Obesity is an epidemic with far-reaching implications for public health. Statistics vary based on the source of data, demographics and time period assessed, but the American Heart Association recently estimated that 168 million people are overweight and 74 million are obese in the U.S. According to data from the National Health and Nutrition Examination Survey (NHANES), the prevalence of obesity was 39.8% in adults and 18.5% in youths in 2015-2016.

Globally, in 2017 the New England Journal of Medicine published a review of data for 195 countries and territories from 1980 through 2015. Researchers reported about 2 billion people worldwide, or about 30% of the global population, are overweight or obese.

The implications of obesity on health and systems of care are burdensome. Obesity-related health conditions like heart disease, stroke, type 2 diabetes and certain types of cancer are some of the leading causes of preventable, premature death. The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars, according to CDC data.

The prevalence of overweight and obesity in children and adolescents is especially concerning. Lifestyle issues like poor diet and lack of exercise as well as psychological and socioeconomic factors can influence unhealthy weight in kids.

Physical complications may include type 2 diabetes, metabolic syndrome, high cholesterol and high blood pressure, asthma, sleep disorders, non-alcoholic fatty liver disease (NAFLD), and bone fractures. Meanwhile, social and emotional complications might include low self-esteem and being bullied, behavior and learning problems, and depression.

Research continues to reveal the consequences of being overweight. For example, a study published in the Journal of Alzheimer’s Disease in 2020 showed that being overweight or obese seriously impacts brain activity and increases the risk for Alzheimer’s disease as well as many other psychiatric and cognitive conditions. One of the largest studies linking obesity with brain dysfunction, scientists analyzed over 35,000 functional neuroimaging scans using single-photon emission computerized tomography (SPECT) from more than 17,000 individuals to measure blood flow and brain activity.

Additionally, as the world struggles with the COVID-19 pandemic, researchers have suggested the obesity crisis may have repercussions for the effectiveness of any future vaccine.

For example, a 2017 paper published in the International Journal of Obesity concluded obese adults vaccinated against seasonal influenza were twice as likely to develop flu and flu-like illness compared to healthy weight adults who were also inoculated.

Solutions Still Sell
Consumers are constantly on the lookout for solutions to losing extra pounds and inches, keeping them off, and/or balancing a healthy weight.

For the year ending April 2020, 43% of U.S. adults experimented with a dietary regimen: 10% intermittent fasting; 7% each the Whole30 diet or a juice/detox cleanse; 6% Weight Watchers; and 5% each the elimination, ketogenic, or paleo diet, according to the International Food Information Council’s (IFIC) 2020 Food and Health Survey. However, only 3% of those who try these diet plans stay on one plan exclusively, according to a 2019 study from the Hartman Group.

Mintel’s 2019 “Diet Trends & Fads” report indicated 120 million U.S. adults tried to lose weight last year. The market research firm predicted sales of meal replacement/weight loss beverages will reach $6.5 billion by 2024. An estimated 25% of households use meal replacement drinks and 19% weight control beverages.

Just over half (53%) of adults associate protein with weight management, and 24% with satiety, according to HealthFocus International. Globally, nearly half of those who buy high-protein foods (59%) do so for weight loss.

Weight loss/management followed by energy, digestive health, heart health, and muscle health/strength topped the 2020 list of health benefits consumers most want to get from foods, according to IFIC’s survey.

At the same time, people are turning to nutritional products to maintain health and lose excess weight. Atkins ($529 million, +27.2%) and Slimfast ($280 million, +29%) were among top nutritional brands, according to IRI data from all outlets for the 52-week period ending Aug. 11, 2019. In fact, both were among the top six growth manufacturers (fifth and sixth, respectively).

Slimfast Keto meal replacement shakes—which contain whey and collagen protein powder, grassfed butter and MCTs—brought in $63 million for that same period.

The COVID-19 pandemic has brought into clear focus the need to manage health conditions, and pivot to more holistic, integrative and preventive solutions. During the 8-week period between Mar. 8 and Apr. 26, dollar sales of center store foods/drinks that offered diabetes support increased nine-times 2019 sales, according to IRI. Weight control product sales increased 11 times and moved from negative to positive unit sales. Products aimed at helping control hypertension posted a 22% dollar sales increase compared to 2019.

Sales of NutriSystem, Weight Watchers, Medifast, and Jenny Craig topped $3.2 billion in 2019, up 4% versus 2018, according to Marketdata Enterprises.

Additionally, two-thirds of global moms said they’d be very likely to buy foods that help manage their child’s weight, according to HealthFocus. Globally, 340 million children aged 5-19 are overweight or obese, according to the World Health Organization (WHO); 34% of U.S. children aged 2-19, per American Heart Association statistics.

Households with children are most likely to look for foods/drinks that provide satiety, weight management, energy, improve digestion, immunity, and mental alertness, according to HealthFocus. When asked, “How important is the role your digestive health plays in each of the following,” 58% of consumers said weight management, second behind only overall physical health. That number jumped to 66% for consumers age 30-39, and 65% for households with kids.

Managing weight and providing satiety are the top two most-desired functional food benefits, according to HealthFocus data.

Assessing the Problems
Compared to other areas of health, managing a healthy weight is unique, said Brian Appell, director, global communications, OmniActive Health Technologies, Inc, “because it is a mix of physiology, biochemistry, and psychology.”

Weight gain and obesity are linked to many other conditions, like heart disease, diabetes, high blood pressure, osteoarthritis, sleep disorders, cancer and more, he added. “As important as weight management is for the basic need to look and feel good, it’s integral to healthy aging.”

Dietary supplements do have a role to play within a broader regimen to help people lose weight by targeting areas like metabolic rate, lipid absorption/fat breakdown, satiety and blood sugar management, Appell continued. “As effective as they are, they’re only as good as part of an overall program that touches on those key areas for weight management.”

Steve Fink, vice president, marketing, PLT Health Solutions, suggested weight management is “the single most important and effective thing that people can do—at any point in their lives—to live and age more healthfully. The evidence of the huge health consequences associated with an overweight/obese population is overwhelming. An unhealthy weight is the underlying or contributing cause to any number of chronic health conditions present in later years such as cardiovascular disease and diabetes, and can exacerbate others like joint health.”

The human body is “hardwired by millions of years of evolution” to put on and maintain weight, Fink added. “At the same time, modern diets and living conditions make that easier and faster to do—in an unhealthier way. This inclination to gain and keep on weight is exacerbated by our emotional relationship to food. We eat for many other reasons than sustenance, including pleasure, stress, and more.”

Diet continues to be one of the largest influences on weight gain and loss, noted Morris Zelkha, co-founder of TriNutra. “Our modern diet often consists of low-nutritional-value, processed foods that are high in sugar, fat and salt. We can also see that many of the food products we choose to consume contain high levels of LDL cholesterols. And when eaten in excess, it’s a basic foundation for unhealthy weight gain.”

The issue of poor dietary habits is often compounded by a lack of exercise and sedentary lifestyles. “Right now, during the pandemic, children are participating virtually in school, exercise facilities are closed, and many people are not even leaving their homes,” Zelkha said. “These events have spiked stress and anxiety, which along with poor diet and exercise, have a negative impact on our ability to maintain a healthy weight.”

A main concern with being overweight is heightened risk of metabolic syndrome, he continued. “Metabolic syndrome is a combination of any two or more conditions such as high blood pressure, high blood glucose, or high blood fats, and is often accompanied by insulin-resistance and a fatty liver. Having metabolic syndrome is a vicious cycle of symptoms that if not addressed, can compromise overall health and cause irreversible health conditions. Beyond the physical effects of excess weight, affected persons can also experience a negative impact on their mental well-being, mood and even their relationships, possibly causing the overweight individual to spiral further in unhealthy habits.”

Aside from genetics, diet and exercise are critical to reaching and maintaining a healthy weight, but building good habits can be challenging, said Sevanti Mehta, president of Unibar. “We are surrounded by food options that are highly processed and nutritionally poor, and many people have to go out of their way to find time in their busy schedules to fit in regular exercise. Additionally, many professionals spend many sedentary hours seated at a desk and rely on convenient yet unhealthy meals and snacks to get through the day. It’s all ingrained in our lifestyles, and lifestyles are hard to change.”

Being overweight can have serious implications for the immune system, “debilitating our body’s ability to fight off aggressors,” Mehta added. “And unfortunately, according to the CDC, roughly 42.4% of adults in the U.S. were considered to be obese in 2018. Almost half of our population is at higher risk. That’s one reason why we find our new CapZfuel to be a valuable option for consumers. CapZfuel is a capsaicin extract that helps to burn existing body fat by supporting non-exercise activity thermogenesis, which uses the fat as a fuel source to improve energy, reduce fatigue, and conserve muscle mass. This then helps further support the consumers’ exercise efforts as they progress in meeting healthy weight management goals.”

Energy/calorie intake and output needs to be in balance in order to maintain a healthy weight, noted Anke Sentko, vice president of regulatory affairs & nutrition communication, BENEO. “To lose weight, the output needs to be higher than the energy intake. A higher output can be achieved by physical exercise on a regular basis. On top of this, there are ways to steer the metabolism in a way that allows the use of fat reserves for energy production. With our normal western-style diet, which results in high levels of the hormone insulin, this fat burning is blocked. Going for a carbohydrate-rich diet based on those carbohydrates that keep the blood sugar level low supports fat burning. In this way, joyful eating is possible and it is easier to keep a healthy weight.”

Consumers may feel frustration in their weight management endeavors for numerous reasons, including a lack of focus on maintaining a healthier diet and/or the lack of opportunity for exercise. Busy lifestyles and “eating on the go” can create bad dietary habits, but once a firm commitment is made to indulge in a healthier lifestyle, including exercise, there are food and beverage ingredients that can help them on that quest, according to Sentko.

Controlled, balanced and low blood glucose levels are key for maintaining or losing weight effectively, she said. “Therefore, blood sugar management plays a key role in weight management and as a major driver of metabolism, insulin is a major influencer of blood sugar levels. Lower levels of this regulating hormone are beneficial for weight management as they allow for fat burning. High-glycemic ingredients are detrimental to weight management efforts as they can lead to the onset of type 2 diabetes and obesity.”

The COVID-19 crisis has also demonstrated more clearly than ever the direct link between diet and overall health, said Sentko. “Studies have shown, for example, a link between a severe progression or fatality of COVID-19 and underlying conditions, such as obesity, high blood glucose levels, (pre-) diabetes, metabolic syndrome, and cardiovascular diseases, often connected to bad dietary habits,” (BMJ, 2020).

Being overweight or obese has a detrimental effect on the body’s metabolic pathways, she continued. “Sensitivity to hormones like insulin decreases; important functions in liver, heart, kidney are going down while chronic inflammation is increasing, which can create a weakened immune system. With lack of attention to weight management, people are drifting into several type of illnesses in the longer term. Weight management is therefore not just to look good, but it is imperative to inner well-being.”

In the field of weight management, science has also revealed the role the gut microbiome plays in feelings of hunger and satiety. “The relevance of the human microbiota is gaining momentum,” said Sentko. “For example, an HFI Global Trend Study (2018) indicated that two in five consumers are very or extremely interested in the gut microbiome. The same study found that 69% of these consumers reported an understanding that a healthy microbiome can impact physical health, and 60% indicated that it can impact mood.”

Understanding of blood glucose levels as a means to manage weight is also growing, reflected by the increasing number of product launches with low/no/reduced sugar claims. According to Mintel’s Global New Product Database, there was a 56.1% increase of these product introductions from 2013 to 2018 globally. Additionally, an Ipsos survey showed U.S. consumers are looking for ingredients supporting balanced energy.

“With newfound knowledge and media attention, consumers have become smarter about methods (i.e., diet and exercise) that contribute to health, fitness, and inner well-being,” said Sentko. “In turn, manufacturers have responded to consumer demands for healthier and clean label food and beverages by seeking out natural and non-GMO ingredients that contribute to healthy weight management.”

Risks, Challenges & Regaining Trust
Weight loss supplements have been a prime target for regulatory agencies, presenting risks and challenges for legitimate brands and marketers selling into today’s market.
“Inadequate science, over-promising benefits and safety are common themes raised by regulatory agencies,” said Appell. “OmniActive’s approach has always been to build the brand and claims around good science to differentiate in this competitive category. Brands should align themselves with suppliers that have done their due diligence to mitigate the risks and support the benefits.

Weight loss products have long been scrutinized, according to Zelkha. “In the past, brands made many promises without any supporting research and many consumers ended up disappointed at the lack of results. For that reason, there is a high level of suspicion around products promising to deliver weight loss.”

To address public suspicion, companies marketing weight loss supplements should not make structure function claims that are not based on “multiple high-quality studies,” Zelkha suggested. “Unfortunately, this research is expensive and challenging to obtain. This leads to the stereotypical exaggerated claims made by marketing companies, which has drawn the attention of regulatory agencies.”

“We believe the underlying health conditions that lead to and result from weight gain are more interesting and relevant to consumers looking to make positive long-term changes to their health,” he continued. “We have focused on metabolic health and the multiple parameters that contribute to metabolic syndrome.”

Clearly, whole foods and healthier eating need to be emphasized as the center of lifestyle management, noted Fink. “But there is an ‘all-hands-on-deck’ need in our society and supplements can play an important role. We can’t afford to wait. There don’t appear to be any panaceas in weight management, but there are many, many things we can do to ‘get better every day.’ Proper use of supplements that have proven efficacy can be an important one of these.”

Mehta noted one of the biggest challenges today is to stand out in a market that is constantly introducing new weight loss solutions. “The ideal way to do so is to create something innovative and support it with research. Additionally, the benefits should go beyond weight loss and help consumers to improve their overall health. Our CapZfuel ingredient doesn’t just help burn fat, it helps to improve energy and thereby supports healthy lifestyle choices like regular exercise. So not only will the consumer lose unhealthy weight but also improve health and strengthen and maintain muscle mass.”

According to Appell, “selling weight management is like selling the hope to look better, be healthier, have more confidence, fit into a smaller pants size. If brands temper their marketing with their science and claims that reasonably represent that science, then consumers can make better informed decisions about what to expect. I believe this approach engenders greater trust— and compliance—for brands in the weight management space.”

Leading weight management companies and brands often focus on the “whole person”—as opposed to just “dieting”—in developing weight management products and regimens, Fink noted. “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. For example, when developing a weight management product for seniors, it is important to consider issues like maintaining muscle mass and blood sugar management.”

A notable shift has also been increased interest in, and reliance on, high quality science to back messaging and build trust with consumers. “PLT has always worked to develop more and better science on our weight management ingredients. The ingredients we introduce are backed by gold-standard, double-blind placebo-controlled clinical trials and extensive pre-clinical work that examines safety and mechanisms of action.”

Zelkha agreed that research is key to earning loyalty and trust among consumers. “While it often takes considerable time and money, providing scientific support to a product pays off in the long-run. Clinical trials are effective when there is a diverse representation of populations,” he added.

Ultimately, research is the best means to demonstrate efficacy, which is the true selling point for consumers in need, said Mehta. “Once you show that a product truly works, then consumers will be willing to trust the brand.”

Quality Assurance
For the most part, branded ingredient suppliers work hard to ensure the quality and efficacy of their products, according to Appell. “I think it’s especially important in the weight management space because of its checkered past,” he said, offering some suggestions on what to look for from potential partners, including: clinical trials in healthy/relevant human populations; defining the mechanism of action as part of understanding the ingredient’s activity; ensuring dosage used reflects the science; ensuring authenticity (is this ingredient tested and proven to include the active and activity levels as promised, and how has this been authenticated?).

Ultimately, quality assurance and trust in a supplier centers around a thorough, all-around understanding about the ingredient, said Fink. “Today, we operate a program called PLT360 to achieve this. PLT360 is a business-wide commitment by PLT Health Solutions to develop ingredients that our customers can be both confident and proud to supply to their own customers, knowing that these ingredients are safe, of high quality, efficacious and harvested and manufactured in a sustainable way. Going beyond traditional quality control programs, PLT360 examines every aspect of an ingredient that we supply in an effort to become transparent with our operations and build trust with the health and well-being community.”

Sustainability and efficacy are built into how PLT Health Solutions approaches quality, Fink added. “A 360° view means that we look at everything that impacts an ingredient and its viability in the marketplace. PLT360 is a comprehensive view of the requirements and responsibilities we have to our customers (and their customers) in supplying traceable, pure, high quality ingredients that meet market needs for performance and sustainability. Within each of the four subject areas of PLT360—ingredient identity, quality, sustainability and efficacy—again, we take a comprehensive view of our responsibility so that we can answer the questions that need to be answered.”

Zelkha reiterated the importance of sound research and offered some counsel on that font. “Start with animal obesity studies and work up to human studies with specific metrics and targets to be measured. The more studies you have the better you can show the safety, quality, and efficacy of the product. That’s why we continue to develop and realize research studies that explore the positive impact our ThymoQuin cold-pressed black seed oil has on metabolic health for better weight management and overall health outcomes.”

Sentko noted that BENEO has made a commitment to provide high-quality, non-GMO, plant-based ingredients. “BENEO’s products are scientifically proven to provide cited health benefits. For example, BENEO has seven EU health claims and two FDA-approved health claims. Also, the FDA confirmed the fact that BENEO’s prebiotic chicory root fibers are indeed dietary fibers, also in the context of the U.S. food labeling legislation. Additionally, its chicory root fibers and functional carbohydrates are recognized in more than 80 countries worldwide. Their benefits can be communicated in all these countries by nutrition and/or health claims backed by scientific research.”

As well as making sure product quality is at the highest level, BENEO is also committed to sustainability, she added. “The majority of BENEO’s ingredients are obtained from the company’s highly-valued farming community that carries a golden standard for sustainable farming from the SAI platform (Sustainable Agricultural Initiative). BENEO’s state-of-the-art factories also use cogeneration of steam and electricity, as well as highly efficient multiple effect evaporation stations and other methods to recover energy. BENEO has focused on energy efficiency over the past 30 years, reducing specific energy consumption by 50% over that time. All of these approaches help to assure the highest level of quality in the ingredients that BENEO delivers.”

State of Innovation
Often considered the lifeblood of healthy industries, innovation takes many forms in the dietary supplement and nutritional products market.

“Innovation is key to improving upon existing solutions,” according to Mehta. “Many natural ingredients have been used as traditional medicine for hundreds and thousands of years and yet we continue to discover new ways to improve them and expand their health applications. One growing trend is to take weight management solutions and apply them to sports nutrition, blending the two categories together. This blurring of the lines allows weight management to become more proactive as part of a lifestyle rather than a desperate reaction to a number on the scale. And in return, consumers are able to see additional benefits from their efforts. CapZfuel is a capsaicin ingredient that helps to burn only body fat, not the muscle mass, into energy for improved sports and exercise performance, bringing together the benefits of both categories for optimal results.”

Fink agreed that weight management benefits have entered other related categories, like active/sports nutrition. “We are seeing sports nutrition companies add weight management components to existing formulations and expand their product lines to include weight management entries. Another area would be weight management products for an older demographic. Whereas weight loss had always been a younger person market, people are realizing that one of the most important things they can do to age gracefully is to keep an eye on their weight.”

Additionally, one of the major changes in recent years has been a “proliferation of delivery systems for weight management ingredients and products,” Fink said. “We’re seeing a lot more beverages, foods, gummies and dissolvable powders. Both our Slendacor and Supresa ingredients have good organoleptics and are easy to formulate. The Slendacor WD ingredient was developed over a two-year period specifically to address the issues of novel delivery forms.”

Appell said he believes innovation in the weight management category is healthy, but offered a caveat. “There are clearly defined targets for weight management (e.g., metabolism, fat absorption, blood sugar, lipolysis, etc.) and I’d be surprised to see something truly novel. But that’s not a bad thing. Because weight management is still a big category—and a hot button for regulatory watchdogs—this space is primed for products and science that improves efficacy. And that’s as important for innovation as developing something not seen before.”

Innovation is an essential ingredient in today’s competitive marketplace, according to Zelkha. “The industry should always be looking for ways to improve its solutions, and we can’t do that if we aren’t trying to think outside the box and make something new, even out of something that has existed and been used for a long time. We chose to focus on an all-natural food, black seed oil, that has been consumed by humans for thousands of years with hundreds of existing research studies. We started by discovering the key active thymoquinone and then found ways to improve the growth of the plant to deliver proper ratios that yield the greatest benefit to human health. Then, by modifying our materials handling and cold-press technology, we were able to deliver the highest-performing black seed oil in the world.”

The company’s innovation didn’t stop there, he added. “By continuing to research the effects of our unique black seed oil, we were able to discover that having thymoquinone standardized to 3%, it is able to combine with other botanicals to provide a synergistic benefit that is greater than the individual parts,” he said. “Kind of like making 1+1=5, and it was only possible because we went out on a limb and tried to do something that hadn’t been done before. Our most recent published study showed the augmented benefits for metabolic health of our ThymoQuin when combined with omega-3 oils and the results were outstanding,” (Antioxidants, 2020).

Today, amid the pandemic, obese people are at higher risk of severe complications due to COVID-19, he continued. “This is because obesity exacerbates the cytokine storms—the excess production of inflammatory cytokines—that are experienced when suffering from severe cases of COVID-19,” said Zelkha. “A recent study by the New York Medical College found that naturally occurring substances that are capable of up-regulating heme oxygenase (HO-1), such as pomegranate seed oil or black seed oil combined with omega-3 oil, are able to provide a therapeutic strategy to alleviate the effects of cytokine storms. This is because our ThymoQuin, in combination with omega-3, was shown to protect against obesity-induced oxidative stress, improve insulin sensitivity, and convert white fat to beige fat in a murine model of obesity.”