Weight Management

What's Best Weight Loss Program: Comparing Diet, Medications, And Surgeries

Brianne Smith, DNP, PhD
Brianne Smith, DNP, PhD22 May 2024
Reviewed and Fact Checked ✔️
Dollar for the Pound: Ranking Best Weight Loss Programs by Results, Cost, ROI, and Weight Regain

We studied 14 different treatments and programs for weight loss and here is what we found:

There Are Three Main Approaches to Weight Loss

Diet-Based Programs

These programs, like Weight Watchers and Nutrisystem, emphasize calorie restriction and balanced nutrition to create a caloric deficit while maintaining nutrient intake. By controlling portions and food choices, they seek to reset eating habits and help participants steadily lose weight.

  • Pros: They offer structured, guided plans that simplify meal planning for a wide range of preferences and lifestyles.
  • Cons: Can feel restrictive and monotonous over time, potentially leading to diet fatigue or burnout.


Pharmaceuticals like Orlistat or Semaglutide work by targeting hunger signals or inhibiting fat absorption to reduce caloric intake or cravings. Their impact directly alters the biological processes driving appetite or nutrient processing.

  • Pros: Often show faster, significant results, especially beneficial for those with obesity-related health conditions.
  • Cons: Potential side effects can limit long-term adherence, and some require a prescription, making them less accessible without medical supervision.


Procedures like gastric bypass, sleeve gastrectomy, and adjustable gastric banding alter the digestive system to limit food intake or reduce nutrient absorption. These irreversible changes fundamentally change the body's physiological response to food.

  • Pros: Proven to deliver significant, sustained weight loss, especially effective for severe obesity cases.
    Cons: High cost, surgical risks, and potential long-term lifestyle changes can be daunting and demand comprehensive pre- and post-operative support.

When it comes to weight loss, it's less about your age, it is more about your current BMI and current health status. 

Ranking Weight Loss Program By Results

Weight loss approaches vary greatly in effectiveness, ranging from diet-based programs like Weight Watchers (-5.1 kg) to surgeries like gastric bypass (-28.6%). Surprisingly, some medications like Tirzepatide (-20.9%) deliver results rivaling surgical procedures, blurring the line between non-invasive and surgical effectiveness.

For someone starting at 200 lbs, surgeries deliver the most drastic results, with BPD/DS leading to an estimated 66.6 lb loss in 2 years, followed by gastric bypass with a 57.2 lb loss over 5 years. Medication-based options like Tirzepatide and Semaglutide offer significant reductions at 41.8 lbs and 29.8 lbs, respectively, over a year. Among diet-based programs, Noom and Jenny Craig rank highest, with losses of 15.28 lbs and 14.6 lbs in a year.

Program/TreatmentWeight Loss ResultsStudy Name

Diet-based Programs: Somewhat effective, widely accessible

Weight Watchers-5.1 kg (12 months)Jebb et al., 2011 (n=772)
Jenny Craig-7.3 kg (12 months)Rock et al., 2010 (n=442)
Nutrisystem-7.5% (3 months)Foster et al., 2009 (n=69)
Noom-7.64% (52 weeks)Toro-Ramos et al., 2020 (n=204)

Medications: Effective but need long-term medical supervision

Orlistat-2.9 kg (12 months)Rucker et al., 2007 (n=10,631)
Phentermine-12.2 kg (36 weeks)Munro et al., 1968 (n=108)
Bupropion/Naltrexone-6.1% (56 weeks)Greenway et al., 2010 (n=1,742)
Liraglutide (Saxenda)-8.4% (56 weeks)Pi-Sunyer et al., 2015 (n=3,731)
Semaglutide (Wegovy)-14.9% (68 weeks)Wilding et al., 2021 (n=1,961)
Tirzepatide (Mounjaro)-20.9% (72 weeks, 15 mg)Jastreboff et al., 2022 (n=2,539)

Surgeries: Best but high risk and strict eligibility

Gastric Bypass-28.6% (5 years)Schauer et al., 2017 (n=134)
Sleeve Gastrectomy-21.7% (5 years)Schauer et al., 2017 (n=134)
Adjustable Gastric Band-20.7% (2 years)O'Brien et al., 2013 (n=80)
BPD/DS-33.3% (2 years)Mingrone et al., 2012 (n=60)
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Brianne Smith, DNP, PhD

Brianne Smith, DNP, PhD, is a public health researcher with a focus on improving patient outcomes through evidence-based practices and clinical research. She holds dual doctorates in Nursing Practice and Healthcare Research, and specializes in advanced patient care management and educational advocacy.

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