Using Internet technology to deliver a behavioral weight loss program.

Brown Medical School/Miriam Hospital, Weight Control and Diabetes Research Center, 14 Third St, RISE Bldg, Providence, RI 02906, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 30.39). 04/2001; 285(9):1172-7.
Source: PubMed

ABSTRACT Rapid increases in access to the Internet have made it a viable mode for public health intervention. No controlled studies have evaluated this resource for weight loss.
To determine whether a structured Internet behavioral weight loss program produces greater initial weight loss and changes in waist circumference than a weight loss education Web site.
Randomized, controlled trial conducted from April to December 1999.
Ninety-one healthy, overweight adult hospital employees aged 18 to 60 years with a body mass index of 25 to 36 kg/m(2). Analyses were performed for the 65 who had complete follow-up data.
Participants were randomly assigned to a 6-month weight loss program of either Internet education (education; n = 32 with complete data) or Internet behavior therapy (behavior therapy; n = 33 with complete data). All participants were given 1 face-to-face group weight loss session and access to a Web site with organized links to Internet weight loss resources. Participants in the behavior therapy group received additional behavioral procedures, including a sequence of 24 weekly behavioral lessons via e-mail, weekly online submission of self-monitoring diaries with individualized therapist feedback via e-mail, and an online bulletin board.
Body weight and waist circumference, measured at 0, 3, and 6 months, compared the 2 intervention groups.
Repeated-measures analyses showed that the behavior therapy group lost more weight than the education group (P =.005). The behavior therapy group lost a mean (SD) of 4.0 (2.8) kg by 3 months and 4.1 (4.5) kg by 6 months. Weight loss in the education group was 1.7 (2.7) kg at 3 months and 1.6 (3.3) kg by 6 months. More participants in the behavior therapy than education group achieved the 5% weight loss goal (45% vs 22%; P =.05) by 6 months. Changes in waist circumference were also greater in the behavior therapy group than in the education group at both 3 months (P =.001) and 6 months (P =.005).
Participants who were given a structured behavioral treatment program with weekly contact and individualized feedback had better weight loss compared with those given links to educational Web sites. Thus, the Internet and e-mail appear to be viable methods for delivery of structured behavioral weight loss programs.

1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: High postpartum weight retention is a strong independent risk factor for lifetime obesity, cardiovascular disease, and type 2 diabetes in women. Interventions to promote postpartum weight loss have met with some success but have been limited by high attrition. Internet-based treatment has the potential to overcome this barrier and reduce postpartum weight retention, but no study has evaluated the effects of an internet-based program to prevent high postpartum weight retention in women. Fit Moms/Mamás Activas targets recruitment of 12 Women, Infants and Children (WIC) Supplemental Nutrition Program clinics with a total of 408 adult (>18 years), postpartum (<1 year) women with 14.5 kg or more weight retention or a body mass index of 25.0 kg/m(2) or higher. Clinics are matched on size and randomly assigned within county to either a 12-month standard WIC intervention or to a 12-month WIC enhanced plus internet-based weight loss intervention. The intervention includes: monthly face-to-face group sessions; access to a website with weekly lessons, a web diary, instructional videos, and computer-tailored feedback; four weekly text messages; and brief reinforcement from WIC counselors. Participants are assessed at baseline, six months, and 12 months. The primary outcome is weight loss over six and 12 months; secondary outcomes include diet and physical activity behaviors, and psychosocial measures. Fit Moms/Mamás Activas is the first study to empirically examine the effects of an internet-based treatment program, coupled with monthly group contact at the WIC program, designed to prevent sustained postpartum weight retention in low-income women at high risk for weight gain, obesity, and related comorbidities. This trial was registered with (identifier: NCT01408147 ) on 29 July 2011.
    Trials 12/2015; 16(1):573. DOI:10.1186/s13063-015-0573-9 · 2.12 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The Families Improving Together (FIT) randomized controlled trial tests the efficacy of integrating cultural tailoring, positive parenting, and motivational strategies into a comprehensive curriculum for weight loss in African American adolescents. The overall goal of the FIT trial is to test the effects of an integrated intervention curriculum and the added effects of a tailored web-based intervention on reducing z-BMI in overweight African American adolescents. The FIT trial is a randomized group cohort design the will involve 520 African American families with an overweight adolescent between the ages of 11-16 years. The trial tests the efficacy of an 8-week face-to-face group randomized program comparing M+FWL (Motivational Family Weight Loss) to a comprehensive health education program (CHE) and re-randomizes participants to either an 8-week on-line tailored intervention or control on-line program resulting in a 2 (M+FWL vs. CHE group) x 2 (on-line intervention vs. control on-line program) factorial design to test the effects of the intervention on reducing z-BMI at post-treatment and at 6-month follow-up. The interventions for this trial are based on a theoretical framework that is novel and integrates elements from cultural tailoring, Family Systems Theory, Self-Determination Theory and Social Cognitive Theory. The intervention targets positive parenting skills (parenting style, monitoring, communication); cultural values; teaching parents to increase youth motivation by encouraging youth to have input and choice (autonomy-support); and provides a framework for building skills and self-efficacy through developing weight loss action plans that target goal setting, monitoring, and positive feedback. Copyright © 2015. Published by Elsevier Inc.
    Contemporary clinical trials 03/2015; 42. DOI:10.1016/j.cct.2015.03.009 · 1.99 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A systematic review of randomized controlled trials was conducted to evaluate the effectiveness of eHealth interventions for the prevention and treatment of overweight and obesity in adults. Eight databases were searched for studies published in English from 1995 to 17 September 2014. Eighty-four studies were included, with 183 intervention arms, of which 76% (n = 139) included an eHealth component. Sixty-one studies had the primary aim of weight loss, 10 weight loss maintenance, eight weight gain prevention, and five weight loss and maintenance. eHealth interventions were predominantly delivered using the Internet, but also email, text messages, monitoring devices, mobile applications, computer programs, podcasts and personal digital assistants. Forty percent (n = 55) of interventions used more than one type of technology, and 43.2% (n = 60) were delivered solely using eHealth technologies. Meta-analyses demonstrated significantly greater weight loss (kg) in eHealth weight loss interventions compared with control (MD -2.70 [-3.33,-2.08], P < 0.001) or minimal interventions (MD -1.40 [-1.98,-0.82], P < 0.001), and in eHealth weight loss interventions with extra components or technologies (MD 1.46 [0.80, 2.13], P < 0.001) compared with standard eHealth programmes. The findings support the use of eHealth interventions as a treatment option for obesity, but there is insufficient evidence for the effectiveness of eHealth interventions for weight loss maintenance or weight gain prevention. © 2015 World Obesity.
    Obesity Reviews 03/2015; 16(5). DOI:10.1111/obr.12268 · 7.86 Impact Factor


Available from