Web-based intervention to promote weight-loss maintenance using an activity monitor: A randomized controlled trial

Abstract

The present study examined whether a web-based intervention could promote weight-loss maintenance, after weight loss. The study was a two-phase, 27-month, randomized controlled trial conducted in Ibaraki, Japan, from 2014 to 2017; 133 participants were recruited through local newspaper advertisements. The eligibility criteria were as follows: age of 40–64 years, body mass index of 25–40 kg/m2, and having at least one metabolic syndrome component. In phase 1, a 3-month, group-based weight-loss program was provided to all eligible participants (n = 119). We then randomly assigned (1:1) participants who had lost 5% or more of their weight during phase 1 (n = 95) to either the self-help (mean 3-month weight loss 7.30 kg) or the web-support group (7.00 kg). Participants in the web-support group regularly reported their body weight and physical activity through a web-based system. They received monthly personalized feedback from a study staff for 24 months. The primary outcome, 27-month body-weight change (mean ± standard deviation), in the self-help and web-support groups were − 5.3 ± 5.0 kg and −4.5 ± 4.9 kg, respectively. There was no significant difference. An exploratory secondary analysis demonstrated that those with greater 27-month increases in their step count, assessed with an accelerometer, lost more weight with no difference in changes in energy intake. The mean 27-month body-weight change in the 4th quartile of changes in step count was −7.78 kg. Although web-based intervention using an activity monitor failed to promote weight-loss maintenance, increased physical activity was associated with successful weight-loss maintenance.

What goes on in digital behaviour change interventions for weight loss maintenance targeting physical activity: A Scoping Review

“…Next, with smaller numbers, the study by Scott and colleagues [38] reported three MoAs and Wing and colleagues [44] reported only one. Four studies did not report any MoA (k = 4; 36%) [37,39,42,43].…”

“…The exception was the trial by Thomas and colleagues [39], in which the intervention group maintained an average weight loss of 10%, significantly greater than the comparative group. Physical activity outcomes were reported in six interventions, of these three reported no significant differences between groups [41][42][43], two observed a decrease in physical activity in the group receiving DBCI in comparison to those receiving personal contact [35,44], and one study found a small significant difference in which the intervention group was significantly more physically active than the control group [45,46].…”

“…Only three studies provided wearable technology to monitor physical activity, i.e., activity monitors (27%; [38,[43][44][45]), and four studies provided wireless weighing scales (36%; 38,[43][44][45]). All but one study provided also provided a weighing scale to the control group [43].…”

“…Five studies (45%) provided detailed information about the duration of the contacts and interactions [35,42,43,45,47]. Two studies reported the order of presentation of intervention content [37,45] (full details in Supplementary File 4).…”

“…The "WLM Website BFS" intervention [35] reported one face-to-face orientation session and one reorientation group session at the twelfth month; the "Motimate" intervention [41] reported to have five clinic visits over the period of twenty four weeks; the NoHoW trial [38] was reported to have twenty six automatically delivered emails; the study by Nakata and colleagues [43] reported twenty four monthly personalized text messages; and Thomas and colleagues [39] reported that the Weight Loss Clinics study had twenty six email contacts with each participant plus six emails asking weight.…”