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04.12.12 Karen Miller-Kovach MBA, MS, RD, Chief Scientific Officer, Weight Watchers International, Inc.

When left to lose weight on their own, most people do not succeed. 433 Participants; mean age 45 years; mean BMI 34km/m 2 KM1 (kg) 1 0-1 Weight Change -2-3 -4-5 -6-7 Week = Self-help = Commercial 0 25 52 78 104 No. Self-help 212 175 170 156 159 Commercial 211 175 176 154 150 Heshka et al., 2003. JAMA, 289

Slide 2 KM1 Would probably change out for similar slide from the IMCT as it's more current Karen Miller-Kovach, 5/16/2013

Community-Based Weight Loss: How Weight Watchers Works

Intensive, multi-component, community-based weight-loss intervention supports healthy weight loss. Our 4-Way Approach Eat Smarter Move More Helpful Habits Get Support

Our goal is to surround the participant with information, tools, and support in a way that promotes engagement and drives compliance. Both attendance at meetings 1 and online usage 2 are highly predictive of weight loss results. 1 S Heshka et al. Journal of the American Medical Association 2003; 289 (14): 1792-1798. 2 L Zukley, V Nguyen, A Summers, J Brosnahan, J Lowndes, T Angelopoulos, J Rippe. Obesity 2007; 15 (Suppl 9): A221.

UK Policy NICE guidance helps health and social care professionals deliver the best possible care based on the best available evidence Self-help, commercial and community settings Primary care organisations and local authorities should recommend to patients, or consider endorsing, self-help, commercial and community weight management programmes only if they follow best practice.

The Evidence: Community-Based Programs Are Scalable and Effective in the UK

Lighten Up Trial RCT involving 6 interventions vs. leaving people to lose weight on their own (12 leisure centre vouchers) for 3 months Weight Watchers (n=100) Slimming World (n=100) Rosemary Conley (n=100) Size Down NHS (n=100) Pharmacy (n=70) GP provision (n=70) Choice (n = 70) Participants: 69.3% female Age: 49.5% ± 15.6 years 86.5% white British i or Irish BMI = 33.5 ± 5.4 Jolly K et al. BMC. 2010;10:439

Weight Loss with Comparator Interventions ti Programme end (3 mth) 1 year Mean diff. 95% CI Mean diff 95% CI Weight -2.24* -3.45, -1.03, -2.30* -4.04, -0.55 Watchers Slimming -1.41* -2.64, -0.19-0.75-2.22, 0.72 World Rosemary -2.18* -3.52, -0.84-0.96-2.63, 0.71 Conley Size Down -0.26-1.39, 0.86-1.37-2.99, 0.26 GP 0.76-0.55, 2.08 0.30-1.32, 1.91 Pharmacy -0.02-1.43, 1.38 0.45-1.11, 2.01 Choice -1.38* -2.58, -0.19-1.03-2.63, 0.61 *p<0.05 - Jolly et al British medical Journal Jolly K, Lewis A, Beach J, Denley J, Adab P, Deeks JJ, et al. Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten Up randomised controlled trial. Bmj 2011;343:d6500.

The Lancet Trial Primary objective To examine the differences in weight loss at 12 months between GP referral to a community-based weight loss program (Weight Watchers) and standard management in primary care (as informed by national guidelines) across three countries. Secondary objectives To investigate number of subjects losing 5% or 10% of baseline weight in each group. To investigate changes in a number of indicators of metabolic risk including waist circumference, body composition, blood pressure, blood glucose, lipids etc. Jebb et al. The Lancet. 2011 Oct 22;378(9801):1485-92.

Participants identified by family doctors, then assigned to treatment group Gender Standard Care Weight Watchers Total (N=395) (N=377) (N=772) Female - N (%) 338 (86) 330 (87) 668 (86.53) Male - N (%) 57 (14) 47 (12) 104 (13.47) Age years 48.2 ± 12 46.5 ± 13.5 47.39 ± 12.9 Weight - kg 86.5 ± 11 86.9 ± 12 86.7 ± 11.5 31.3 ± 2.6 31.5 ± 2.6 31.4 ± 2.6 Height - m 1.66 ± 0.08 1.66 ± 0.09 1.66 ± 0.08 % Fat mass 38.2 ± 7.4 38.6 ± 6.7 38.4 ± 7.1 Waist cm 99.9 ± 9.3 100.0 ± 9.2 99.9 ± 9.2

Percentage weight loss (completers only) Standard Care 0 44% 13% 23% 20% Weight Watchers 0 14% 32% 26% 28% - 10% -5 - -9.9% -0.1 - -4.9% Weight gain/ No loss

Weight Watchers on Referral: An observational study of weight change among adults referred to Weight Watchers by the NHS Based on data from 29,326 referrals, 58% completed a 12 week course of Weight Watchers meetings Median weight loss in completers was 5.2kg 55% of completers achieved weight loss of 5% or more, with 12% losing 10% or more of initial weight Of all courses initiated, 33% resulted in weight loss of 5% or more of baseline weight, with 7% resulting in weight loss of 10% or more Ahern AL, Olson AD, Aston LM, Jebb SA. Weight Watchers on prescription: an observational study of weight change among adults referred to Weight Watchers by the NHS. BMC Public Health 2011;11:434.

USA Policy The USPSTF recommends screening all adults for obesity. Clinicians should offer or refer patients with a body mass index (BMI) of 30 kg/m 2 or higher to intensive, multicomponent behavioral interventions. Grade: B Recommendation. Preventive Services Covered Under the Affordable Care Act Under the new rules, a Non-Grandfathered Plan must provide benefits for and prohibit the imposition of cost-sharing requirements (including co-payments, co-insurance or deductibles) with respect to items or services that have in effect a rating of A or B in the current recommendations of the United States Preventive Services Task Force (Task Force) with respect to the individual involved.

04.12.12 Karen Miller-Kovach MBA, MS, RD, Chief Scientific Officer, Weight Watchers International, Inc.