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Saturday, March 2, 2019

What’s gone wrong at Weight Watchers?

For a business that now sees itself as being all about wellness and not just shedding pounds, the company formerly known as Weight Watchers looks like it has been on a crash diet.
In the second half of its financial year, it dropped 600,000 subscribers.
And at the beginning of its peak season – when Christmas overindulgence morphs into New Year virtuousness – membership is well below forecasts.
The problem, it seems, is all in the name.
After 56 years of trading as Weight Watchers, the company changed its name last September to WW, which, it says, doesn’t stand for anything – not Weight Watchers, not even its new tagline “Wellness that Works”.

Why did Weight Watchers change its name?

The intention, under new chief executive Mindy Grossman, was to modernise the brand amid a cultural shift to body positivity that now emphasises health and wellness as opposed to counting calories.

But Ms Grossman this week admitted to analysts – when the company missed full-year forecasts and warned on profits – that using the word “weight” in its marketing actually carried, well, more weight.
“I think it needed to be more weight-loss focused, especially in the January season,” she said.
She added that it needed to be made clearer that Weight Watchers is now WW.
Mindy GrossmanImage copyrightGETTY IMAGES
Image captionMindy Grossman became chief executive of WW in July 2017
Yanhui Zhao, assistant professor of marketing at the University of Nebraska at Omaha, says that the rebranding of Weight Watchers to WW was “a risky move” in the first place.
“A rebranding project may lead to losses in brand awareness and brand familiarity.
“These risks were even bigger for WW, considering their almost 60-year brand history in the market. Firms should be especially cautious when abandoning a long-standing brand name.”

How was the new brand received?

Not even the motivational tones of Oprah Winfrey – a board member, strategic adviser and owner of an 8% stake in WW – could lift subscriber numbers and avoid the £50m dent to operating profit in the first quarter following the name change.
Despite introducing a voice over by Ms Winfrey to its advertising explaining that Weight Watchers is now WW, the company made a “soft start” to the year which, its chief financial officer Nick Hotchkin says, is “difficult to recover from”.
Camilla Butcher, strategist at branding company Siegel+Gale, questions whether the company should have changed the brand at all.
“The name, if anything, for any brand is really sometimes the most important asset. That is what a brand is when it really comes down to it, it can be name, the meaning and the feelings that are associated with that name.”
She adds: “I think that we live in such a fast-moving time… and there’s nothing more shifting than the diet and weight loss category.”
Weight Watchers foodImage copyrightGETTY IMAGES
Image captionWW used to be known as Weight Watchers
WW boss Ms Grossman says the company is operating in a “very competitive environment”, with trends such as the high-fat, low carb “keto” diet becoming popular.
But Ms Butcher says: “By nature, it is a whole industry of fads and things that come and go, and Weight Watchers’ absolute strength was the fact that they had stood the test of time.”

How did shareholders react?

Shareholders, it appears, also weren’t too sold on the name change when it was announced back in September.
In a study looking at the effects of rebranding on share price returns by University of Nebraska’s Professor Zhao, in association with Prof Roger Calantone and Prof Clay Voorhees from Michigan State University, an examination of 215 announcements showed that on average, stocks rose 2.5%.
But the research also found that 40% of the rebranding announcements were associated with negative shareholder reactions.
For WW, Prof Zhao found that its share price fell 30% in the month after it said it was changing its name.

Was WW right to change its strategy?

While the name change may have puzzled some, the reasoning behind it makes sense.
Ms Butcher says: “I think there are very valid conversations to be had about the term ‘weight’ and whether that is a helpful thing to be talking about any more.”
Also, the image of the company needed refreshing. says Prof Zhao: “Their previous brand image was outdated and was not appealing to millennials, males and many other demographics.”
In order to address this, WW recruited singer Robbie Williams and Instagram star DJ Khaled as “brand ambassadors”.
However, it was not the idea, but its execution that has hurt WW.
DJ KhaledImage copyrightGETTY IMAGES
Image captionInstagram star DJ Khaled is a brand ambassador for WW
“I just think it happened very quickly… the timing was probably a mistake,” Brian Nagel, senior equity analyst at Oppenheimer told CNBC. “They did this around October, November of last year, two months before the peak season.”
WW’s peak first quarter season brings in about 40% of its annual recruits.
While its total subscribers for 2018 rose by 22% on the previous year – helped by strong first half as it introduced its new WW Freestyle programme – recruitment numbers have fallen in the first quarter.
Revenue for the first three months of the year will now be down by 10% and operating profit will drop by $50m compared to the same period last year.
For the full year, sales will now be $1.4bn, down from $1.5bn in 2018, and WW will no longer meet its $2bn annual revenue target by 2020.

How should have Weight Watchers changed its brand?

Prof Zhao says: “Although rebranding was necessary for them, they probably shouldn’t have acted so fast to change their brand name.
“They should have started with a revised brand strategy and updated brand offerings, and then started to made small changes to their brand identity, such as brand logo and tagline.
“Corporate name change should have been their very last step of rebranding.”
For its part, WW is sticking with its new name.
Ms Grossman said: “We believe [in] the most WW and Wellness that Works for the long-term relevance and performance as a brand is the right thing to do.
She added: “We are not giving up our leadership in healthy weight loss.”
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Lifestyle Changes Can Lower Breast Cancer Risk

While genetics, such as carrying BRCA gene mutations, play a role in who is more likely to get breast cancer, everyday lifestyle factors are involved, too.
Research published in JAMA Oncology used data from thousands of women to identify which lifestyle factors in particular could affect a woman’s risk for breast cancer.
The study found that three specific steps could potentially prevent up to 29 percent of all breast cancers: Avoid alcohol and, after menopause, avoid both obesity and estrogen-progestin replacement hormone therapy.
The researchers noted that these recommendations could be most helpful for women at a high risk of breast cancer because of factors they can’t change, like genetics and their age at menstruation and menopause. In fact, for them, having a low body mass index, not drinking alcohol, not smoking and not taking hormone therapy could lower breast cancer risk to that of the average woman.
The research has some limitations, however. For instance, the study only looked at data from white women in the United States, not other ethnic groups. But these are lifestyle changes that can boost overall health for all women.
For more global advice, the American Institute for Cancer Research states that excess body fat is one of the strongest factors linked to a greater risk of breast cancer after menopause. So is abdominal fat, regardless of your body mass index (a measure of body fat based on height and weight).
The organization also warns that drinking alcohol can increase breast cancer risk beforemenopause and touts the positive effects of daily exercise and, for new moms, of breastfeeding.
More information
The American Institute for Cancer Research has more on reducing breast cancer risk.
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Heart Attacks Rising Among Younger Women

Younger U.S. women are suffering heart attacks at a higher rate now than 20 years ago — even while the picture has improved for younger men.
Those are the key findings from a new study of four U.S. communities, in which researchers report the heart attack rate among women younger than 55 has steadily inched upward since 1995. In contrast, the rate dipped among men in that age group.
By 2014, those younger women accounted for 31 percent of hospitalizations for heart attack — up from 21 percent in the late 1990s.
The findings were published Feb. 19 in a special issue of the journal Circulation focusing on women’s heart health.
It’s not entirely clear why heart attacks rose among younger women. But the study period spanned a time of increasing obesity rates nationwide.
“Young women have a higher prevalence of obesity than men in the same age group, and this is especially true among minorities,” said senior researcher Melissa Caughey. She is an instructor in cardiology at the University of North Carolina, in Chapel Hill.
“Obesity can be a risk factor for high blood pressure and diabetes,” Caughey said, “and all three can lead to a higher risk for heart attack.”
In fact, the study found, high blood pressure and diabetes were more common among younger women who suffered a heart attack, versus their male counterparts.
Dr. Suzanne Steinbaum pointed out that “obesity, high blood pressure and diabetes all seem to be more detrimental to women.” She is a spokesperson for the American Heart Association who was not involved in the study.
“I wish I could say I’m surprised by these findings, but I’m not,” added Steinbaum, who directs women’s cardiovascular prevention, health and wellness at Mount Sinai Hospital, in New York City.
The results are based on a 19-year study of adults living in four U.S. communities in North Carolina, Mississippi, Minnesota and Maryland. Over that time, there were nearly 29,000 hospitalizations for heart attack: 30 percent were among people aged 35 to 54.
But while that hospitalization rate dipped among younger men over the years, it crept up among younger women — to between two and three heart attacks per 1,000 women by 2014, the findings showed.
At that point, 31 percent of heart attack hospitalizations were happening among younger women — up from 21 percent in the late 1990s.
In contrast, the number of young men hospitalized for a heart attack declined over time — though the rate remained higher compared with young women, at roughly four per 1,000 by 2014.
One problem, according to Caughey’s team, is the enduring myth that heart disease is a “man’s disease.”
Steinbaum agreed. Even among doctors, she said, there remains an “unconscious bias” to take conditions like high blood pressure less seriously in women, versus men.
The study did find that younger women with heart attacks were less likely than men to get recommended medications to reduce their risk of another attack.
For women, Caughey said, the findings underscore the importance of early attention to prevention.
“Many of the risk factors for heart attack are modifiable,” she said. “Although it’s never too late to adopt a heart-healthy lifestyle, earlier is better. And that’s something young women can keep in mind.”
That can, however, be easier said than done — and that’s a big part of the problem, according to Steinbaum. Women in their 30s to 50s are often working and raising kids, and may be caring for aging parents, too.
“The lives of women today are really complicated,” Steinbaum said. “We need to figure out a way to take care of ourselves, too.”
Getting up and moving throughout the day is critical, she said — whether that means going to the gym, taking a walk or turning on music and dancing with your kids.
“Exercise is the best medicine,” Steinbaum said. “Make the time, as best you can, to get that 150 minutes of activity every week.”
A second study in the same issue highlights the importance of simply getting off the couch. It followed older women, finding that the less time women spent sitting or lying down throughout the day, the lower their risk of eventually suffering a heart attack or stroke.
The effect was independent of how much time women dedicated to exercise, like brisk walking. That, researchers said, suggests that older women benefit just from getting up and moving throughout the day.
More information
The American Heart Association’s Go Red for Women campaign has advice on heart disease prevention.
SOURCES: Melissa Caughey, Ph.D., instructor, division of cardiology, University of North Carolina School of Medicine, Chapel Hill; Suzanne Steinbaum, D.O., director, women’s cardiovascular prevention, health and wellness, Mount Sinai Hospital, New York City, and volunteer medical expert for American Heart Association’s Go Red for Women; Feb. 19, 2019, Circulation, online
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Fast Food Delivers Even More Calories Than Decades Ago

Fast food fans today are ordering off menus that have grown more apt to make them fat.
Portion sizes have risen dramatically over the past three decades at the most popular fast food restaurants in the United States, a new study has found.
As a result, the amount of calories and excess sodium has also increased among fast food offerings, said lead author Megan McCrory, a research associate professor with the Boston University College of Health and Rehabilitation Sciences.
Average portion size nearly quadrupled for fast food entrees, and more than quadrupled for desserts between 1986 and 2016, McCrory and her team discovered.
Calories and sodium content in entrees, sides and desserts also increased significantly.
Desserts packed on an extra 62 calories per decade, while entrees increased by 30 calories per decade, researchers reported.
Meanwhile, sodium increased by about 4.6 percent of recommended daily value for entrees each decade, and 3.9 percent of daily value for sides.
“The portion size increase is largely responsible for the increase in calories and sodium,” McCrory said.
Responding to the new study, the National Restaurant Association said it has championed menu labeling “to give customers the information they need to make healthier choices for their families.
“In 2008, we launched the Kids LiveWell program to promote consumption of fruit and vegetables, lean protein, whole grains and low-fat dairy, while limiting unhealthy fats, sugars and sodium,” the association said in a statement. “The association continues to educate members about the benefits of offering healthier menu items and participating in portion balance discussions with industry leaders.”
But the increases discovered in this research also reflect the “provocative” changes that have occurred in fast food within recent years, said Michelle Milgrim. She’s a registered dietitian and manager of employee wellness at Northwell Health in New Hyde Park, N.Y., and was not part of the study.
These changes include sandwiches that replace buns with fried chicken breasts, pizza crust filled with cheese, and bacon added to many menu items, Milgrim said.
“We’re seeing new items we’ve never seen before,” Milgrim said. “The American public is probably not necessarily picking up on the nuanced increases in portion size year over year, decade over decade, that these new items entail.”
Fast food restaurants are more popular than ever, with nearly 2 out of 5 adults eating fast food on any given day, researchers said in background notes.
The average amount of total daily calories represented by fast food has more than doubled, rising from 4 percent of total caloric intake in 1977-1978 to 11 percent in 2007-2010.
For this study, the researchers reviewed menu items offered at 10 popular fast food restaurants in 1986, 1991 and 2016. The restaurants were Arby’s, Burger King, Carl’s Jr., Dairy Queen, Hardee’s, Jack in the Box, KFC, Long John Silver’s, McDonald’s and Wendy’s.
Menus at these restaurants offer more selection than ever. The total number of entrees, desserts and sides increased by 226 percent, or about 23 items per year, researchers found.
But portion sizes also steadily increased over the years, a trend that reflects overall American eating patterns, McCrory said.
“I think we see an increase in portion size pretty much in the entire food supply,” McCrory said. “In some ways, the fast food restaurants are probably just keeping up with expectations of the size of the food people expect to be served. The same kind of things are happening in other restaurants that aren’t fast food.”
Milgrim said she’s most concerned with the steady increase in fast food’s salt content.
“These foods are just sodium-laden,” Milgrim said. “With obesity and hypertension as main causes of mortality among the American public, it’s so important for us to consider sodium.”
It’s not all bad news. Calcium and iron levels also increased in fast food over the years, meaning that folks are getting more of these important nutrients, McCrory said.
But given how calorie-rich fast food is, “there are better places to get calcium and iron,” McCrory added.
People who love fast food can take steps to cut back on calories, McCrory said.
They can split their fries or dessert with a friend, or order a single burger instead of a double, for example.
“They can still get the same taste, they would just be getting less calories,” McCrory said.
Even better, people can start considering fast food as a treat instead of a regular option.
“I understand fast food is an economical way to get food that tastes good, and you know what you’re getting when you go there,” McCrory said. “But it might be good to eat fast food less often, make it more of a special occasion instead of something that’s done regularly.”
The new study was published in the March issue of the Journal of the Academy of Nutrition and Dietetics.
More information
The Harvard T.H. Chan School of Public Health has more about healthy eating.
SOURCES: Megan McCrory, Ph.D., research associate professor, Boston University College of Health and Rehabilitation Sciences; Michelle Milgrim, R.D., C.D.N., manager, employee wellness, Northwell Health, New Hyde Park, N.Y.; March 2019, Journal of the Academy of Nutrition and Dietetics
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SAGE Therapeutics raises $575m ahead of FDA review date for Zulresso

In just under three weeks, Sage Therapeutics should hear back from the FDA on its filing for new antidepressant Zulresso, and the company has just raised $575m to help the commercial rollout if approved.
Sage already has a positive FDA advisory committee meeting in hand for GABAA modulator Zulresso (brexanolone) as a fast-acting, intravenous therapy for post-partum depression (PPD), and should get a verdict from the regulator by 19 March.
If approved, it could become the first product specifically indicated for PPD, which affects an estimated 400,000 women in the US each year and in severe cases it can raise the risk of suicide or even harm to the baby.
Unlike conventional antidepressants, which can take weeks to kick in, Zulresso starts working within two to three days of dosing and can lift women quickly out of the sadness, anxiety, irritability, and social withdrawal that can accompany PPD. It has a breakthrough designation from the FDA for PPD.
Topping the list of plans for the oversubscribed public placement is to build up Sages development and commercial capabilities ahead of a possible US launch for Zulresso, says the companys SEC prospectus for the fundraising.
It will also use the cash to accelerate the development of pipeline programmes including SAGE-217, a follow-up antidepressant with the same mechanism of action that Sage thinks has even more commercial potential than Zulresso.
SAGE-217 met its targets in a phase 3 trial in PPD reported at the JP Morganconference last month, and according to the company the candidate seems to offer rapid efficacy in tackling symptoms just like Zulresso but is less prone to causing side effects including loss of consciousness. It also has an FDA breakthrough designation for this indication.
The follow-up is also being developed in a phase 3 programme as a short oral course for major depressive disorder, with results due in 2020. It is also in earlier-stage studies for MDD plus insomnia as a maintenance therapy for depression and bipolar disorder.
The cash injection will also help Sage bring forward its lead neurology candidate SAG-324 for essential tremor and epileptiform disorders, and neuropsychiatry candidate SAGE-718 for cognition-related disorders such as Huntingtons disease, both of which are in phase 1 testing.
Shares in Sage rose 4% in the wake of the fundraising. The company has been repeatedly mentioned in dispatches as a possible takeover target by a big pharma group as its pipeline matures.
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Indivior Publishes Phase 3 Data on Buprenorphine Extended-Release

Indivior PLC (LON: INDV) announced that data from its pivotal phase 3 clinical trial evaluating the efficacy, safety and tolerability of SUBLOCADETM (buprenorphine extended-release) injection for subcutaneous use (CIII), were published by The Lancet. The 24-week trial met its primary and key secondary endpoints for both the 300/300 mg and 300/100 mg dosage regimens of SUBLOCADE, which demonstrated clinically and statistically significant differences in percentage abstinence from opioid use based on negative urine samples and self-reports of illicit drug use as well as treatment success defined as participants with =80% opioid abstinence during weeks 5-24, compared to placebo1.
“Findings show that SUBLOCADE administered by healthcare providers delivered sustained buprenorphine exposure for the entire monthly period while increasing abstinence rates and controlling craving and withdrawal symptoms for patients in this pivotal trial, compared to placebo. This represents an effective option in the treatment of opioid use disorder,” said Christian Heidbreder, Ph.D., Chief Scientific Officer of Indivior. “We are proud of the potential impact that these data represent for patients on their path to recovery from opioid use disorder and our continuing efforts to partner with the treatment community.”
The manuscript, published on February 18, 2019 in The Lancet, is titled “Efficacy and safety of a monthly buprenorphine depot injection for opioid use disorder: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.” This phase 3 study served as one of the key studies from the clinical development program that supported the U.S. Food and Drug Administration (FDA) approval of SUBLOCADE in November 2017.
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Amazon Plans Grocery Chain

Amazon.com Inc. is planning to open dozens of grocery stores in several major U.S. cities, according to people familiar with the matter, as the retail giant looks to broaden its reach in the food business and touch more aspects of consumers’ lives.
The company plans to open its first outlet, in Los Angeles, as early as the end of the year, one person said. Amazon has already signed leases for at least two other grocery locations with openings planned for early next year, this person said, without saying where those stores would be.
Additional talks are under way for Amazon grocery stores in San Francisco, Seattle, Chicago, Washington, D.C., and Philadelphia, the people familiar with the matter said.
The new stores would be distinct from the company’s upscale Whole Foods Market chain. It isn’t clear whether the new stores would carry the Amazon name.
After two decades of upending the retail industry by shifting shoppers to the internet, Amazon in recent years has become increasingly focused on physical retail, posing a threat to traditional grocers. The new chain would help Amazon in fulfilling a yearslong initiative to build out a physical grocery presence, which was at one point potentially envisioned to reach more than 2,000 brick-and mortar stores in a variety of sizes and formats
Amazon is also exploring purchasing regional grocery chains with about a dozen stores under operation, one person said, that could bolster the new chain.
While Amazon has already signed leases, that doesn’t guarantee it will open the grocery stores. Retailers sign contracts and then pull out or delay store openings if certain conditions aren’t met.
Amazon’s further push into physical retail is its latest move far beyond its origins selling books and music on the web. Over the years it has become a cloud-computing giant, a major player in Hollywood entertainment and a burgeoning provider of logistics services. More recently it has emerged as a major competitor in digital advertising and launched forays in finance and health care.
The company, which briefly took the crown of world’s most valuable public company early this year, also has taken steps to broaden its customer base to include lower-income consumers, such as by offering a discounted version of its Prime membership service to Americans who qualify for Medicaid and other government-assistance programs.
The new stores aren’t intended to compete directly with the more upscale Whole Foods stores and will offer a different variety of products, at a lower price point, these people said. Whole Foods doesn’t sell products with artificial flavors, colors, preservatives and sweeteners, among other quality standards.
Suppliers with big brands have hoped to have inroads into Whole Foods since Amazon bought the chain nearly two years ago. While Whole Foods has gradually expanded the big brands it carries — such as Honey-Nut Cheerios and Michelob beer — a conventional grocer can carry a much larger assortment of items.
Amazon has had mixed results with its food-delivery business, and it wants to better understand how it can cater to grocery shoppers, according to people briefed on the company’s strategy.
Supermarket operators Walmart Inc., Kroger Co. and others are also trying to find ways to offer delivery and pickup to customers in a more cost-efficient manner.
After The Wall Street Journal reported news of Amazon’s plans Friday, share prices of other supermarket operators tumbled, with Kroger losing 4.5% of its value and Walmart ending down 1.1%. Amazon shares rose 2% on the day.
Amazon’s new grocery brand also comes as the retailer rolls out its cashierless Amazon Go stores in urban areas. It is testing that checkout technology for bigger retail stores. Meanwhile, Whole Foods is expanding its national footprint.
For its new stores, Amazon is targeting new developments and occupied stores with leases ending soon. It could, for instance, consider a portion of a vacated Kmart, a person familiar with the matter said. Stores in the new grocery brand could be in strip centers as well as open-air shopping centers, the people said, and will be about 35,000 square feet, smaller than the typical 60,000-square-foot supermarket.
Amazon doesn’t want restrictions on the type of goods it may sell at its stores and wants the ability to change the store and sell health and beauty products for instance, the people familiar said. Leases in shopping centers often include limitations so that businesses complement rather than cannibalize each other.
It is unclear whether these new stores will be cashierless, but they will be heavily tilted to customer service and pickup capabilities, according to the people. Amazon is also looking to have some control over the attached parking lot to speed shoppers’ ability to get groceries, the people said.
Some analysts say a strategy where big retailers combine e-commerce with physical stores is the direction the industry is heading.
“Customers want to be able to shop when it is most convenient for them, which could be in-store, online or a combination of the two,” said a spokeswoman from the International Council of Shopping Centers.
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