EWING. A randomized controlled trial of a commercial Internet weight loss program. Obes Res. 2004;12: 1011-1018. Objective: To assess, in a 1-year randomized controlled trial, the efficacy of eDiets.com (a commercial Internet weight loss program) in improving weight, cardiovascular health, and quality of life. Research Methods and Procedures: Participants were 47 women with a mean age of 43.7 Ϯ 10.2 (SD) years and a mean BMI of 33.5 Ϯ 3.1 kg/m 2 . They were randomly assigned to either: 1) eDiets.com, a commercial Internetbased program available to the public; or 2) a weight loss manual (i.e., LEARN Program for Weight Control 2000). At baseline, participants in both groups met briefly with a psychologist who instructed them to follow the components of their program as closely as possible. Additional brief visits were provided at weeks 8, 16, 26, and 52 to review their progress. Change in weight was the main outcome measure. Results: At week 16, participants in eDiets.com lost 0.9 Ϯ 3.2% of initial weight compared with 3.6 Ϯ 4.0% for women assigned to the weight loss manual. At week 52, losses increased to 1.1 Ϯ 4.0% and 4.0 Ϯ 5.1%, respectively. Results of a last-observation-carried-forward analysis found that women in the manual group lost significantly (p Ͻ 0.05) more weight (at both times) than those treated by eDiets.com. (Results, however, of baseline-carried-forward and completers analyses did not reach statistical significance.) There were no significant differences between groups in changes in cardiovascular risk factors or quality of life. Discussion: This study provides consumers with important information about the probable benefits they can expect from participating in a popular Internet-based weight loss program.

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Objective: To evaluate the effects of weight loss on the risk of having metabolic syndrome after 1 year of treatment with lifestyle modification alone, pharmacotherapy alone (sibutramine) or the combination of the two. Design: Randomized, controlled, 1-year clinical trial. Patients: One hundred and eighty women and 44 men, 18-65 years of age, with a body mass index of 30-45 kg/m 2 , free of uncontrolled hypertension or type 1 or 2 diabetes. Intervention: Fifteen milligrams of sibutramine per day alone, lifestyle modification counseling alone, sibutramine plus lifestyle modification counseling or sibutramine plus brief lifestyle modification counseling. Measurements: The metabolic syndrome, as defined by the Adult Treatment Panel III. Results: Before treatment, 34.8% of the participants had the metabolic syndrome. Metabolic syndrome was more prevalent in Caucasians than African Americans (42.5 vs 20.3%; Po0.03), in males than females (65.1 vs 34.9%; Po0.002) and in older (444 years) than younger (p44 years) participants (47.5 vs 20.8%; Po0.0001). After 1 year of treatment, a moderate decrease in weight (8.078.7 kg) resulted in significant reductions in the prevalence of metabolic syndrome from 34.8 to 27.2% of all participants (Po0.02). Logistic regression analyses indicated that for each 1 kg of weight lost, the odds of metabolic syndrome were reduced by 8% (CI ¼ 0.89-0.97; Po0.003). Lifestyle modification either alone (Po0.04), or in combination with sibutramine (Po0.05), significantly reduced the prevalence of metabolic syndrome compared with sibutramine alone. The group effect was removed after controlling for weight loss. Conclusions: The metabolic syndrome was prevalent in over one-third of obese individuals who sought weight loss treatment, and the prevalence differed by age, sex and ethnicity. Moderate weight loss markedly reduced the odds of metabolic syndrome in this sample.

background:No previous research has examined the association between metabolic syndrome (MetSyn) and health-related quality of life (HRQoL) using standard criteria for defining MetSyn. We hypothesized that MetSyn would be associated with lower HRQoL on measures of physical and mental health. Methods and Procedures: Participants were 361 individuals in two randomized weight loss trials. MetSyn was defined by the National Cholesterol Education Panel criteria. The Medical Outcomes Study, Short Form-36 (SF-36) was used to assess HRQoL. Differences in HRQoL and in clinical and psychosocial characteristics were compared among participants with and without MetSyn. Multiple regression was used to determine predictors of HRQoL. Results: MetSyn was associated with lower scores on the physical function and general health subscales of the SF-36 and on the physical component summary (PCS) score. This association remained after controlling for age or depression but was eliminated by controlling for BMI. MetSyn was not associated with lower mental quality of life, a higher depression score, tobacco or alcohol use, or a higher rate of psychosocial stressors. Discussion: Individuals with MetSyn reported lower HRQoL. This appeared to be an effect of increased weight, rather than a unique effect of MetSyn. Larger studies are needed to assess whether MetSyn may have an independent effect on HRQoL.

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