A new wave of digital weight loss companies are raking in millions in funding by relying on decades-old psychology principles, experts say

Providing products and services from prepared meal plans to medical care-related weight loss options, the weight loss industry's reputation has changed significantly in recent years due to a widespread shift towards body acceptance and away from fat-shaming and promotion of disordered eating habits. 

Meanwhile, healthcare professionals remain divided on whether to tell people with obesity to lose weight. The BMI, which determines whether patients are overweight or obese, is no longer considered the only body composition-related health standard. 

Now, a new wave of direct-to-consumer digital weight loss companies think they can win users and get more Americans to lose weight. Although they each have different approaches, experts told Insider they largely use the same behavioral psychology principles that have been used for decades, only delivered via mobile apps. 

Experts say tech approaches to weight loss use the same principles as traditional options

By avoiding traditional diet language in how they sell their app-based services to potential users, companies like Noom, Lifesum, Calibrate, and Wellory have managed to secure a combined $169 million in venture capital funding.

Noom, the largest venture-backed digital weight loss startup, said it had raised $115 million to date via company spokesperson. The company operates via free and paid subscription tiers, starting with ad-supported access to a calorie counter that grades food on a stoplight color system and weight loss articles, with higher-tier premium memberships giving users the ability to message Noom health coaches.

In 2020, company reported it had over 45 million users, according to CEO Artem Petakov, who was featured in Insider's list of 30 healthcare leaders under 40.

"Weight is the foundation of health, and it is a large and proven market," the company said via email.

Lifesum, a competing digital weight loss startup, has raised $22 million to date, primarily from European venture funds. The Stockholm-based company expanded to the US in 2019. Similar to Noom, the company offers a nutrition-based subscription approach to weight loss, including food and exercise tracking and meal plans. 

Calibrate, which Insider reported on last June, raised $5.1 million for its "metabolic health" direct-to-consumer approach to weight loss. In January, the company announced an addition $22.5 million in funding, bringing its total funding to $27.6 million.

Founder Isabelle Kenyon said in June that Calibrate's science-backed, subscription-based platform moves beyond the calories-in-calories-out approach to promote long-term behavioral change. Kenyon declined to speak to Insider for this article.

The explicitly "anti-diet" nutrition app Wellory raised $4.5 million in funding last December. Through subscriptions starting at $12 a week, the app matches users with a licensed nutritionist, registered dietitian or certified health coach. Users then work with their coach to create a personalized plan to lose weight or achieve other health goals. 

Clinical psychologist Katie Rickel, who runs the residential weight loss treatment center Structure House in Durham, North Carolina, said Noom uses the same type of approach to losing weight as Weight Watchers did two decades ago. Rickel's clients at Structure House, she said, fall into a different category. Rather than pay for a $29.99 subscription, they're willing to pay $12,000 for monthlong treatment.

Noom, she said, primarily takes a cognitive behavioral approach to weight loss, which dates back to the 80s.

"It's not a new treatment or a new concept," Rickel said. "It just looks new because it's in an app rather than a book."

Though she said she thinks Noom's AI-assisted life coaches can't replicate in-person counseling, Ricket said she's "fully in support of any track or program that encourages people to be mindful of their behavior."

Christy Harrington, a registered dietitian, journalist, and the author of "Anti-Diet: Reclaim Your Time, Money, Well-Being and Happiness Through Intuitive Eating," said she's annoyed by the fact companies like Wellory have marketed themselves as "anti-diet," when she considers their approach anything but. 

"I find it frustrating that a company like this is trying to capitalize on the growing opposition to diets and weight stigma," Harrington said. "They're selling the same old stuff." Although not explicitly anti-diet, Noom's tagline is "Stop dieting. Get life-long results."

After publication, Wellory's representative responded with this comment: "At Wellory, we don't believe in "good" or "bad" foods. Instead, we believe in the power of real human relationships to help make real changes in our clients' relationships with food."

Harrington points out that Noom's traffic light system, for example, walks a fine line between encouraging and making people feel guilty about their food choices. 

"Those are hallmarks of diet culture. In my definition, one of the key pillars is demonizing certain foods and lionizing others," she said.

Noom, for its part, contended that it's focused on behavioral changes.

"Noom's foundation is built on scientifically proven behavioral science principles like CBT, and this science has evolved tremendously since it was introduced in the 80s," Noom's chief of psychology, Andreas Michaellides said in a statement. "Our unique advantage comes from how we apply these modalities to successfully engage our users and in how we continually optimize thanks to our digital platform and more than 3,000 human coaches."

Most weight loss programs don't produce long term results, research shows

With all the money that's poured into the US weight loss industry over the decades, Americans' overall average weight and BMI have not improved.

"If it was effective to shame people about the size and shape of their bodies, then you would see changes in the numbers," Harrington said.  

According to Harrington, 70% of weight is genetically determined, but disordered eating patterns encouraged by diet culture can lead to weight cycling and eventual permanent weight gain. 

Five years from starting a diet, about two-thirds of people gain back more weight than they lost, according to a 2007 review of studies evaluating long-term dieting studies by researchers at the University of California, Los Angeles. Among digital weight loss companies, Noom has the largest body of peer-reviewed scientific studies, including one showing that 78% of users lost weight while they were using the app.

In a 2017 study, 100 Noom users had lost an average of 5.2% of their body weight a year after followup, down from the 7.8% reported at the end of their 15-week Noom program. However, none of the published studies span over two years from when patients used Noom to lose weight. 

In a recent Inc. podcast, Calibrate founder Isabelle Kenyon acknowledged that nutritionists and other researchers have learned in the last decades that consumers can't lose weight off sheer willpower alone. 

Kenyon said her biggest "aha moment" was realizing after reading enough research there is no "scientifically proven, repeatable" way for people to lose more than 10 to 12% of their body weight long term. The entire principle of her startup, Calibrate, rests on beating those odds.

The second realization, Kenyon added, was a Deloitte-backed forecast that people are likely to spend more of their money on consumer health and wellness products, rather than medical costs, as the US focuses on preventive healthcare.

Growth in the app-based weight loss market?

Despite concerns from experts, these apps may have staying power. The healthcare industry and patients alike are buying into earlier, preventive ways to stay healthy, as predicted in the Deloitte report.

Although it remains to be seen whether insurer or employers will become a core aspect of their business, Noom has already garnered partnerships with some Aetna and Blue Cross Blue Shield plans, as well as employers like Samsung and multinational lightning corporation Philips.

Via email, the company confirmed it is a "consumer-led digital health platform," but would continue to assess other larger scale opportunities.

Lifesum also identified itself as primarily selling directly to consumers, but has also garnered partnerships with PayPal, General Electric, and Perkbox, a London-based employee benefits company. Access to Lifesum is also included on Oscar Health's benefits platform, as well as via the online platform behind Amazon's recent wearable, Halo.