Effect of JumpstartMD, a Commercial Low-Calorie Low-Carbohydrate Physician-Supervised Weight Loss Program, on 22,407 Adults

Background. Commercial weight loss programs provide valuable consumer options for those desiring support. Several commercial programs are reported to produce ≥3-fold greater weight loss than self-directed dieting. The effectiveness of JumpstartMD, a commercial pay-as-you-go program that emphasizes a low-to-very-low-carbohydrate real-food diet and optional pharmacologic treatment without prepackaged meals or meal replacement, has not previously been described. Methods. Completer and last observation carried forward (LOCF) of clinic-measured weight loss (kg) in 18,769 female and 3638 male JumpstartMD participants. Results. Completers lost (mean？±？SE) 8.7？±？0.04？kg, 9.5？±？0.04% with 44.5？±？0.5% achieving ≥10% weight loss at 3 months (mo, N？=？14,999 completers); 11.8？±？0.1？kg, 12.6？±？0.1% with 66.4？±？0.6% achieving ≥10% weight loss at 6？mo (N？=？11,805); and 11.5？±？0.2？kg, 12.0？±？0.2% with 57.6？±？0.9% achieving ≥10% weight loss at 12？mo (N？=？8514). LOCF estimates were ？6.5？±？0.03？kg, ？7.2？±？0.03% with 27.1？±？0.3% achieving ≥10% weight loss at 3？mo; ？7.7？±？0.04？kg, ？8.5？±？0.04% with 36.3？±？0.3% achieving ≥10% weight loss at 6？mo; and ？7.7？±？0.1？kg, ？8.4？±？0.1% with 34.6？±？0.3% achieving ≥10% weight loss after 12？mo. Frequent health coach meetings was a major determinant of weight loss, with women and men attending ≥75% of their weekly appointments losing 8.8？±？0.04 and 11.9？±？0.1？kg, respectively, after 3？mo, 13.1？±？0.1 and 16.5？±？0.3？kg after 6？mo, and 16.5？±？0.3 and 19.4？±？0.8？kg after 12？mo. Phentermine and phendimetrazine had a minor effect in women only at 1 (6.1% greater weight loss than untreated), 2 (4.1%), and 3？mo (1.2%), but treated patients showed longer enrollment than nontreated during the first 3 (females: +0.4？±？0.01; males: +0.3？±？0.04？mo), 6 (females: +1.1？±？0.04; males: +1.0？±？0.1？mo), and 12？mo (females: +2.7？±？0.1; males: +2.4？±？0.2？mo). JumpstartMD produced generally greater weight loss than published reports for other real-food and prepackaged-meal commercial programs and somewhat greater or comparable losses to meal replacement diets. Conclusion. A one-on-one medically supervised program that emphasized real low-carbohydrate foods produced effective weight loss, particularly in those attending ≥75% of their weekly appointments