December 14, 2023

In this photo illustration, the Weight Watchers (WW

WeightWatchers has been through a lot of changes recently. In 2018 the popular weight loss program changed its name to WW with an updated mission: “Wellness That Works.” For the first time, that mission includes medications.

Last spring, the company acquired Sequence, a digital health company, which allowed members to get prescriptions for weight loss drugs. Now the 60-year old company is launching WeightWatchers Clinic, which will give them access to telehealth weight loss management and doctors who can prescribe weight loss medications like semaglutide (Wegovy) and tirzepatide (Zepbound).

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It’s a significant shift for a company that has long focused on behavior-based strategies: making changes in diet and exercise, utilizing a “points” system for tallying the caloric and nutritional value of different foods, and relying on a community of support through coaches and other members that meet regularly to keep dieters motivated.

“We are no longer a consumer retail brand; we are a digital health company,” says WeightWatchers CEO Sima Sistani. “We are trying to lead the conversation around obesity and get people thinking about not just lifestyle interventions, but also clinical solutions like medications.”

“If we get it right, it could be the end of diet culture,” Sistani says, “and diet can go back to literally meaning habitual nourishment.”

WeightWatchers won’t be generating revenue from prescribing weight loss medications, but it will charge members an additional $99 a month on top of the monthly fee to access the clinic that givens them access to the drugs. The company is also beefing up the programs it offers on its app and is launching a program specifically for people taking these medications.

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“Some people see it as a left turn,” says Gary Foster, chief scientific officer at WeightWatchers. “But we’re evolving as the science evolves.”

Foster says the program is needed since the medications introduce a completely different set of challenges for people taking them. Most people trying to lose weight focus on managing the constant food cues that surround them, as well as learning about portion control and how to quell emotional triggers for eating. But because the new drugs drastically reduce appetite, people taking them have the opposite problem: remembering to eat, and specifically making sure they consume enough protein to maintain muscle mass.

WeightWatchers’ evolving stance on weight loss drugs

Jean Nidtech founded WeightWatchers in 1963 when she realized that having a group of friends who were trying to lose weight together would provide critical psychological support and motivation. The support-group-style meetings, in which members shared their challenges and successes and received encouragement throughout their journey, remain a mainstay of the program.

Even when various weight loss drugs became available over the years, WeightWatchers has never included them in its program. “There wasn’t much consumer interest in those medications, since they were associated with 7%, 8%, and 9% weight loss,” says Foster.

The program focused instead on more scientifically supported strategies, such as addressing sleep and stress and teaching cognitive behavioral skills such as recognizing eating triggers and findings ways to manage cravings.

But then a new generation of drugs called GLP-1 agonists came along, achieving mainstream popularity over the past few years. What makes these drugs different is how effectively they suppress hunger signals and control the activity of the stomach and digestive system. Semaglutide (sold under the brand names Ozempic and Wegovy) is part of this group, while tirzepatide (brand names: Mounjaro and Zepbound) targets both GLP-1 and another hormone, GIP. Both are more effective than any previous weight loss drugs. Studies show that people taking semaglutide can lose around 15% of their body weight, and people taking tirzepatide can lose more than 20%.

With strong scientific studies supporting how well they worked, Foster says adding them to WeightWatcher’s options just made sense. “We are combining the best of biology with the best of behavior change,” he says. “It’s a false dichotomy to say it’s either behavior or medications. Medications will drive weight loss, but behavior change has never been more important because no medication will teach you how to eat healthier, make sure you’re getting enough protein, and ensure you have enough muscle mass through strength training.”

Inside WeightWatchers’ new GLP-1 program

The new GLP-1 support program, which will be included in the company’s $23 monthly membership, is for people who want to address the physical and psychological changes that come with taking these drugs.

Donna Deutsch, a longtime WeightWatchers member, decided she wanted to try one of the newly approved drugs for weight loss earlier this year. Most were approved for treating diabetes at the time, but could be prescribed off label to help with weight loss. She didn’t feel comfortable asking her primary care physician about them—thinking “I would be automatically denied if I asked her about these drugs,” she says—so she turned to the telehealth company, Sequence, after seeing a commercial about its services. After a virtual consultation in which the doctor discussed her weight and medical history, the physician prescribed tirzepatide (Mounjaro).

Deutsch understood that the prescription was off label, and because she does not have diabetes, she had to pay for the injections out of pocket.

Still, she says it was worth it. She quickly started losing weight because she no longer felt hungry. “The food noise disappeared: the noise coming from my kitchen, telling me to come back and eat chocolate or ice cream,” she says. She’s been taking Mounjaro for nearly a year and no longer snacks throughout the day. Within a few months, she had lost 30 to 35 pounds.

Around that time, Deutsch was invited to participate in a pilot program WeightWatchers was launching for members who were taking one of the newer weight loss medications—what is now the GLP-1 program. Deutsch joined, eager to better understand how her body was responding to the medication, and wanting to sustain the early success she was having. The supportive community she had previously found in WeightWatchers, along with resources like recipes and access to a dietitian, were a huge help. “It became a lot easier,” she says, to grocery shop and know what to cook to meet the specific nutritional needs she has while taking the medication, such as getting enough protein and drinking plenty of water.

Her current diet is much different from the one she used to adhere to when doing WeightWatchers before Mounjaro. That’s because her dietary needs are, too. “I’m learning about different sources of protein and combinations of foods I can incorporate into my daily diet,” she says. “I was not a big egg-eater, but now I do a lot of egg salads and deviled eggs, and I always have hard boiled eggs in the refrigerator. And my big craving now is for blueberries.”

WeightWatchers’ new clinic

Members can now get the drugs directly from the WeightWatchers telehealth clinic: a reworked version of Sequence’s telehealth services. Those who are interested in prescriptions for Wegovy, Zepbound, or other weight loss medications can take an intake survey and then discuss with a health care provider whether they qualify for one of the new drugs according to criteria set by the U.S. Food and Drug Administration: namely, that they have a BMI over 30 or a BMI of 27 or above plus at least one obesity-related condition, such as high blood pressure or elevated cholesterol. Members can upload parts of their electronic health records to help providers determine if they could benefit from taking a weight loss drug, and if so, which one. Members also must upload pictures of themselves, with identification, to validate their weight and identity to ensure that they are getting the appropriate drug.

Clinic users will also benefit from another perk: WeightWatchers will help them obtain any pre-authorization clearance required by their insurers if the drug is covered by their plan or by their employer. Playing an active role in advocating for reimbursement is important, says WeightWatchers CEO Sistani. “If employers and insurers start covering these drugs, that will be an opportunity to really shift global health outcomes,” she says.

Because Wegovy and Zepbound can cause thyroid issues and digestion problems, members receiving these drugs through the clinic will also get monthly check ins with their clinic health care provider to monitor their weight loss and any side effects. Dr. Spencer Nadolsky, medical director at WeightWatchers, says half of the doctors staffing the clinic are board certified in obesity medicine, and all of them need to complete a training program to ensure they are up to date on using the newer weight loss medications.

Not everyone who wants the new drugs will necessarily be right for them, or, even if they qualify, be able to get access to them. That’s especially true of Wegovy, which is in short supply after its manufacturer, Novo Nordisk, decided to limit starter doses to ensure that anyone who starts taking the drug can continue to get it. That’s why some members using the clinic can also get older weight loss drugs at no cost if their clinic doctors believes these medications can help until supply increases.

Deutsch is currently taking the highest dose of Mounjaro and hopes to eventually move to maintenance treatment, which could mean tapering down the dose or even stopping the injections. “I’m hoping I will continue to be successful in keeping weight off once I’m off Mounjaro,” she says. “But if not, I know I still have WeightWatchers, and I can still go back to following the system that made WeightWatchers so successful. I know I won’t be alone.”

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