Weight loss—or health?
While we tend to connect weight with health (or lack thereof), new science is questioning whether that connection is valid, and whether weight loss is always necessary. “The prevalence of obesity around the world has tripled over the past 40 years, and, along with that rise, dieting and attempts to lose weight also have soared,” notes Maggie McNamara, Marketing Director, Gencor. “But according to a review article published September 20 in the journal iScience, when it comes to getting healthy and reducing mortality risk, increasing physical activity and improving fitness appear to be superior to weight loss. Employing a weight-neutral approach to the treatment of obesity-related health conditions also reduces the health risks associated with yo-yo dieting. In a weight-obsessed culture, it may be challenging for programs that are not focused on weight loss to gain traction, but the future of weight management is moving towards activity and exercise and effective supplementation with ingredients that make a difference. Weight management, after all, involves adopting a healthy lifestyle that includes a knowledge of nutrition and exercise, a positive attitude, and the right kind of motivation. Internal motives such as better health, increased energy, self-esteem, and personal control increase the chances of lifelong weight management success.”
Given that, approaches to weight management that are much more holistic are showing increased success, McNamara says. “The approach of healthy living versus weight loss shouldn’t be the primary criterion for judging the success of a lifestyle intervention program; this is especially important when you consider the physiological realities of obesity. Siddhartha Angadi of the School of Education and Human Development at the
University of Virginia states that ‘Body weight is a highly heritable trait, and weight loss is associated with substantial metabolic alterations that ultimately thwart weight loss maintenance.’”
The most common response to this might be that obesity is associated with multiple health conditions—but McNamara suggests that trying to lose weight not only might not be the best answer, but might result in further health complications: “Weight cycling, commonly called yo-yo dieting, is also associated with health problems, including muscle loss, fatty liver disease, and diabetes. So by focusing on fitness rather than weight loss, people can gain the benefits of exercise while avoiding the risks associated with weight cycling.”
What’s more, the premise of thin = healthier may be flawed. In a 2020 review considering the evidence for adopting weight-inclusive health policy, writers note that the association between an elevated BMI and health risk comes from studies that couldn’t prove causation, and state that concluding from this evidence that higher body weight equals poorer health is falling prey to the ‘correlation equals causation’ fallacy. The authors continue: “To ascribe a causal role of body weight in poor health ignores the likely possibility of third variables or reverse causation” (1). The authors point to behavior as “an obvious third variable,” and reference a study in the New England Journal of Medicine wherein higher body weight participants underwent large-volume liposuction, losing 28-44% of their fat tissue, but saw no improvements in insulin resistance, inflammatory markers, or coronary heart disease risk factors 12 weeks post-operation. This suggests that weight itself may not be the cause of these health struggles. The authors add that, even where the relationship between weight and health is causative, it may be in the opposite direction: “For example, metabolic dysfunction such as insulin resistance may be the true driver of poor health, with higher body weight merely a side effect that gets the blame… Similarly, sedentary behavior (a behavior distinct from physical activity; Ekelund et al., 2016) could be driving both poor health and higher weight. Indeed, at all levels of BMI, sedentary behavior is linked prospectively with mortality. Including sedentariness in the model erases the effect of BMI on mortality.”
This suggests that while fat burners may be the most obvious product for consumers to look for—and may be useful to many—there is an opportunity here to educate your customers on the factors that lead to weight fluctuation, and an opportunity to promote supplements that address those factors, and provide support as customers work towards a healthier lifestyle. “Companies in the weight management market are increasing their production capabilities in gummies that uplift a consumer’s mood and boost their metabolism for faster weight loss,” McNamara shares. “Manufacturers in the weight management market that are including vitamins, botanicals, and other ingredients that not only support weight loss but also improve digestion, help with inflammation, and provide an energy boost will be very successful.”
Manufacturers that acknowledge that there are multiple causes of weight gain or difficulty managing weight may have a better shot at market share. “Science is just now unveiling physiological differences and individual variations in how people process energy in the form of calories, control their appetites, or metabolize fats,” notes Trisha Sugarek MacDonald, BS, MS, Sr. Director of R&D, Bluebonnet Nutrition. “Since everybody is different, science has proven that the one-size-fits-all, single magic bullet approach to losing weight does not work. All too often, people embark on a particular diet or are drawn by marketing hype to a special diet product that never addresses the specific reasons they gain weight.” Those reasons can include more calories consumed than burned, a metabolism slowed by age, an inability to break down stored fat, stress, and more.
All of this goes double for the coming year. “We have been talking about the next year as one of the biggest ‘weight-loss seasons’ ever,” shares Steve Fink, VP Marketing, PLT Health Solutions. “If you think about it—the end of year holidays last 6 weeks. People have been indoors for a year and a half. As far as what we need to consider, an emphasis on healthier eating and exercise is always going to be the foundation of achieving and maintaining a healthy weight. But there is an ‘all hands-on deck’ need in our society and supplements can play a vital role. There don’t appear to be any panaceas in weight management, but there are many things we can do to ‘get better every day.’”
The Body Mass Index (BMI) is used to categorize weight, sorting individuals into “underweight,” “normal weight,” “overweight,” and “obese.” Theoretically, where a person falls is indicative of their body fat and health—but there are problems with this.
Aubrey Gordon, writing for Elemental, reports that Adolphe Quetelet (1796-1874) the mathematician and statistician who pioneered what is now known as the BMI, “was best known for his sociological work aimed at identifying the characteristics of l’homme moyen—the average man—whom, to Quetelet, represented a social ideal… Quetelet believed that the mathematical mean of a population was its ideal, and his desire to prove it resulted in the invention of the BMI, a way of quantifying l’homme moyen’s weight. Quetelet derived the formula based solely on the size and measurements of French and Scottish participants” (2).
Explaining why this formulation is problematic, Alissa Rumsey, R.D., notes that Quetelet was not a doctor looking at health outcomes, but a statistician looking at averages—and not global averages: His data did not come from a representative sample of the general population, and does not account for differences in body sizes in other ethnic groups; and BMI doesn’t take into account age, sex, body frame, body composition, fat distribution, or how muscle mass changes with age (3). Looking at how BMI is used now, Rumsey writes: “The differences between BMI classifications are largely arbitrary…For example: a few decades ago, the ‘normal’ weight BMI cutoff was lowered in response to a report funded by pharmaceutical companies that make weight-loss drugs. Overnight, millions of people went to bed a ‘normal’ weight and woke up ‘overweight.’” All this, in spite of the fact that a review study looking at mortality considered 97 studies covering 2.88 million people and found that being overweight “was associated with significantly lower all-cause mortality” compared to being a normal weight, and that even “Grade 1 obesity overall was not associated with higher mortality” (4). A 2016 study using NHANES data further found that 29% of obese individuals were metabolically healthy, while over 30% of normal weight individuals were metabolically unhealthy—meaning that, when using BMI, an estimated 74,936,678 U.S. adults are misclassified as cardiometabolically healthy or unhealthy (5).
Plus, because the “ideal man” that Quetelet studied was Western European men, all other people are being held to an impossible standard. For instance, BMI overestimates obesity in African-Americans, according to a 2009 study presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C. “Compared to Caucasians, African-Americans of the same age, gender, waist circumference, weight and height may have lower total and abdominal fat mass,” said principal investigator Samuel Dagogo-Jack, M.D., Professor of Medicine and Chief, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center.
The final word on this from Gordon: “Science has repeatedly demonstrated that a measure built by and for white people is even less accurate for people of color—and may even lead to misdiagnosis and mistreatment…And it papers over significant sex-based differences in the relationship between body fat and the BMI. That is, because so much of the research behind the BMI was conducted on those assigned male at birth, those assigned female may be at greater health risk if their diagnosis hinges on a measurement that was never designed for them.”
There’s plenty in this category to help people looking to manage their weight or drop some holiday pounds. Our experts pinpointed innovations that can address both weight and health. One major upcoming trend in this area, according to Sugarek MacDonald: “The newest and hottest products in this category are going to include those with apple cider vinegar. For instance, a clinical trial completed in Japan investigated the effects of vinegar intake on reducing body fat mass in obese Japanese men and women in a double-blind trial. The vinegar used in this trial contained 4-8% acetic acid, the same concentration found in Bluebonnet’s Apple Cider Vinegar Vegetable Capsules. During the 12-week treatment period, the subjects in each group ingested 500 ml daily of a beverage containing either 15 ml of vinegar (750 mg AcOH), 30 ml of vinegar (1,500 mg AcOH), or 0 ml of vinegar (0 mg AcOH, placebo). Bodyweight, visceral fat area, waist circumference, and serum triglyceride levels were significantly lower in both vinegar intake groups than placebo. The authors concluded that daily intake of vinegar might be useful in preventing metabolic syndrome by reducing obesity. While the research is limited, customers are flocking to websites and the stores for the latest and greatest.”
Another approach: Microbiome modulators. “Offering a much more natural approach to weight management, prebiotic and dietary fiber blends, probiotics and postbiotics are all solutions that can help consumers maintain a healthy weight,” explains Steven Riley, Director of Marketing and Consumer Sales at OptiBiotix Health Plc. “Prebiotic dietary fibers in combination with a trace mineral like chromium, for instance, have been proven to reduce body weight, while aiding sustainable weight loss. Our multi-award-winning SlimBiome has demonstrated this in its latest scientific study conducted by the University of Roehampton. When SlimBiome was taken for just four weeks, it led to significantly reduced body weight by an average of 1.9kg, body fat percentage, waist and hip circumference, and systolic blood pressure. In addition, participants showed a reduction in sweet cravings, a statistically significant reduction in savory cravings, and statistically significant positive impact on mood and gut microbiome composition.”
Muhammed Majeed, Ph.D., Chairman and Founder, Sabinsa, notes three new ingredients Sabinsa is offering in this category. “Cirpusins nutgrass root—Cyperus rotundus—supports a healthy body mass index. It is well-known in Ayurveda for various health benefits, ranging from antimicrobial, anti-convulsant, anti-platelet activity, analgesic, and anti-ulcer, but the activity that caught our interest is anti-obesity. The second ingredient, CurCousin, Sabinsa’s branded ingredient containing Calebin A, is a curcumin analog naturally present in Curcuma longa and Curcuma caesia. It helps balance cholesterol and support healthy blood sugar levels and circulation. It also supports a healthy body weight by inhibiting adipogenesis, fat cells. The third product, Nigellin, is a product enriched with thymoquinone and thymohydroquinone, isolated from the seeds of Nigella sativa, commonly known as black cumin seed. Nigellin is formulated to enhance the many therapeutic benefits of black cumin seeds. Modern clinical trials have sufficient evidence to show that Black Seed or its extracts, essential oil, or major components can lower blood pressure, relieve oxidative stress, lower fasting and postprandial glucose in diabetics, improve mitochondrial function, and more. Nigellin was awarded a U.S. patent for its use in decreasing blood glucose levels by inhibiting the enzyme involved in carbohydrate digestion and absorption, and increasing glucose uptake by the cells, indicating a potential use in managing diabetes and related conditions.”
Combo products, too, are an area of burgeoning innovation. “Another trend we are seeing is the inclusion of weight management ingredients in new categories of health-supporting products,” says Fink. “This is particularly the case in active/sports nutrition where today, most major pre-workout or daily use products feature a weight management component. We don’t see why weight management can’t team up with other condition-specific products—like joint health or cardio health—moving into the future.”
That holistic viewpoint is being taken up in other areas, as well—Riley points to some behavioral health measures: “A major weight loss brand, for instance, has recently launched its new platform application that helps its customers manage stress and anxiety. Personalized health is still an upcoming area, but it is one that the weight management industry is beginning to reap the benefits from.”
Seconding that, Fink adds: “One trend that we see with leading weight management companies is a focus on the ‘whole person’ and not just the ‘dieter’ in developing weight management products and weight management regimens. We call this ‘smart weight management’—that, first, recommends diet and exercise as an integral part of weight management and then addresses a range of concerns for the target demographic.”
One example of the wide-open space that is personalization: senior citizens. “There is a good deal of evidence that seniors can use help in managing their weight,” Fink says. “The concerns of this population are specific, though, so it is important to keep the end-user in mind when formulating products. Are there certain nutrients that a specific demographic might need? Those nutrients might be important to include in a weight management supplement. For example, when developing a weight management product for seniors, it is important to consider issues like maintaining muscle mass and blood sugar management. And yet, if one were to Google ‘senior’ and ‘weight management’—most of the products that will come up are designed for dogs. Across every demographic, there are opportunities to be ‘smart’ about formulating weight management products that target the needs of the ‘whole person’ and not just the ‘dieter.’”
Other innovation is coming from delivery format. “Energy drops, protein shake powders that relieve stress, and weight-loss drinks are increasingly replacing sugar-sweetened beverages and fruit juices,” says Gencor’s McNamara. “Functional Foods have taken over and this is where weight management manufacturers have an opportunity. Manufacturers in the weight management market are boosting their output capacities in cumin tea and protein shake powders that help to keep the stomach feeling satisfied. Fat burner and energy drops for women can help to relieve stress, promote weight loss, and naturally suppress appetite. Herbal formulas in powerful blends of African mango, maca, and rhodiola are gaining prominence in energy drop products.”
And fat burners themselves are a draw. One option: Diem Direct offers Omne Diem, which combines the company’s exclusive Adiposano complex with aXivite phenylcapsaicin. aXivite has been shown to help burn fat and control appetite, while Adiposano has been found to modulate pro-inflammatory compounds, thereby promoting joint comfort and metabolic health, according to the company.
Your Edge Over Amazon
“It’s smart for retailers to make sure that the products they stock and recommend to their customers be clinically validated as well as delivering the desired benefits,” said Dr. Majeed, “and contain the amounts of the ingredients that research shows delivers those benefits.”
While most independent retailers already do this, it’s getting easier to use it to your advantage. While Amazon is upping its standards, the platform still has on offer a variety of products that no self-respecting retailer would ever sell. For instance, NOW Foods has tested products on Amazon, looking at specific ingredients and testing whether or not they meet label claims and heavy metal specifications. The latest results were posted in October, looking at Glutathione. Out of 19 brands, two tested high for heavy metals, three didn’t meet label claim, and one didn’t even have a label claim—and the amount of glutathione it did contain was 19-22mg, as found by NOW and Eurofins respectively, compared to the 500mg contained in NOW’s product. Commenting on the findings, Dan Richard, NOW’s VP of Global Sales and Marketing, stated: “The quality of these lesser-known brands purchased on Amazon is greatly improved, but we are still finding unacceptable lapses.” NOW has tested several other ingredients, as well, and previous tests have produced worse results. All of this suggests that while you may have a smaller selection than Amazon, or even may not carry a customer’s preferred brand, what you do have—and can sell—is a quality control process that prevents those unacceptable lapses.
Plus, vetting products—and making it clear to your customers that you do—can help you make up for what you may not have: online reviews. “Online reviews and recommendations are either making or breaking a company’s brand image on popular eCommerce websites including Amazon,” shares McNamara. If you can guarantee to your customers that your products are all high-quality and scientifically backed, you knock out most of the need for online reviews. Quality is one of the best tools in your anti-Amazon toolbox. WF
- Jeffrey M. Hunger, Joslyn P. Smith, A. Janet Tomiyama, “An Evidence-Based Rationale for Adopting Weight-Inclusive Health Policy,” Social Issues and Policy Review. 14(1). 73-107(2020). DOI: 10.1111/sipr.12062 https://jeffreyhunger.com/uploads/3/4/4/8/34481134/hunger_smith___tomiyama__2020__-_sipr.pdf
- Your Fat Friend, “The Bizarre and Racist History of the BMI,” Elemental. Posted 10/15/2019. Accessed 11/01/2021. https://elemental.medium.com/the-bizarre-and-racist-history-of-the-bmi-7d8dc2aa33bb
- Alissa Rumsey, “5 Reasons Why BMI is Totally Bonkers,” AllissaRumsey.com. Posted 12/07/2020. Accessed 11/01/2021. https://alissarumsey.com/the-problem-with-the-bmi/
- Katherine M. Flegal et al, “Association of All-Cause Mortality with Overweight and Obesity Using Standard Body Mass Index Categories.” JAMA. 309(1). 71-82(2013). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/
- A.J. Tomiyama et al., “Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005-2012,” International Journal of Obesity. 40(5). 883-6(2016). https://pubmed.ncbi.nlm.nih.gov/26841729/
- The Endocrine Society, “Widely Used Body Fat Measurements Overestimate Fatness in African-Americans, Study Finds,” ScienceDaily press release. Posted 6/22/2009. Accessed 11/01/2021. https://www.sciencedaily.com/releases/2009/06/090611142407.htm