Holly F. Lofton, MD
Holly F. Lofton, MD, clinical associate professor at NYU Grossman School of Medicine, director of the NYU Medical Weight Management Program and a weight-loss clinical researcher, New York City. Med.NYU.edu
Which weight-loss program will work for you? The one you’ll follow at this moment, says obesity medicine specialist Holly F. Lofton, MD. As long as the plan creates a calorie deficit—you expend more calories than you take in—you’ll lose weight if you stick with it. And surprisingly, the same diet may not work for you at different stages of your life.
Any diet plan you’re considering should have the following elements…
Maintenance plan—a way to bridge to the “forever” stage.
Foods that work with your tastes.
Strategies for improving lifestyle habits.
Tailored recommendations delivered via a platform you’re comfortable with.
Credentialed administrators—therapists and coaches who stress the psychology of weight loss or, for a medication-based program, a medical director and doctors.
Apps can reinforce your meetings with coaches and therapists and counter the “obesogenic environment” we live in, which is not conducive to weight loss. We know what to eat to lose weight, but we are bombarded with messages that distract us. App reminders act as your cheerleader for reaching daily goals. Since costs vary, take advantage of any free trial period to see if you like an app before you pay. Reminder: Spending more doesn’t guarantee success—you get out what you put in. Look for these key features…
Ability to track food intake. The app should tally calories and offer nutrition information to help you make better choices. Calorie counts should come from reliable sources such as the USDA or the nutrition labels of packaged foods.
Goal setting and motivational help, including affirmations, stress-management tools and cognitive-behavioral strategies. Higher level interactive apps should offer coaches for guidance and accountability with feedback via text messages, video calls and/or phone calls.
Syncing with other apps and devices. Connectivity with an Apple watch or Fitbit and a wireless scale let you track other important components such as physical activity and pounds lost.
App-based programs to consider…
LoseIt! Premium. Track your meals and workouts, and set goals. Enter the amount of weight you want to lose and your time frame, and the app creates your daily calorie limit. If you can’t find a brand-name food in the database, you can scan the barcode and the information will be added. You can tap into wellness articles and recipes under the “Discover” tab and access the user community for nutrition- and weight-loss–related forum discussions. $40 per year…lifetime membership, $100. LoseIt.com
Noom focuses on the psychology of weight loss with interactive lessons to help you make behavioral changes. It offers ways to manage emotional eating. Features include virtual coaches, food and activity tracking, and recipes. A stress-management program called Noom Mood is available for an additional fee. $59 per month…$199 per year. Noom.com
Train With Kickoff. After an online questionnaire consultation, you will be matched with a coach for customized workouts and personalized nutrition advice. There’s daily support and guidance to improve lifestyle habits, learn easy food swaps, access live workouts and get feedback about your form. Coaches include certified personal trainers and registered dietitians. $95 per month…live workouts start at $27 per session. TrainWithKickoff.com
MyBodyTutor offers personal coaching to help you change your eating habits and your mindset around food along with a customized diet and exercise program. This program is good for those who want daily accountability, but it’s expensive—$299 per month…$599 for a daily scheduled phone call. MyBodyTutor.com
The effectiveness of doctor-prescribed glucagon-like peptide-1 (GLP-1) medications for weight loss, including Wegovy and Ozempic, has led to an explosion of online programs offering these drugs. They can be worthwhile, but you still must do your due diligence. Look up the credentials of a program’s medical director and the doctor or other providers who will be supervising you. Bona fide programs will require an initial, possibly virtual, doctor visit plus blood tests to check for any underlying medical conditions. They will prescribe GLP-1 medications only to those who qualify according to FDA guidelines—people with a body mass index (BMI) of 27 or more and a medical condition related to being overweight…or with a BMI of 30 or over who do not have a risk for medullary thyroid cancer or a history of pancreatitis, among other contraindications.
Important: Most GLP-1s are injectables that you’ll need to give yourself. Other things to consider…
GLP-1 medications don’t work for everyone—about 13% of participants had no response to the medications.
You may experience side effects, such as headache and nausea.
The required blood tests and drugs can be very expensive and aren’t always covered by insurance. The cost of joining a program itself, without the medications, is expensive, too.
Beware of any company that prescribes alternate versions of GLP-1 drugs. These formulas have not been sufficiently tested and are not FDA-approved.
One important benefit of reputable online programs: They are accessible if you don’t have a local board-certified obesity specialist or have shied away from the medical community after not being treated respectfully or being made to feel uncomfortable because of your weight. Look for programs that offer personalization and remote patient monitoring, including weigh-ins via Bluetooth. Some prescribe less expensive generic drugs, such as metformin, as an alternative to GLP-1s.
Medical programs to consider (note that the costs below do not include lab tests or the medications)…
Noom Med. This Noom program makes GLP-1 medications available to existing members who qualify. You’ll start with a health evaluation by a board-certified physician or a physician-supervised nurse practitioner and get necessary lab work, followed by an individualized program. $49 per month plus basic Noom membership ($59 per month or $199 per year). Noom.com/med
Calibrate includes an initial virtual visit with a board-certified doctor and one-to-one video coaching with a credentialed and Calibrate-trained “accountability coach” who will help you set goals and make lifestyle changes and monitor your progress. It requires a one-year commitment. $1,749 for the one-year program, which can be financed monthly. JoinCalibrate.com
Found offers less expensive medications for those who can’t afford or take GLP-1s. Its doctors are board-certified and specially trained in weight management. You’ll get a one-to-one consultation to customize a plan for you and have access to a library of recipes and health articles curated by registered dietitians. $149 per month…less with a longer commitment. JoinFound.com
If you’re looking for a medically supervised program, consider working with a doctor certified by the American Board of Obesity Medicine. These specialists were initially board-certified in an area of medicine by the American Board of Medical Specialties (or the osteopathic medicine equivalent) and then trained and certified in treating obesity. Search at ABOM.org by clicking on “Find A Physician.”
Another source of weight-loss specialists is ObesityCareProviders.com, a service of the national nonprofit Obesity Action Coalition (ObesityAction.org).
Some in-person and online medical weight-loss programs now offer extensive DNA testing on blood, saliva and hair to supposedly identify unique biomarkers that will determine the best diet for you. But: There’s no scientific evidence that designing a diet and fitness plan according to your genes makes any difference.
What has been proven is that you need a caloric deficit to produce weight loss, even if the diet itself is a healthy way of eating. Examples: The DASH diet is great for hypertension and the Mediterranean Diet is great for heart and brain health, but you won’t lose weight on either one unless you eat fewer calories. Also, look at the quality of the diet being recommended. A low-calorie diet is not necessarily bad, but it is unhealthy if all you’re eating is cabbage soup.
Reminder: Avoid programs with unrealistic guarantees. One chain in the Northeast promises “up to 40 pounds lost in 40 days.” If you weigh 200 pounds, that equals a 20% reduction in body weight—a loss that would take about six months even with medication.
