The following story appeared yesterday in both the Charlotte Observer and The News & Observer. The basic reporting was done by The New York Times; I provided the local comments. Yesterday, I ran more of those local comments in this space. The story below appears in expanded form, with links.

When Linda Helms first tried Weight Watchers four years ago, she lost weight using the venerable weight-loss program’s popular points system, but she didn’t feel like she was eating healthy.
“Sugar-free cookies, Fig Newtons, Snackwells, those used to be my snacks,” says the Mount Ulla resident. “It’s not really a bad thing,” she says of the low-calorie but processed foods, “but they’re not as healthy. Done before, you didn’t touch a banana. It was a lot of points.”
But when Weight Watchers revisited its approach last year, then tweaked it in December, Helms and her husband, Rex, were ready to recommit.
“The best part for both of us is having fruit,” says Helms, which Weight Watchers now tells the devout they can have as much of as they like. “Fruit is a far more sensible snack, and under the old points system it was almost out of the question.”
Diane L. Robrahn of Cary, who dropped out of Weight Watchers in the 1980s, agrees. “In the 80s, you had the choice between a cookie and a banana. Well, you’d choose the cookie.
“I’m so happy about the push toward natural food,” adds Robrahn, who has lost 106 pounds since rejoining Weight Watchers less than a year ago.
Millions of people around the world belong to Weight Watchers International, ranked best commercial diet plan by U.S. News & World Report last year, and even nonmembers look to it for guidance and recommendations. The 51-year-old program is best known for its points system, which assigns specific values to different foods and permits each member a daily allotment. At its weekly group meetings, healthy eating and exercise are emphasized over rapid-fire results.
The latest iteration of the weight-loss plan, called Points Plus, is intended to steer people toward more healthy food choices, encouraging people to eat more fresh fruits by giving them zero points, as most vegetables already were.
The change, Weight Watchers’ first adjustment in 13 years, annoyed some who said they haven’t been able to lose as much weight. In December, in a move that seemed to acknowledge the difficulty some dieters were having, Weight Watchers recommended that all members consider reducing their daily food intake, or points allotment, by 10 percent, not counting fruits and vegetables. (For those who’ve missed a few meetings, that means most women might cut their daily Points Plus allotment to 26 per day, down from 29.)
Weight Watchers officials say the change in points allotments was optional – that members could adjust their daily points up or down – and insist that it was not a response to members’ failure to lose weight.
“I don’t believe the pounds come off quite as fast as before,” agrees Helms, “but not being hungry keeps us from wanting to give in to bad food temptations.”
Company officials insist that the only reason Weight Watchers modified the plan was because they had become convinced members were getting more than adequate nourishment under the new plan and would not be harmed by eating less.
“We chose to be conservative when we introduced the plan, because we wanted to make sure that the things we stand for, nutritional health and well-being, weren’t going to be compromised,” said Karen Miller-Kovach, a registered dietitian who is chief scientific officer of Weight Watchers.
Still, she said the company had been following the progress of members who use online tracking tools and had found that dieters have been gaming the new system.
“People were having to circumvent the system in order to lose weight at a healthy rate,” she said.
While weight loss is important, many say they like the new program because it continues to push them in the direction of lifelong healthy eating.
“It reframes how I use food and view food,” says Swooz Brazzell of Charlotte. “As you can tell by my slow progress” — she’s lost 25 pounds in nearly two years and expects, eventually, to lose 20 more — “this system is retraining me over time to have a healthier relationship with food.”
One aspect of the new approach that has raised a professional eyebrow or two regards fruit: Under the new plan, participants can eat as much as they like.
“No single dietitian I know would count fruit as a ‘free’ food if someone is on a diet and trying to lose weight. You have to account for it,” said Marjorie Nolan, a New York City dietitian who speaks on behalf of the Academy of Nutrition and Dietetics.
She expressed surprise that even bananas (which used to cost two points under the previous Weight Watchers plan) are zero points.
“That just doesn’t make sense,” she said. “They’re a denser fruit.”
But Dr. Jeffrey Mechanick, vice president of the American Association of Clinical Endocrinologists, said there was no evidence that indulging in fruit impedes weight loss.
The reason fruit and most vegetables are zero points is that the formula actually “prepays” those points, Miller-Kovach said; the daily points allocation includes an allowance for what the plan has determined is a typical daily consumption of fruits and vegetables. Miller-Kovach said she could not divulge the number of fruits and vegetables used in the calculation because the information is proprietary and not revealed even to participants.
But since average consumption of fruit is low in this country, usually not reaching the five to nine servings a day recommended by government health experts, the prepayment may underestimate the effect of more liberal fruit consumption on waistlines.
Joanne Latham of Cary is on her third try with Weight Watchers. On her first two go-rounds, “We ate a ton of pretzels and a lot of frozen meals.” Low on points, low on nutrition as well. Now, she packs four to five servings of fruit in the morning and snacks on it throughout the workday.
“It keeps you from doing the vending machine thing,” says the 51-year-old Latham, who has lost 50 pounds since joining Weight Watchers May 20.
“I’m in the best shape of my life.”
Results of randomized clinical trials of the new Points Plus program have not been published in peer-reviewed journals. But two brief reports have been presented at scientific meetings on obesity, and the authors found no difference in weight loss between the old and new points plans.
In one of those studies, participants lost an average of 8.2 pounds over 12 weeks and saw significant improvements in their total cholesterol and triglyceride measures. But only 111 overweight adults completed the 12-week trial, and only 55 people were following the new Points Plus program.
Weight Watchers officials said the number of participants was sufficient to provide statistical proof that the new diet system works.
The new Points Plus plan also was evaluated in an earlier unpublished trial, Miller-Kovach said. And Weight Watchers has been following more than 12,000 members in Germany since the introduction of the new Points Plus program there. So far no differences in weight loss have been found between users of the new and old programs, she said.
Sherry Casey joined Weight Watchers the same day as Latham and has lost 35 pounds (their Weight Watchers chapter at work, Allscripts in Raleigh, has lost a cumulative 1,500 pounds between 55 participants). For her, the healthier diet promoted by the new system has had a more profound impact than weight loss.
“My family has a history of heart disease, and I had high blood pressure and cholesterol,” says Casey, of Cary. Now, she says, those numbers are in check.
“My grandmother died at 56,” Casey said. “I’m 51. I felt that’s just too young to die.”