Put the questions below to the staff of each weight program you are comparing, before you pay any of them. Staff at a weight program should be able to answer questions about its features, safety, costs and results, and their answers can separate programs whose sales pages read the same.
What should a weight program have inside it?
A book or an app can promise help with weight, but a weight program is a formal program that gives you ongoing guidance and support to build healthy lifestyle habits that may promote weight loss. It should have four parts:
- a healthy, reduced-calorie eating and drinking plan
- a plan for increasing physical activity, if appropriate
- guidance and support for adopting these habits
- a plan for keeping the weight off
Every sales page can claim all four in a sentence, so ask about each part with a question that needs a specific answer:
| Part | A question that tests it |
|---|---|
| Eating plan | Do I have to buy special meals or supplements? If so, what are the daily or weekly costs? |
| Physical activity | How does your program address different ability levels and intensity of physical activity? |
| Guidance and support | Does your program offer one-on-one or group counseling to help me develop and stick with my healthier habits? |
| Keeping the weight off | How long is the weight-loss maintenance program, and what does it include? |
Other questions worth asking include whether you need to track what you eat each day and whether you need to join a gym or a structured exercise program.
Most programs use the internet, smartphones or other devices in some way, and some may be delivered fully online, with no in-person contact. If one of the programs you are comparing works that way, make sure it also includes:
- weekly sessions online, tailored to your personal goals
- support from a trained professional, such as a registered dietitian, health counselor or lifestyle coach
- a plan to track changes to habits such as eating and physical activity, using tools such as phones, activity counters and online journals
- regular feedback on your goals, progress and results from a counselor, by email, phone or text message
- the option of support from a group, through online meetings or chat groups
Has the program been tested, and which promises give an ad away?
Ask the staff whether there is evidence that the program works, in these words:
- Has your program been formally studied to find out if it is safe and effective?
- Have study results been published in a scientific journal?
- Can I get a copy or a link to the study findings?
If there is none, you may want to consider a different program. Any salesperson can answer smoothly, but either the staff send you the study, or a link to it, or they cannot. If you get a study and have questions about its findings, go over them with your doctor or another health care professional at your next visit.
Studies suggest some virtual programs may work if they include the key features of a successful program, which are the four parts above plus help setting realistic weight-loss goals. Researchers are still studying whether virtual programs are effective, especially over the long term, so put the study questions to an online program as well.
An advertisement gives itself away by what it promises. Before you compare sales pages, read the types of promises to stay away from on the federal weight-management page, and set each program's own claims beside that list.
A program that offers a prescription medicine is held to the same list, and to the false promises the FTC names in weight-loss ads. No product will let you eat all the food you want and still take weight off, and permanent weight loss requires permanent lifestyle changes, so distrust any product that promises once-and-for-all results. Even if a product could help some people in some situations, no one product works for everyone, and everyone's habits and health concerns are unique.
Other warning signs include very small print, asterisks and footnotes, which may make it easy to miss important information, and photographs or personal endorsements that look too good to be true. Read the footnotes on every program you are comparing, however professional its page looks.
Success stories are easy to make up and are not a substitute for scientific evidence, and reviews on popular online marketplaces and social media can be fake. Scammers also write glowing online reviews themselves or pay others to write them, and they place false news stories about weight loss products on fake news websites, blogs, banner ads and social media, often with the stolen logos of real news organizations.
You can report false claims or scams by weight-loss programs to the Federal Trade Commission. A false claim about a weight loss product can also go to the FTC at ReportFraud.ftc.gov or to your state attorney general.
What will you pay beyond the price on the page?
Ask the program's staff for the total cost of the program, from beginning to end, and check that it includes costs such as:
- membership fees, or fees for weekly visits
- food, meal replacements, supplements or other products
- medical tests
- counseling sessions
- follow-up to maintain the weight you have lost
- online chat access
If the eating plan depends on special meals or supplements, ask what they cost each day or each week. Supplements are worth a second look for another reason: hundreds of dietary supplements have been found by the FDA to contain potentially harmful drugs or other chemicals not listed on the product label, and many of them are sold for weight loss and bodybuilding (see Weight-loss supplements reach the shelf without FDA approval).
A free trial can end in charges. Many people who signed up for free trials of weight loss products wound up paying a lot of money and being billed for recurring shipments they did not want, so before you start one, ask the program's staff what is charged when the trial ends and how to stop it.
If a program asks you to sign a contract, check it the way you would a gym contract: read it and confirm that it includes everything the salesperson promised, find out whether there is a cooling-off or trial period, and check the cancellation policy, including whether you get a refund if you cancel.
Who runs the program, and what happens if it goes wrong?
Ask whether a doctor or other certified health professional runs or oversees the program, and whether you can speak with one if you need to. Then ask about the rest of the staff: whether the program includes certain experts, such as a registered dietitian, a mental health counselor or an exercise physiologist, what certifications, education, experience and training the staff have, and whether they are trained in cultural competence, that is, in working with people of different cultures and backgrounds.
Before you join, put these questions about harm to the staff:
- Could the program cause health problems or be harmful to me in any way?
- Is there ongoing input and follow-up to ensure my safety while I'm in the program?
- Will the program's doctor or staff work with my health care professional if needed, for example to address how the program may affect an ongoing medical issue?
If the answer to the last one is no, you will be the one carrying information between the program and your doctor.
Ask any program that ships you a product where the product comes from. Some potentially dangerous or unproven products are ordered direct from overseas by mail, getting around normal Customs and FDA inspections and other safety measures (see Is a cheap injection from a private seller safe to buy?).
If a product a program sold you gave you a reaction and you think it is a medical emergency, go to the closest emergency room or call 911. Hives with trouble breathing after an injection are one such reaction (see Hives with trouble breathing after an injection mean 911). For any reaction to a product, tell your doctor which product it was, and report it online or by phone at 1-800-FDA-1088 to MedWatch, the FDA's medical product safety reporting program, which receives reports from the public.
If NicoCares is one of the programs you are comparing, hold it to the same questions. NicoCares itself does not prescribe: a physician licensed in the state where you live reads your answers and makes the clinical decision about treatment. Patients are asked to tell their care team promptly about side effects, through Spruce, a messaging app they join from an email Spruce sends them. NicoCares offers no emergency care, so a reaction you think is an emergency goes to 911 or an emergency room, not into a message.
Is a program the right route for you?
For many adults, treating overweight and obesity starts with lifestyle changes, and overweight and obesity may also be treated with weight-loss medicines and weight-loss surgery. When medicines or surgery are used, health care professionals most often recommend lifestyle changes along with them, so what a program contains still matters if you are also asking about medicine. Talking with a health care professional about your weight is an important first step. If you already have a program in mind, ask your own doctor at your next visit whether it may be a good fit for you, and whether you should consider those other options.
