From TOPS to Telehealth: A History of Weight-Loss Programs

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History

A history of weight-loss programs from company records, SEC filings, FTC cases and major trials: TOPS (1948), Weight Watchers (1963), Nutrisystem, Jenny Craig, the FTC "results not typical" rules, the DPP, apps and telehealth GLP-1 programs.

Key takeaways

  • TOPS (Take Off Pounds Sensibly) opened in 1948 and describes itself as the first weight-loss organization of its kind.[1]
  • Jean Nidetch officially founded Weight Watchers in 1963, after weekly meetings in her Queens living room grew to 40 women.[3]
  • Jenny Craig's 1997 FTC settlement required testimonials to say "This result is not typical" unless they showed typical results.[9]
  • In the 2002 Diabetes Prevention Program, a structured lifestyle program cut new cases of diabetes by 58% compared with placebo.[11]
  • In Look AHEAD, an intensive lifestyle program led to 8.6% weight loss at one year and 6.0% at the end of the study.[16]

In short: Organized weight-loss programs began in 1948, when TOPS (Take Off Pounds Sensibly) opened as a low-cost support group. Weight Watchers grew out of Jean Nidetch’s living-room meetings in Queens and became a company in 1963; Nutrisystem (1972) and Jenny Craig (1983 in Australia, 1985 in the U.S.) added packaged meals and centers. In 1993 the Federal Trade Commission charged five of the biggest programs with unsupported weight-loss claims, which is why ads now say results are not typical. Research then caught up: the Diabetes Prevention Program (2002) showed what a structured lifestyle program can do, and Medicare began covering behavioral therapy in 2011. Apps arrived in the 2010s, and since 2023 many programs have added telehealth prescribing of GLP-1 medicines.

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This page tells that story from company records and SEC filings, FTC case documents and the major trials. It is history, not a recommendation: for today’s options, see our weight-loss programs hub, the non-prescription programs ranked by evidence and, for prescribing services, telehealth programs compared. The bigger picture of diets, drugs and surgery is in our history of weight loss.

Weight-loss programs in four dates

  • 1948TOPS opens, "the first weight loss organization of this kind," in its own wordsTOPS Club
  • 1963Jean Nidetch officially founds Weight Watchers after starting meetings in her Queens living roomWeightWatchers
  • 1993the FTC charges five of the largest commercial diet programs over unsupported claims and testimonialsBaltimore Sun, October 1, 1993 (reported)
  • 2023WeightWatchers completes its purchase of the telehealth company Sequence (April 10)WW International 10-Q, SEC

Checked on October 6, 2026

Before programs: books and calorie counting

For the first half of the 20th century, people trying to lose weight mostly did it alone, with a book. William Banting’s “Letter on Corpulence” (1863) and Lulu Hunt Peters’ calorie guide “Diet and Health” (1918) were best sellers, but there was no group, coach or follow-up. Our history of diet fads covers that era. The idea that changed weight loss after World War II was simple: people do better together, with regular check-ins.

1948: TOPS and the support group

TOPS, short for Take Off Pounds Sensibly, describes itself as “the first weight loss organization of this kind” and says it opened its doors in 1948. It is a nonprofit based in Milwaukee, Wisconsin, with weekly peer-led meetings in person and online across the U.S. and Canada, and members who reach their goal join “KOPS” (Keep Off Pounds Sensibly). TOPS is still one of the lowest-cost programs. A 2015 study in the American Journal of Preventive Medicine looked at 207,469 people who joined between 2005 and 2011: the 35.9% who renewed their membership had lost an average of 6.0% of their weight at one year, and those who renewed for seven years in a row kept off 8.3%. Because it only counted people who stayed, it shows what is possible for committed members, not what is typical for everyone who joins.

1961 to 1968: Weight Watchers and the weekly meeting

Jean Nidetch, of Queens, New York, began her own weight-loss effort with a New York City Board of Health program and started inviting friends to talk about it in her living room. According to the company’s own history, about two months later 40 women were meeting there weekly. She officially founded Weight Watchers in 1963 and took the company public five years later. Weekly group meetings with a weigh-in became the familiar model for commercial programs. In 2013, New York’s mayor declared March 25 Weight Watchers Founder Celebration Day for its 50th anniversary. Today’s program is covered on our WW (WeightWatchers) page.

1972 to 1985: packaged meals and diet centers

The next wave sold food as well as support. Nutrisystem’s SEC filings say its businesses began in 1972 and operated for years through company-owned and franchised weight-loss centers; in late 1999 it began selling directly to consumers by internet and phone, and in 2001 through the QVC shopping channel. Jenny Craig’s filings say the company began in Australia in 1983, had 69 centres there by the end of fiscal 1985, and expanded to the U.S. in February 1985 with 13 centres in the Los Angeles area, followed by six in Chicago that September. Both combined portion-controlled meals with counseling, an approach that later trials tested directly. Our pages on Nutrisystem and Jenny Craig describe them now.

1993 to 1997: the FTC and “results not typical”

By the early 1990s, commercial programs were a big business, and regulators questioned their advertising. In September 1993, as the Baltimore Sun reported on October 1, the Federal Trade Commission charged five of the largest programs, Weight Watchers, Jenny Craig, Diet Center, Physicians Weight Loss Centers and Nutri/System, with making unsubstantiated weight-loss claims and using testimonials without evidence that they reflected typical results. Three settled right away; Weight Watchers and Jenny Craig said they would fight. The FTC estimated that about six million people spent more than $2 billion a year on these programs.

Jenny Craig settled in May 1997. Under the order, testimonials had to show typical results or carry the line “This result is not typical. You may be less successful,” claims about keeping weight off had to say “For many dieters, weight loss is temporary,” long-term maintenance claims needed evidence from customers followed for at least two years, and ads had to disclose mandatory fees. Disclosures like these are now a familiar part of weight-loss advertising. The FTC kept up the pressure: its 2014 “Gut Check” guide for media lists seven claims it calls false, such as losing a lot of weight without diet or exercise. Our guide to choosing a program turns those warnings into questions.

2002 to 2015: science tests the programs

Rigorous trials changed how programs are judged. The Diabetes Prevention Program, published in the New England Journal of Medicine in 2002, randomly assigned 3,234 adults with prediabetes to placebo, metformin or a lifestyle program aimed at losing at least 7% of body weight and doing 150 minutes of activity a week. Over an average of 2.8 years, the lifestyle program cut new cases of diabetes by 58% and metformin by 31%. That program became the model for the CDC’s National Diabetes Prevention Program and, after CMS certified it for expansion in 2016, for a Medicare benefit.

Diabetes Prevention Program: new cases of diabetes per 100 person-years
Diabetes Prevention Program: new cases of diabetes per 100 person-years
ItemValue
Placebo11
Metformin7.8
Lifestyle program4.8

3,234 adults with raised blood sugar, average follow-up 2.8 years. The lifestyle goal was at least 7% weight loss and 150 minutes of activity a week.

Source: Knowler WC et al., New England Journal of Medicine 2002 (Diabetes Prevention Program) (checked on October 6, 2026)

Turning a trial into a national program took time. In the first four years of the CDC’s National Diabetes Prevention Program, 14,747 adults took part; they attended a median of 14 sessions, lost 4.2% of their weight on average, and 35.5% reached the 5% goal, with each extra session linked to a little more loss. Medicare’s version runs as 16 weekly core sessions followed by monthly sessions, and Medicare.gov says people who qualify pay nothing. The lesson that carried over to every later program was that attendance matters: people who keep showing up tend to lose more.

In 2011, Medicare began covering intensive behavioral therapy for obesity in primary care for people with a BMI of 30 or more: weekly visits in the first month, every other week for months 2 to 6, and monthly for months 7 to 12 for those who had lost at least 3 kg (about 6.6 lb). The Look AHEAD trial, published in 2013, tested an intensive lifestyle program in 5,145 adults with type 2 diabetes, with planned follow-up of up to 13.5 years. Weight loss was 8.6% vs 0.7% at one year and 6.0% vs 3.5% at the end; the program improved blood sugar and fitness but did not reduce heart attacks and strokes, showing both the reach and the limits of lifestyle programs on their own.

Look AHEAD: average weight loss with an intensive lifestyle programValues in %
Look AHEAD: average weight loss with an intensive lifestyle program
ItemLifestyle programDiabetes support and education
At 1 year8.6%0.7%
At study end (median 9.6 years)6%3.5%

5,145 adults with overweight or obesity and type 2 diabetes at 16 U.S. centers. The trial stopped early for futility on its heart outcome.

Source: Look AHEAD Research Group, New England Journal of Medicine 2013 (checked on October 6, 2026)

Commercial programs were finally compared too. A 2015 systematic review in the Annals of Internal Medicine of 45 studies found that, compared with education or no program, Weight Watchers led to at least 2.6% more weight loss at 12 months and Jenny Craig at least 4.9%; Nutrisystem led to at least 3.8% more at 3 months, and very-low-calorie programs such as Medifast showed short-term gains that faded after 6 months. The authors noted that many trials were short and lost many participants. Our medical vs commercial programs guide puts these results next to medical care.

Extra weight loss with commercial programs vs education or no program (2015 review)Values in %
Extra weight loss with commercial programs vs education or no program (2015 review)
ItemValue
Jenny Craig, 12 months4.9%
Very-low-calorie programs, short term4%
Nutrisystem, 3 months3.8%
Weight Watchers, 12 months2.6%

Minimum differences ('at least') vs control or education, at different time points; the very-low-calorie figure is vs counseling. Not a ranking: the programs were studied in different trials, and the programs have changed since.

Source: Gudzune KA et al., Annals of Internal Medicine 2015 (45 studies) (checked on October 6, 2026)

2008 to 2020: apps and digital coaching

Smartphones moved programs from the church hall to the pocket. Noom was founded in 2008, according to a profile of its co-founder by the Korea Society, and built a program of short daily lessons based on behavior-change psychology with food and weight logging; a 2016 study of 35,921 users found 77.9% reported losing weight while using it, though it was observational and relied on self-reported data. Established programs added apps and online meetings, and Nutrisystem had already shifted to online sales. In 2018 the U.S. Preventive Services Task Force recommended that clinicians offer or refer adults with a BMI of 30 or more to intensive behavioral programs, noting that the effective ones usually had 12 or more sessions in the first year. Our Noom page and WW vs Noom comparison show where those two stand now.

2023 to today: programs that prescribe

GLP-1 medicines changed the business model. On April 10, 2023, WeightWatchers completed its acquisition of Sequence, a telehealth company, and now offers clinician visits and prescriptions alongside its points program. Noom, Ro and Hims & Hers built similar services. The older center-based model weakened: in May 2023 news reports covered the closure of the original Jenny Craig company, and on July 5, 2023 Wellful, which also owns Nutrisystem, bought the Jenny Craig brand and relaunched it online. WeightWatchers itself went through Chapter 11 bankruptcy in 2025, filing on May 6 and emerging on June 24 after eliminating $1.15 billion of debt.

Prescribing brought new questions. During and after shortages, many telehealth services sold compounded semaglutide and tirzepatide, which the FDA stresses are not FDA-approved or reviewed for safety, effectiveness or quality; on February 6, 2026, the agency announced it intends to act against non-FDA-approved GLP-1 drugs that are mass-marketed by companies. Our pages on telehealth weight loss and compounded GLP-1s explain what to check before signing up.

YearMilestoneWhat it added
1948TOPS (Take Off Pounds Sensibly) opensLow-cost peer support groups
1963Weight Watchers founded by Jean Nidetch; public in 1968Weekly meetings and weigh-ins as a business
1972Nutrisystem businesses beginCenters and packaged foods
1983 / 1985Jenny Craig starts in Australia, then the U.S.Centers, meals and one-to-one counseling
1993 / 1997FTC charges five programs; Jenny Craig settles“Results not typical” disclosures
1999Nutrisystem moves to internet and phone salesDirect-to-consumer delivery
2002Diabetes Prevention Program resultsProof that a structured lifestyle program prevents diabetes
2008Noom foundedApp-based coaching
2011Medicare covers intensive behavioral therapy for obesityPrograms in primary care
2013Look AHEAD resultsLong-term limits of lifestyle programs alone
2014FTC “Gut Check” guideA public list of false weight-loss claims
2015Systematic review of commercial programsSide-by-side evidence
2016 / 2018Medicare Diabetes Prevention Program certified; USPSTF recommendationCoverage and a national standard
2023WeightWatchers buys Sequence; Jenny Craig brand sold to WellfulPrograms that prescribe
2025WeightWatchers completes Chapter 11A restructured industry
Sources: TOPS; WeightWatchers; Nutrisystem and Jenny Craig SEC filings; FTC; NEJM; CMS; USPSTF; Annals of Internal Medicine; SEC and company releases. Checked October 6, 2026.

What 75 years of programs teach

Five lessons from TOPS to telehealth

  1. Support worksFrom TOPS meetings to the DPP, regular contact and accountability are the common thread of programs that help.
  2. More sessions, more resultsThe USPSTF found that effective programs usually had 12 or more sessions in the first year.
  3. Typical is smaller than the adsThe FTC made "results not typical" a rule because testimonials overstated what most people lose.
  4. Keeping it off is the hard partLook AHEAD and the TOPS study show weight loss can last, but usually less than at the peak.
  5. Ask what is prescribedTelehealth programs can be helpful, but check whether a medicine is FDA-approved or compounded.

If you are choosing a program today, start with our 12 questions to ask, and for keeping weight off afterward, see our guide to maintaining weight loss and the habits of people who keep it off. Programs that prescribe medicines are medical care, so the decision belongs with you and a clinician.

Questions to ask a professional

  • Which kind of program fits my health, schedule and budget?
  • Is there published evidence for this specific program?
  • If a program prescribes medicine, is it FDA-approved or compounded?
  • Does my insurance or Medicare cover a behavioral program or diabetes prevention program?

Frequently asked questions

What was the first weight-loss program?

TOPS (Take Off Pounds Sensibly), a nonprofit support group that opened in 1948, describes itself as the first weight-loss organization of its kind. Weight Watchers followed as a company in 1963.

When did Weight Watchers start?

Jean Nidetch began hosting weekly meetings in her Queens, New York, living room; about two months later 40 women attended. She officially founded the company in 1963 and took it public in 1968.

Why do weight-loss ads say results are not typical?

In 1993 the FTC charged five large diet programs over unsupported claims and testimonials. Jenny Craig's 1997 settlement required the line "This result is not typical. You may be less successful" for testimonials that did not show typical results.

When did Nutrisystem and Jenny Craig start?

Nutrisystem's SEC filings say its businesses began in 1972. Jenny Craig began in Australia in 1983 and opened its first U.S. centres in Los Angeles in February 1985.

When did weight-loss programs start prescribing GLP-1s?

Telehealth prescribing grew quickly after GLP-1 medicines were approved for weight. WeightWatchers completed its purchase of the telehealth company Sequence on April 10, 2023, and other programs built similar services.

References

  1. TOPS Club (Take Off Pounds Sensibly). TOPS Club, Inc.. (accessed October 6, 2026) Other
  2. Mitchell NS, Polsky S, Catenacci VA, Furniss AL, Prochazka AV. Up to 7 Years of Sustained Weight Loss for Weight-Loss Program Completers. American Journal of Preventive Medicine, 2015. doi:10.1016/j.amepre.2015.02.011 · PMID 26033350 (accessed October 6, 2026) Other
  3. Celebrating WW’s founder, Jean Nidetch. WeightWatchers. (accessed October 6, 2026) Other
  4. Banting W.. Letter on Corpulence, Addressed to the Public (1863). Project Gutenberg (public-domain edition), 1863. (accessed October 6, 2026) Other
  5. Peters LH.. Diet and Health, With Key to the Calories (1918). Project Gutenberg (public-domain edition), 1918. (accessed October 7, 2026) Other
  6. NutriSystem, Inc. Form 10-K for fiscal 2002 (business history). U.S. Securities and Exchange Commission (EDGAR), 2003. (accessed October 6, 2026) Other
  7. Jenny Craig, Inc. Form 10-K for the fiscal year ended June 30, 1999 (company history). U.S. Securities and Exchange Commission (EDGAR), 1999. (accessed October 6, 2026) Other
  8. FTC cites five diet programs; agency says ads are deceptive. The Baltimore Sun, 1993. (accessed October 6, 2026) News (reported facts only)
  9. FTC Reaches Settlement with Jenny Craig to End Diet Program Advertising Litigation. Federal Trade Commission, 1997. (accessed October 6, 2026) Government page
  10. Gut Check: A Reference Guide for Media on Spotting False Weight Loss Claims. Federal Trade Commission, 2014. (accessed October 7, 2026) Government page
  11. Diabetes Prevention Program Research Group. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. New England Journal of Medicine, 2002. doi:10.1056/NEJMoa012512 · PMID 11832527 (accessed October 7, 2026) Randomized trial
  12. Ely EK, Gruss SM, Luman ET, et al.. A National Effort to Prevent Type 2 Diabetes: Participant-Level Evaluation of CDC’s National Diabetes Prevention Program. Diabetes Care, 2017. doi:10.2337/dc16-2099 · PMID 28500215 (accessed October 7, 2026) Other
  13. Medicare Diabetes Prevention Program. Medicare.gov (CMS). (accessed October 7, 2026) Government page
  14. Medicare Diabetes Prevention Program (MDPP) Expanded Model. Centers for Medicare & Medicaid Services. (accessed October 6, 2026) Government page
  15. National Coverage Determination 210.12: Intensive Behavioral Therapy for Obesity. Centers for Medicare and Medicaid Services. (accessed October 6, 2026) Government page
  16. Look AHEAD Research Group; Wing RR, et al.. Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes (Look AHEAD). New England Journal of Medicine, 2013. doi:10.1056/NEJMoa1212914 · PMID 23796131 · NCT00017953 (accessed October 7, 2026) Randomized trial
  17. Gudzune KA, Doshi RS, Mehta AK, et al.. Efficacy of commercial weight-loss programs: an updated systematic review. Annals of Internal Medicine, 2015. doi:10.7326/M14-2238 · PMID 25844997 (accessed October 7, 2026) Meta-analysis
  18. Saeju Jeong: an unwavering visionary behind Noom. The Korea Society. (accessed October 6, 2026) Other
  19. Chin SO, Keum C, Woo J, et al.. Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity. Scientific Reports, 2016. doi:10.1038/srep34563 · PMID 27819345 (accessed October 6, 2026) Other
  20. Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions. U.S. Preventive Services Task Force, 2018. (accessed October 7, 2026) Guideline
  21. WW International, Inc. Form 10-Q for the quarter ended April 1, 2023 (Note 17: acquisition of Sequence completed April 10, 2023). U.S. Securities and Exchange Commission (EDGAR), 2023. (accessed October 6, 2026) Other
  22. Nutrisystem News Room (release of May 11, 2023 on Jenny Craig’s closure). Nutrisystem, LLC, 2023. (accessed October 6, 2026) News (reported facts only)
  23. Wellful, Inc. acquires Jenny Craig brand, expanding its portfolio of leading health and wellness brands. Wellful, Inc., via PR Newswire, 2023. (accessed October 6, 2026) News (reported facts only)
  24. WeightWatchers Completes Financial Reorganization Following Chapter 11 Plan Approval. Simpson Thacher & Bartlett LLP, 2025. (accessed October 6, 2026) News (reported facts only)
  25. FDA intends to take action against non-FDA-approved GLP-1 drugs. U.S. Food and Drug Administration, 2026. (accessed October 6, 2026) Government page
  26. FDA’s concerns with unapproved GLP-1 drugs used for weight loss. U.S. Food and Drug Administration, 2026. (accessed October 7, 2026) Government page

Facts checked on October 6, 2026

Educational information, not medical advice. Talk with a qualified healthcare professional about your own situation. In an emergency call 911.

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