The Science behind the PointsPlus™ Program

The Weight Watchers approach delivers a science-based, lifestyle modification program based on 4 pillars— diet, physical activity, positive thinking skills and a community of support.
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The PointsPlus program does not waiver from this foundation, but rather incorporates advances in science and nutrition as it relates to weight management. It has been tested in a rigorous, independent clinical trial, and the results demonstrate it delivers significant weight loss as well as improvements in cardiovascular risk factors and eating behaviours linked with long-term weight loss and hedonistic hunger (an urge to eat when the body does not have a biologic need to). 1,2

Key Features in the PointsPlus Program
While the PointsPlus program continues to build on the heritage of Weight Watchers, this fresh approach has led to three distinct features: 1) a different method of calculating the values by which the counting system works (i.e., PointsPlus values), 2) the identification of Power Foods, and 3) assigning fruits and most vegetables a PointsPlus of 0.

The PointsPlus Formula
The PointsPlus formula uses the grams of total fat, carbohydrate, dietary fibre and protein to calculate the assigned PointsPlus value. While creating a caloric deficit is at the core of weight loss, the formula accounts for the fact that the body uses calories differently, depending on a food’s nutrient composition.

To gain a greater understanding of how the PointsPlus formula works, it’s important to understand the difference between food calories and human calories. Nutrition information on a food package in the grocery store provides the number of calories in that food which is based on the Atwater system developed in the late 1800s. The calories on a nutrition label do not reflect the processing the body must do to convert those food calories into calories the body can use. This conversion process takes some work and the amount of work depends on the nutrients involved. Protein and fibre have the highest conversion costs. Fat has the lowest conversion cost, while non-fibre containing carbohydrates require a bit more work. 3,4 The conversion cost of each of these nutrients is factored into the PointsPlus value of a food and the daily PointsPlus Target reflects the calories your body has available for use as opposed to simply the calories available from the food itself. While the calorie-providing nutrients vary in their conversion cost, it has also been recently discovered that they are also quite different in providing feelings of fullness (or satiety). And, interestingly, the progression of nutrients for conversion cost and the progression of nutrients for satiety are the same. Research has shown that protein is more filling than carbohydrate and carbohydrate is a bit more filling than fat. 5,6,7 Fibre calories are not only limited in their availability to the body, they are also linked with feelings of increased fullness.8 As a result, the PointsPlus formula guides food choices beyond reducing overall calorie intake to enhance feelings of satiety.

Weight Watchers Power Foods
The Power Foods provide a way to easily and quickly pick the food choices that are most nutritious as well as most satisfying when working to lose weight. They are a list of diverse foods that are highlighted due to their low energy density and healthfulness (taking into consideration the total fat, saturated fat, sugar, sodium and/or fibre content). Power Foods were created by assigning a food to a category of similar foods (e.g., beef products, fish and shellfish, cooked cereal, pasta, yogurt, etc). The foods within each category were ranked using a proprietary formula tailored to the category. The foods that rose to the top of the list—meaning they had a lower energy density, less fat , saturated fat, sugar, sodium, and/or higher in fibre – were identified to be Power Foods. There is strong clinical evidence to demonstrate that a low energy density, nutritious diet is important to weight management as well as good health because of the nutrients they contain as well as their ability to increase satiety.9,10 The Power Foods provide an easy way to incorporate this scientific research into day-to-day food choices. These food selections also provide a means to implement the recommendations put forth in the 2010 Dietary Guidelines for Americans in an uncomplicated way.11

0 PointsPlus Fruits and Vegetables
In the PointsPlus program, all fruits and most vegetables have a PointsPlus value of 0. This feature promotes the intake of these foods as research shows that most individuals fall significantly short on including the recommended intake into their diet.12 At the same time, it is well established that these foods are critical to ensuring good health and are filling, satisfying choices. To ensure weight loss, the daily Target has been adjusted to account for the calories coming from fruits and vegetables. A randomized clinical trial was also done where individuals followed the program with this feature and the researchers found that it did not hinder weight loss.

The PointsPlus Program Works
Development of a weight-loss system based on scientific concepts and theories doesn’t prove that it will work in the real world. Knowing this, Weight Watchers has extensively tested the PointsPlus program. Participants have included current Weight Watchers followers, past Weight Watchers participants, and those who have never followed Weight Watchers. In addition, a 12-week, prospective, randomized clinical trial was performed by an independent research group at a large medical university. Some results of this trial have been published in the scientific literature.1,2,3,4 Further manuscripts are under development and review.

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1 Milsom V, Malcolm R, Cronan G, Pechon S, Miller-Kovach K, Rost S, O’Neil PM. Changes in cardiovascular risk factors with participation in a 12-week weight loss trial using a commercial format. Obesity Reviews 2010; 11(Suppl 1):S244.

2 O’Neil PM, Boeka A, Cronan G, Miller-Kovach K. Changes in weight-related behaviors and hedonic hunger with participation in a 12-week weight-loss trial using a commercial format. Annals of Behavioral Medicine 2010; 39(Suppl): S211.

3 Tappy L. Thermic effect of food and sympathetic nervous system activity in humans. Reprod Nutr Dev. 1996; 36(4):391-7.

4 Jéquier E. Pathways to obesity. Int J Obes Relat Metab Disord. 2002 Sep; 26 Suppl 2:S12-7.

5 Weigle DS, Breen PA. A high-protein diet induces sustained reduction in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. Am J Clin Nutr. 2005; 82:41-48.

6 Potier M, Darcel N, Tomé D. Protein, amino acids and the control of food intake. Curr Opin Clin Nutr Metab Care. 2009 Jan; 12(1):54-8.

7 Moran LJ, Luscombe-Marsh ND, Noakes M, Wittert GA, Keogh JB, Clifton PM. The satiating effect of dietary protein is unrelated to postprandial ghrelin secretion. J Clin Endocrinol Metab. 2005 Sep; 90(9):5205-11.

8 Slavin, JL. Dietary fiber and body weight. Nutrition. 2005 Mar; 21(3):411-8. Review.

9 Ledikwe JH, Rolls BJ, Smiciklas-Wright H, Mitchell DC, Ard JD, Champagne c, Karanja N, Lin PH, Stevens VJ, Appel LJ. Reductions in dietary energy density are associated with weight loss in overweight and obese participants in the PREMIER trial. Am J Clin Nutr 2007; 85:1212-1221.

10 Flood A, Mitchell N, Jaeb M, Finch EA, Laqua PS, Welsh EM, Hotop A, Langer SL, Levy RL, Jeffery RW. Energy density and weight change in a long-term weight-loss trial. Int J Behav Nutr Phys Act. 2009 Aug 14; 6:57.

11 Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010.

12 State-specific trends in fruit and vegetable consumption among adults --- United States, 2000-2009. MMWR Morb Mortal Wkly Rep. 2010 Sep 10; 59(35):1125-30.

13 O’Neil P, Cronan G, Turner T, Nance L, Malcolm R, Pechon S, Rost S, Miller-Kovach K. Changes in Dietary Energy Density With Participation in a 12-Week Weight Loss Trial Using a Commercial Format. Obesity 2010; 18(Suppl 2):S96.

14 O’Neil P, Cronan G, Turner T, Nance L, Malcolm R, Pechon S, Rost S, Miller-Kovach K. Nutritional Correlates of Energy Density Before and During a 12-Week Weight Loss Trial. Obesity 2010; 18(Suppl 2):S96.