthier foods, but not leave them feeling deprived.
What’s more, diet foods themselves may prompt weight gain — in part because people misunderstand labels. According to a study published in 2006 in the Journal of Marketing Research, people who saw a “low fat” label on a food package ate up to 50% more of that food in a sitting than people who didn’t. Plus, consumers assume that foods labeled low-fat have significantly fewer calories than they actually do, even though that’s often not the case. Normal-weight consumers who saw a low-fat food label on a one-serving bag of granola estimated that the bag contained 141 calories, even though it actually contained 201 calories (a nearly 43% difference). For overweight people, the difference was even more pronounced: Those in the low-fat label-group underestimated the calories by 57%.
Non-caloric artificial sweeteners — like those found in many diet soft drinks — have been linked to weight gain, though it’s difficult to prove cause and effect. Several large-scale studies have found a link between aspartame consumption and weight gain, including a widely cited 2008 study that found that the risk of becoming overweight or obese among people who consumed 21 or more artificially sweetened beverages per week vs. those who did not consume any was nearly double. While it’s hard to say why we’re seeing this link, some researchers speculate that artificial sweeteners may not fully satisfy our sugar cravings, thus inspiring future sugar binges, and others think the sweeteners may impact our metabolism. (The makers of the popular artificial sweetener Splenda say that it does not cause weight gain, and the Sweet ‘N Low website points to research that shows that artificial sweeteners don’t cause overeating.)
3. “You might do just as well on Twinkies and Doritos.”
When most people think “diet,” they think of eating fruits, veggies and lean protein. But Mark Haub tried something different. The professor of human nutrition at Kansas State University put himself on a “convenience store diet” made up of things like Twinkies, Doritos, Oreos and sugary cereals. The twist: He limited his caloric intake to 1,800 calories a day (the average man eats 2,640 calories per day).
In two months, Haub had lost 27 pounds and lowered his bad cholesterol by 20%. Haub’s kind of diet isn’t nutritionally advantageous (though his regimen included vitamin and mineral supplements), but it does show that total calories consumed make a big difference in weight loss.
Indeed, many doctors and nutrition experts say that to lose weight, you need do little other than reduce the number of calories you eat and increase the number you burn. A study published in the New England Journal of Medicine — which divided participants into four groups, putting each group on a diet with a different make-up of fat, protein and carbs but all with similar calorie counts — found that “reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize.”
This means that consumers might not need to shell out big bucks for the latest diet books and products, says nutritional biochemist and author Shawn Talbott. Dieters can keep a journal of what they eat and count calories that way, or they can try out one of the many free calorie-counting apps, such as MyFitnessPal. Katie Rickel, a clinical psychologist at weight loss facility Wellspring at Structure House in Durham, N.C., says that “keeping track of what you’re eating every day is one of the best methods for long-term weight loss.” Look to cut calories and make sure you’re getting the proper nutrition, including fruits and veggies, she says.
Diet companies disagree with those who say you don’t need a weight-loss company to help you lose weight. A Nutrisystem spokesperson points out that its system, which provides customers with meal delivery, means that there is “no counting, measuring or weighing,” so it’s easier to stick to. And a study published in 2013 in The American Journal of Medicine found that Weight Watchers — whose methodology, to some degree, encourages users to cut calories — is more effective than doing a weight-loss program yourself and that the more often participants used Weight Watchers tools, the better; the study was sponsored by Weight Watchers.
4. “We’re making you — and your kids — unhappy.”
Not only does dieting often leave you feeling hungry, it can do all sorts of unpleasant things to your psyche. A study titled “Grapes of Wrath: The Angry Effects of Exerting Self-Control” published in 2011 in the Journal of Consumer Research found that people on a diet may be more prone to anger. Indeed, when people chose an apple over a chocolate bar in the study, they then were more likely to opt to watch movies with anger or revenge themes than to view more innocuous films; and in a related study, participants who ate a healthy snack instead of a better tasting snack were more annoyed by marketing messages that included controlling words like “you ought to” or “you must.”
What’s more, dieting may also make us depressed and hurt our self-esteem. A study from the University of Montreal published in 2012, which looked at the brains of mice, found that cutting fatty foods out of a diet may change brain chemistry in ways that could make people depressed and more sensitive to stress. And anecdotally, psychologists and doctors say they’ve seen some dieters who are downright depressed about dieting. “When dieting, people divide foods into ‘good’ and ‘bad,’ which are moral, not nutritional, terms.” says Koenig. “This does a job on self-esteem.”
Weight-loss companies say that they’re trying to combat such thinking and help dieters overcome issues like these. A Nutrisystem spokesperson says that studies show that there are positive effects on self-esteem with weight loss and that they have trained counselors who advise dieters “to leave their setbacks in the past, and focus on the future and the success they’ve achieved thus far.” Jenny Craig also cites its personalized one-on-one consultations as ways to help dieters remain positive. For its part, Weight Watchers encourages people to remain positive and try to consider a setback as “feedback, not failure”.
Still, the stress of parents’ diets may have an impact on children. Studies show that mothers who diet are more likely to push their daughters to diet. And Chicago-area psychologist Elizabeth Lombardo says that children know their parents are on a diet even when parents don’t specifically tell their children they’re on one. “Their food issues trickle down to their kids,” she says — which can lead children to feel anxiety, stress and sadness about what they eat.
5. “Side effects range from stinky breath to … much worse.”
Some diets and weight-loss products can cause unpleasant side effects. Devotees of low-carb diets like Atkins have reported bad breath, dizziness, headaches and constipation. Those who opt for a juice cleanse may get bouts of diarrhea mixed with constipation. And many popular diets leave devotees feeling irritable.
But that’s child’s play compared with the serious side effects of other products — many of them diet supplements. OxyElite Pro, which is marketed as a weight loss and muscle building supplement, was linked to dozens of cases of hepatitis, liver failure (some patients needed liver transplants) and one death; after the FDA warned USPlabs LLC, which distributes OxyElite Pro, that it considered certain OxyElite products adulterated because they contain the ingredient aegeline, USPlabs agreed to recall certain OxyElite products and told the FDA it would destroy warehouse stocks of the supplement; however, in a Nov. 4 letter to the FDA, USPlabs maintained that aegeline has been safely used for centuries.
The diet-supplement problem isn’t likely to subside soon, because supplements are much less strictly regulated than many food and drugs. Indeed, most of the FDA regulation around supplements happens only when the FDA hears complaints from consumers after they’re already on the market; and thus it can take months for dangerous items to get removed from the shelves. Steve Mister, president and CEO of the Council for Responsible Nutrition, a supplement industry trade association, doesn’t see the regulations as the problem. “Dietary supplements are amply regulated by the FDA and FTC,” he says. “Unfortunately, as in every industry, there are fringe players who do not comply with the law.”
6. “That fat and calorie count? It’s way off.”
Many a dieter has indulged in goodies that seem to be low-calorie or low-fat, based on the nutritional data on their packaging. Unfortunately, you can’t fully trust those numbers. A study published in 2010 in the Journal of the American Dietetic Association found that the actual amount of calories in frozen foods was an average of 8% higher than what was listed on the label, and that items served in restaurants had 18% more calories than the menus said they did. The author of the study, Susan B. Roberts, director of the Energy Metabolism Laboratory at the USDA Human Nutrition Research Center and founder of the online weight loss program MyIDiet.com, suspects that inaccuracies like these are likely on packaged snack foods as well.
The discrepancy is partially due to the fact that under rules published by the FDA, which regulates nutrition labels on foods, “the ratio between the amount obtained by laboratory analysis and the amount declared on the product label in the Nutrition Facts panel must be 120% or less.” That means that if a lab analysis of a food found that it had 120 calories, the food’s packaging could state that it had 100 calories and would still be in compliance with FDA regulations; similarly, a food that actually had 20 grams of fat but listed 17 would be in compliance. What’s more, the FDA requires that food packages contain at least 99% of the weight listed on the box, so in practice, Roberts says, food manufacturers often put more food into the package than they list on the label in order to make sure they comply.
To be sure, this doesn’t mean dieters should stop believing the labels entirely, experts say. Instead, dieters should account for the higher totals when tracking their food intake.
7. “We know you’re getting tired of us ...”
Dieting may dominate the New York Times best-seller list — where books like “Grain Brain” (about harmful carbs) and “Giada’s Feel Good Food” (about how to eat and exercise to stay fit) are mainstays in the top 10. But the number of Americans on diets is declining. A study released this month by research firm NPD Group found that 19% of American adults reported that they were on a diet, down from a peak of 31% in 1991 — and that women were “leading the decline in dieting.” What’s more, other surveys suggest that Americans are staying on diets for a shorter time.
One reason for these changes may be that Americans are more accepting of overweight people’s appearance: The 2012 study by NPD found that 23% of Americans said they thought that people who were not overweight were significantly more attractive than those who were overweight, compared with 55% in 1985. But the changes may also be due to a change in heart: “I think that people are starting to realize that diets don’t work,” says Dr. J. Shah, the chief medical director of Amari Medical in Scarsdale, N.Y.
Those trends are reflected in industry growth figures: From 2008 to 2013, the weight-loss industry contracted, with industry revenue declining at an annual rate of 3.7%. And as of the third quarter of 2013, industry leader Weight Watchers — which has over 1 million members — saw its meeting attendance decline more than 15% compared with the year prior and its weekly online paid subscribers drop 2.6%. That trend might continue: In the company’s third-quarter earnings call, Weight Watchers CEO James Chambers said that “we expect fourth-quarter revenues to be down low double digits, given our continuing negative recruitment trends.”
8. “… But our profits are still through the roof.”
While the weight loss industry is experiencing some issues, it’s still raking in the dough. In 2013, Americans will spend an estimated $2.4 billion on weight-loss services alone, according to a report by research firm IBISWorld, which predicts that industry revenue will hit $2.7 billion by 2018; this may be thanks to increased consumer spending, an improving economy and industry operators increasingly targeting men.
What’s more, profit margins for the weight-loss industry average 11.8% of revenue and are higher than in most personal-service industries, where they average 4.2%, according to IBISWorld. Despite its declining attendance and revenue, Weight Watchers reported a third quarter 2013 profit of $60.3 million (down from $67.4 million a year earlier) and revenue of $393.9 million (down 8.5% on a constant currency basis). Nutrisystem reported a third-quarter profit of $4.3 million and $85.4 million in revenue (up 5%) — beating estimates.
9. “That surgery will make you thin — and could make you sick.”
The number of bariatric surgeries — weight-loss procedures like gastric bypass and gastric banding, typically done on severely obese individuals — now totals about 150,000 to 160,000 each year in the U.S., up roughly 10% over the past 10 years, according to Ninh Nguyen, the president of the American Society for Metabolic and Bariatric Surgery. One of the major reasons for their popularity is their effectiveness: A study published in The Journal of the American Medical Association, found that three years after their gastric bypass surgery, people had lost and kept off an average of 31.5% of their body weight; for patients who had the lapband surgery, that figure was 15.9%. What’s more, these surgeries sometimes help lower participants’ incidence of diabetes and high blood pressure, the study found.
But they still have serious potential risks and side effects. The Department of Surgery at the University of Southern California lists infections, ulcers, spleen injuries, stroke, heart attack and death as possible side effects of gastric bypass and gastric banding. The department estimates that one out of every 200 people die following complications from gastric bypass procedures and one out of every 1,000 from gastric banding. These odds are improving because many of these surgeries are now done laparoscopically. Still, “some patients don’t go through with it because they are worried that the surgery is too risky,” says Nguyen.
10. “Fellas, you’re next on our hit list.”
Despite the fact that the percentage of men who are overweight (73%) is higher than the percentage of women who are overweight (64%), membership in many weight-loss programs is dominated by women. For example, an estimated 90% of Weight Watchers members are women. But the weight-loss industry hopes that will change. An IBISWorld report on the industry identifies men as a “large, untapped market” and predicts an uptick in marketing efforts focused on weight-loss programs for men.
Indeed, we’re already seeing some efforts to target men. In the past few years, football player Lawrence Taylor (Nutrisystem), former NBA pro Charles Barkley (Weight Watchers), and Ross Mathews (Jenny Craig), famous for his role as Ross the Intern on “The Tonight Show with Jay Leno,” have served as spokesmen for the companies. “They’re trying to make men as miserable as we’ve been,” jokes Conason, the psychologist. And their efforts might work: Dr. Dyan Hes, who sits on the board of the American Board of Obesity Medicine and is the medical director of Gramercy Pediatrics in New York City, says that it’s becoming more socially acceptable for men to diet.
Catey Hill covers personal finance and travel for MarketWatch in New York. Follow her on Twitter @CateyHill.
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