The simple pairing of diet and exercise still proves overwhelming for many people. Knowing you should eat well and knowing how to eat well are two different things entirely, much like joining a gym versus actually working out. In these cases, people may turn to weight loss programs or drugs. Researchers from Duke-National University of Singapore would like to shed some light on these alternatives.

A recent study found among various weight loss programs and drugs, the two that stood out as the most cost-effective were the Weight Watchers program and the drug Qsymia. The team took into account absolute cost, the average annual weight loss on each program or pill, and the long-term cost-benefit judged in cost per quality adjusted life year saved, a measure known as QALY.

"The obesity epidemic is raising serious health and cost consequences, so employers and third-party payers are beginning to consider how to provide some coverage for commercial weight loss programs," said senior author Eric Finkelstein in a statement. The results are intended to help consumers make smarter choices about their personal health.

Finkelstein began the study alongside his research assistant, Eliza Kruger. Together they conducted a literature review of each clinical trial they could find that evaluated weight loss programs and pills. They analyzed each for its ability to help people lose weight and keep the weight off for at least a year, which they took from individual studies in kilograms lost per year. Three diet programs and three medications met the criteria: Weight Watchers, Jenny Craig, and VTrim, along with the diet pills Qsymia, Lorcaserin, and Orlistat.

While weight loss surgery and some popular diet drinks were excluded, such as Slimfast and Medifast, because they didn’t meet the criteria, the team believes their ranking still offers the most valuable analysis for consumers. Weight Watchers was shown to be the least expensive intervention, costing an average of $377 per year. VTrim fell at $682, and Jenny Craig soared at $2,500 per year. As you may expect, diet pills were more expensive. Qsymia was the cheapest, at $1,336 a year. The two others, Lorcaserin and Orlistat, fell behind at $1,743 and $1,518, respectively.

All told, weight loss was mostly unremarkable. Disciples of Weight Watchers lost around 5 pounds, 6 pounds for Orlistat, and 7 for Lorcaserin and VTrim. More impressive were the subjects who used Qysmia, who lost 15 pounds on average, and Jenny Craig, where subjects lost around 16 pounds. These benefits were weighed against the financial cost and computed for a per kilogram cost. Qysmia and Weight Watchers emerged as the victors.

According to Finkelstein, these numbers don’t matter much in terms of effecting top-down change. "Health policy makers do not understand value in terms of cost per kilogram lost, but if you tell them that an intervention improves QALYs at better than $50K per QALY saved, they recognize that as good value for money," he said, referring to the baseline savings of $50,000 per person for public health policy. This figure is regularly used as a way to gauge a product’s effectiveness — or, to put it another way, how much diseased people burden a health care system.

"Although containing rising rates of obesity is a public health imperative, employers and third-party payers remain hesitant to sink big money into commercial weight loss strategies," Finkelstein said. The new analysis should help provide a helpful lens, he added, for people to view alternative weight loss strategies if diet and exercise fail.

Source: Finkelstein E, Kruger E. Meta- and cost-effectiveness analysis of commercial weight loss strategies. Obesity. 2014.