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It’s the Age of Ozempic. Do We Need Weight Watchers Anymore?

May 30, 2023 6:00 AM

It’s the Age of Ozempic. Do We Need Weight Watchers Anymore?

CEO Sima Sistani is eager to leave problematic notions of weight loss behind and keep her company relevant in the midst of a drug-fueled revolution.

Sima Sistani on a terrace overlooking NYC standing next to a sign that reads OFFICE with an arrow underneath.
Photograph: Tonje Thilesen

Schaub’s burgers and melted ice cream: Those are the food items logged in my memory from the night I first met Sima Sistani. This was a decade ago, before she became the chief executive of Weight Watchers. Sistani was working at Yahoo, and I had just moved to Silicon Valley. A mutual friend connected us, and Sistani invited me over for dinner. I accepted with “What can I bring?”

This is how I ended up buying charcoal-colored beef patties at her preferred butcher. That night we talked about Yahoo’s content business. We talked about Sheryl Sandberg’s Lean In. We talked for so long the ice cream became soup in our bowls. It was some kind of indoctrination into the Valley. It was also evident that Sistani wanted to be someone. Her sharp observations about the tech industry continued long into the night. What wasn’t obvious—because why would it be, and whose business was it anyway—was that Sistani was logging her food in the Weight Watchers app. She and her husband had recently had their first baby, Adrian, and she was attempting to lose the weight she’d gained during pregnancy.

Sistani’s career has been a winding one. After jobs at Goldman Sachs, Creative Artists Agency, and a short-lived tech startup, she became the head of media for Yahoo-owned Tumblr. Then the VP of media for Meerkat, a buzzy livestreaming video startup. Sistani and a Meerkat founder decided to stealthily launch a second live-video app, called Houseparty. In 2019, Epic Games acquired that venture for a reported $35 million.

Sistani didn’t need to work again, but in 2020 she contacted Weight Watchers and expressed interest in advising the company on its digital strategy—planting a seed that would eventually result in the chief executive role. Something about the company's emphasis on community was appealing. It was, in fact, this sense of community that had set the company apart from its earliest days. Weight Watchers started in 1962 in Jean Nidetch’s living room, and by 1968 it had a million members across the world.

In 2018, Weight Watchers attempted a rebrand, changing its name to “WW” and focusing on general well-being instead of dieting. The company tried to capitalize on the wellness movement that people were gravitating toward as a kind of salve for society’s ills. (And we hadn’t even lived through a pandemic yet!) It didn’t go well.

When Sistani took the helm in March of 2022, Weight Watchers was set to record a loss of over $250 million that year. The pandemic had nearly killed its in-person retail business, but its digital business, which charges for access to science-backed nutrition plans and a “members only” social network, was also in decline. Sistani was brought in to chart a digital path through a post-pandemic world, to give the service more social juice both online and offline.

Of course, the company's renewed mission is now colliding head-on with the body positivity movement, which encourages acceptance instead of weight change, and competing with digital apps (like Noom and MyFitnessPal) and drugs (like Ozempic) that promise to make dropping pounds oh so easy. It’s weight-loss whiplash. What a time to be the new CEO of Weight Watchers, a service that, despite its millions of still satisfied subscribers, has hoards of critics calling its points-based system the epitome of unhealthy diet culture.

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So in April I asked to spend some time with Sistani and met her at Shiraz Kitchen and Wine Bar, a Persian restaurant in Manhattan’s Chelsea neighborhood. The next day, I made my way to the high-ceilinged Weight Watchers offices on Sixth Avenue. I sat with Sistani in her private office and in various meetings—including one where staffers talked about new weight-loss medications, at length.

Tuesday April 18—Shiraz restaurant

[A server comes over to deliver a platter of desserts and three mugs of tea.]

Server: This is a baklava. This is a Persian love cake. That’s a chocolate mousse. That’s saffron ice cream.

Lauren Goode: Oh wow.

Sima Sistani: Thank you very much.

How many points is this?

Oh, I can do this in my head. Right off the top I would say … each one of these is going to be 5 points. My guess here [points to baklava] is the nuts are going to drive this one higher. I bet this [points to ice cream] is like, 8 points.

And then the chocolate mousse is anyone’s guess.

Yeah, well, “Everything’s on the menu.” You really have to try this saffron ice cream. It’s got rosewater flavor in it. It’s ice cream, but it doesn’t taste like ice cream. It’s a Persian delicacy.

You’re a first-generation American, right?

I was born in Texas. I grew up in Alabama, but my parents were immigrants from Iran. They didn’t expect to stay here. My dad was getting his master’s degree in soil science here, and then Iran imploded. When my mom got pregnant with me, the war and the Iran hostage crisis were happening, and my mom said, “You know what, we’re not going back.”

I’m taking us on a tangent, but the year I graduated from Duke, my mom got her PhD in food science. She’s also a registered dietician. The year I got the job at Weight Watchers, my mom became chair of her department of consumer sciences. It ends up coming full circle.

Sima Sistani
Photograph: Tonje Thilesen
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Your prior job was at Epic, after the company acquired Houseparty. From social video games to weight management—what’s the connection there?

You know, when I moved to North Carolina because I was taking the job at Epic, I thought, “I’m leaving my career behind.” Because my career was Silicon Valley, and I was moving out here.

But when Weight Watchers came up, it was a moment to say, “Oh, I can just take all those learnings and things that happened in my past and I can apply them to a totally different business and industry. The things I’m passionate about, like growth tech and the social internet, I can apply to networks that will actually have massive health outcomes.” That was eye-opening for me.

And you decided you would essentially commute from North Carolina to New York City. Did you take time off between Epic and Weight Watchers?

We did have one week. My first day at Weight Watchers was March 21—because I’m a little witchy, I wanted it to be the Persian new year. March 21 is the vernal equinox. [She rolls up her sleeve.] This is 14 in Farsi, in my mother’s handwriting. My father has this tattoo and my brother does too. Fourteen is the date of my son Adrian’s birthday, my daughter Ariana’s birthday, my brother’s birthday, my parents’ anniversary. When we moved to North Carolina, it was on June 14 of 2021. I accepted this job on February 14 of 2022 … I’m not planning this stuff.

Witchy? What do you mean by that?

Oh, it just means that I believe in a higher power. I believe in doing good and in karma, the golden rule. I didn’t grow up with religion. Technically I’m Muslim, but my parents never ascribed to organized religion. But growing up in the South in a very Christian community where kids would go to summer camps, I did wish for religion. Sometimes I feel sad that I’m not taking my kids to those places, because there’s really great community there. Where I’ve netted out in my life is, it’s a mountain. I believe in a higher power and that different people just have different paths up the mountain. And I describe it as “witchy” because “agnostic” suggests you don’t care.

Your community is largely women, right? And you, as CEO, have a sphere of influence. If push came to shove, what’s your position on women’s health in places like North Carolina, where you live, or New York, where you work?

Yes. And our employees are 75 percent women. And so we were very clear [when Roe vs. Wade was overturned] that we would help our employees have access to reproductive rights, no matter where they are. Last year, we [also] did a lot of work on food insecurity.

So what is on your docket now?

Well the onus is on us again because now we’re having this conversation about these GLP-1 [diabetes] medications. Most people who are taking them are either paying cash or they’re working for a company like ours and have insurance coverage. Which means that the communities that need it most do not have access. So that’s a place we can try to move policy so that Black and brown communities that need it more than most of the rest of the population have access.

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Wednesday April 19—at the Weight Watchers headquarters

In your marketing meeting just now, your team really leaned on the story of Jean Nidetch for the 60th anniversary campaign. Tell me about Jean.

That was one of the craziest things I discovered when I joined. Weight Watchers is a company founded by this woman Jean Nidetch, and—especially when the world went through its Girl Boss moment—nobody talks about her. When she first started this company, she couldn’t even sign the lease. Her husband had to sign it for her. And then she got divorced and started dating Fred Astaire. … Her story is wild.

So in a way you are tied to this legacy brand, but you’ve been brought in to reshape it and to propel a digital transformation and to bring in new customers. Let’s say I’m a proxy for that new person coming in. I don’t understand the slogans and phrases. I have no idea who Jean is. How do you transform Weight Watchers?

You know, the whole move to calling the company WW in 2018 was a glossy way of trying to be like, “We’re wellness, we’re wellness.” But I decided, “No, let’s have the hard conversation.” What we’re trying to say is that living overweight and with obesity is a health detractor. If we want to be the best at helping people manage their weight, the conversation is about weight and health. That’s why you come to us. Not for meditation or sleep advice or fitness. To answer your question, “Who are we, authentically?” That’s what we are. WW is fine, but we’re going to re-embrace the Weight Watchers of it all.

What does that mean?

Now we are having the hard conversation about what that means in a world of body acceptance. What does that mean in a world where there’s so much stigma and bias against people who live with overweight and obesity? Let’s try to reduce the shame around that conversation. I can’t tell you how many times I’ve listened to a podcast where people say, “Well, it’s a bunch of white men trying to get us to shrink ourselves for the male gaze.” And I’m like, “Excuse me: woman of color here running this company. No.” That’s not why I would ever come here. There’s a lot of misinformation about who we are, why we exist in the world. And, yes, some of that is rooted in a part of our past.

Sima Sistani
Photograph: Tonje Thilesen
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Do you think it’s possible today to have a conversation about weight in general where it’s positive?

That’s what we’re trying to get at.

But it’s extremely hard, right?

It’s incredibly hard. I think that the narrative has shifted to the idea that if you are talking about the desire to lose weight, that it is somehow at odds with body positivity and body acceptance. And it all lives within this conversation around the patriarchy. That’s an important conversation. But we’ve jumped the shark a bit in saying, “Well, that means we need to also be OK with sick bodies.” For me the positive part of the conversation is, “We all come in different shapes and sizes and everything, but we also need weight health.”

That’s the pivot that we’re trying to make. Even right now, the clinical conversation has become, “Well, people are going and getting these medications and taking them away from people with diabetes.” There’s bias in that statement right there. You are saying that somebody who’s living with obesity is less important than somebody living with diabetes, and you are also saying that that is not a chronic condition that deserves care.

Within the conversation about who should get Ozempic or any of these appetite-inhibitor medicines, there’s still a broader assumption that being overweight does equal unhealthy. And for some people, being a larger body, having a larger frame, carrying extra weight—who actually makes that judgment that that is unhealthy?

Scientists. There’s a body of science that says that if you are living overweight and/or with obesity, even if you are healthy at this moment, you are more likely to develop cancer or heart disease, high cholesterol, diabetes. To me, this is like the anti-vaxxer conversation. And there is—

In what way?

Meaning, there are people who are going to look at a certain set of data and they’re going to see it one way and some people who are going to not accept that data and believe that it comes from a biased source. The data is there, and the data says that if you’re living with overweight and obesity that this is a chronic condition.

There are some data sets that are problematic, though, and there have been studies around certain health measurements where their methodology is not correct either. Take BMI as an indicator of health and weight—

Which is true. BMI, I totally agree, is in some respects a problematic metric. But over time the science—the community of medical doctors and scientists who have used it—has come to say, “Well, it is still the best metric that we have.” There are also all of these beyond-the-scale metrics that people take into account. I think that’s important until we come up with a better measurement than BMI.

It just seems like that sets people up against impossible metrics.

But the hard part is that we’re all knocking heads with each other. Whether you say “I would like to lose weight because my joints hurt” or “I would like to lose weight because I have a history of heart disease in my family” or, in my case, “I would like to lose weight because I gained 60 pounds when I had my baby and I don’t feel good in my body”—who are we to judge?

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The social internet has elevated these conversations to such heated, polarized levels. If somebody chooses that they want to lose weight because they want to live a healthier life, the fact is there’s now this backlash. I mean, you obviously see it with celebrities and influencers who post about this, but I think you also see it in smaller groups. When I was trying to lose weight, I felt a lot of shame saying, “I’ll get the salad at lunch” because it was like, “Oh, what, you’re not eating?” Immediately there was this feeling, “Do you have disordered eating?” I was like, “No, I’m just trying to be healthy right now.” I wanted to get back into my clothes. I want to be able to walk without losing my breath. And I couldn’t lose the weight.

And you did Weight Watchers then, right?

I did. I also had developed a thyroid condition through the pregnancy, so for me, there was a clinical intervention as well. Synthroid was a part of my therapy to get back to a place where I felt healthy again. But I feel like that is what connects me to this member community because it’s a really emotional experience. I’ve never worked on a product before where emotion was so at the center of it.

You’ve just overseen the multimillion-dollar acquisition of Sequence, a telehealth company that facilitates appointments with weight-loss clinicians. How will this work?

We’re still figuring out the integration. But in general what they’re doing is providing access to a clinician who can say whether or not it’s medically appropriate to be on medications. And then if it is, now you are creating an easier adherence to our traditional Weight Watchers behavior-change, nutrition-science program.

These medications and the clinical trials that are showing 15 to 20 percent weight loss after a year, those clinical trials involve combination therapy. The people are taking the medications and being advised by a nutritional and lifestyle expert to actually have a better diet alongside it. I mean, I can’t tell you the misinformation behind all of this. “I want to take these drugs so I can eat all the pizza and ice cream that I want.” That’s not how it works.

So the synergy … God, I hate that word … the complement—come on, somebody come up with something better—where we can combine to create an experience that I think doesn’t exist in the world is when somebody goes to a GP to get medications, their doctor doesn’t really understand obesity therapies. My brother is a doctor, and throughout his whole education he had one class on nutrition. One class!

There’s also something in hearing you talk about Ozempic and drugs like it that feels like it’s an inevitability. That the horse is out of the barn. And you want to be a part of that rather than being left behind. Is that accurate?

The way I would describe it is there’s a massive paradigm shift, a huge innovation in science. And of course we would embrace it. But to me it’s not about being left behind. That’s not the way I think in general.

When I joined Weight Watchers, I actually didn’t know about these medications. I saw we had all these PhDs working here, people with my mom’s level of education who are studying and understanding the sciences and the new innovations. For 60 years, everything we’ve done has been evidence-based. When everybody was all about, say, Atkins, Weight Watchers never got on that bandwagon. We’re always: Everything in moderation. Everything’s on the table.

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And then at the scientific advisory board meeting, my first month here, they did a readout on all the clinical trials that were happening with these medications. The FDA had approved Wegovy. We dug into it. We even met with Novo Nordisk, really trying to understand what is happening. And I just thought, “We’ve unlocked this amazing thing. How can we embrace it? How can we take it and help our members? We have a significant lapsed membership base, some of whom are lapsed because they had success on the program and moved on, but others who lapsed because our program alone couldn’t help them. And so here’s this opportunity to help people.”

A friend said the other day, “Why would I ever use Weight Watchers if we’re all getting shots someday that are going to suppress our appetites?”

That probably comes from somebody who’s privileged and understands healthy eating. For a lot of people, they’re still going to need education. We’re now able to address the hungry gut through the medications, but still the part that is missing is the hungry brain. It’s about understanding foods with high nutrient density, ways for me to ensure that I’m protecting my lean muscle mass. Those are all going to be important to the medications working well long term.

Can you explain the difference between the hungry gut and the hungry brain?

Behavior change therapy addresses cognitive patterns—the hungry brain—but there is only so much that you can adhere to with behavioral modification if your biological factors are working against you—the hungry gut. The dual-action support with medications and behavioral interventions allows members [with this chronic condition] to make behavioral changes more easily as each—brain and gut—is provided with the necessary support.

You’re already seeing that, by the way. If you go on TikTok, you’ll find a lot of people who are on the medications who are doing it alongside Weight Watchers.

I often ask technologists this: A lot of these innovations, as exciting as they are, are predicated on the idea that most of them will be used for good. I also think about scenarios in which a doctor rejects a patient for potentially life-saving medications because they see in the Weight Watchers app, “Oh, but you’re not actually eating that healthy.” I mean, that judgment happens now. They think they’re lazy. That’s it.

There’s a lot in there. One part that is interesting, with regard to how we’re entering the medication space, is that we’ve heard from people that they don’t want to go to their general practitioners who have told them their whole life, “Just lose the weight, just eat healthier.” Many of these people have had chronic conditions that weren’t recognized. It wasn’t about their own behavior. So they’re more likely to choose this kind of pathway—because of the shame that they experienced in those offices.

The separate thing then is, if you are on these medications, are you going to change your diet alongside them? That’s a tough one. If you are hypertensive and you’re taking ACE inhibitors but you still eat steaks and high-sodium foods, does that mean you shouldn’t receive the medication? That seems like a wild judgment that I would not make.

Going back to the question you started with, which was like, “Did you feel like you would be left behind or what does this mean for your core program?” To me, it’s even interesting that you’re asking that question here. Because the difference is we would never judge, for instance, a more traditional tech company for introducing new features or adopting AI or trying to do the new thing.

Oh, we do judge them a lot though.

You think?

Well, it depends. But yes.

But also, we all have this expectation and desire for those companies, the establishment, if you will, to disrupt themselves and understand when maybe in the past they were wrong or when they could be doing better. And so the question is, “What can we do better?” I think here, this an opportunity for us to say, “Oh wow, we didn’t recognize the hungry gut for most of our existence. But science has evolved now, we know more, we’ve learned more, we’re going to do better for those members.” That’s how I see it.

Let us know what you think about this article. Submit a letter to the editor atmail@wired.com.

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Lauren Goode is a senior writer at WIRED covering consumer tech issues. She focuses on the intersection of new technologies and humanity, often through experiential or investigative personal essays. Her coverage areas include communications apps, trends in commerce, AR and VR, subscription services, data and device ownership, and how Silicon… Read more
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