Telemedical Coaching Improves Long-Term Weight Loss in Overweight Persons: A Randomized Controlled Trial

Abstract

Background Lifestyle interventions have shown to be effective when continuous personal support was provided. However, there is lack of knowledge whether a telemedical-approach with personal coaching contributes to long-term weight losses in overweight employees. We, therefore, tested the hypothesis that telemedical-based lifestyle interventions accompanied with telemedical coaching lead to larger weight losses in overweight persons in an occupational health care setting. Methods Overweight employees (n=180) with a body mass index (BMI) of >27 kg/m2 were randomized into either a telemedical (TM) group (n=61), a telemedical coaching (TMC) group (n=58), or a control group (n=61). Both intervention groups were equipped with scales and pedometers automatically transferring the data into a personalized online portal, which could be monitored from participants and coaches. Participants of the TMC group received additionally one motivational care call per week by mental coaches to discuss the current data (current weight and steps) and achieving goals such as a healthy lifestyle or weight reduction. The control group remained in routine care. Clinical and anthropometric data were determined after the 12-week intervention. Additionally, weight change was followed up after 12 months. Results Participants of TMC (-3.1 ± 4.8 kg, p<0.0001) and TM group (-1.9 ± 4.0 kg; p=0.0012) significantly reduced weight and sustained it during the 1-year follow-up, while the control group showed no change. Compared to the control group only weight loss in the TMC group was significantly different (p<0.001) after 12 months. TMC and TM group also reduced BMI, waist circumference, and LDL cholesterol. Moreover, TMC group improved additionally systolic and diastolic blood pressure, total cholesterol, HDL cholesterol, and HbA1c. Conclusions Telemedical devices in combination with telemedical coaching lead to significant long-term weight reductions in overweight persons in an occupational health care setting. This study is registered with NCT01868763, ClinicalTrials.gov.

Weight Reduction by the Low-Insulin-Method—A Randomized Controlled Trial

“…Telemedical coaching . The education program was continuously supported by telemedically supported coaching [ 25 ]. Coaching sessions included information about coping strategies for lifestyle changes, healthy diet for maintaining insulin levels low, physical activity, motivation and overweight or obesity-related diseases like type 2 diabetes.…”

“…Data, which had been acquired from the telemetric devices (which could be monitored by coaches and participants during the whole study), were discussed within the coaching sessions (i.e., steps, weight). Furthermore, participants were motivated to achieve their individually determined goals (i.e., weight goals, step counts) using the medical mental motivation program [ 25 , 27 ], and negative developments regarding recorded data were evaluated and discussed with the participants. Therefore, coaching sessions were also used to increase the study compliance and adherence of probands by coaches.…”

“…Therefore, we have developed the Low-Insulin-Method and integrated it into to multicomponent occupational healthcare program SHAPE-AND-MOTION-Medical-Accompanied- Slimming (SAMMAS) that aims to lower insulin levels in order to allow for effective lipolysis. In previous studies we have shown that lifestyle interventions of our Low-Insulin-Method, including a low-carbohydrate meal replacement [ 20 , 21 , 22 ], self-monitoring of blood glucose (SMBG) [ 23 , 24 ], telemedical monitoring with telemetric devices [ 25 , 26 ] and telemedical coaching including medical mental motivation [ 20 , 27 ], lead to clinically relevant improvements in body weight and other cardiometabolic parameters in different cohorts. In this randomized controlled trial (RCT), we combined these evaluated lifestyle intervention components and tested the hypotheses that (i) the application of SAMMAS in an occupational health care setting for 12 weeks supports clinically relevant weight loss in individuals with overweight or obesity compared to a control group and (ii) the long-term effects on weight-loss as well as on laboratory, anthropometric and behavioural parameters after 52 weeks.…”

Ketogenic diets: Opportunities and limitations in practical application (LITERATURE REVIEW)

“…Insulin in overweight patients does not only suppress lipolysis but also slows down fat absorbtion. Unfortunately, insulin makes it more effectively when the body weight is higher, which was reported by a research team from Basel University Clinic (156,159). It was shown that glucose load in patients with body mass index ≥ 30 kg/m 2 increases the level of insulin more than when BMI ≤ 25 kg/m 2 .…”

“…The target can be achieved not only in T2D patients, but also in people, only susceptible to overweight. According to a recently published research in Dusseldorf (156), where the use of an intervention program aimed at changing the way of life under supervision of a medical team led to a significant loss of weight and improved metabolic control in overweight patients at risk for diabetes.…”