Web‐based Weight Loss in Primary Care: A Randomized Controlled Trial

Abstract

Evidence is lacking regarding effective and sustainable weight loss approaches for use in the primary care setting. We conducted a 12-week randomized controlled trial to evaluate the short-term efficacy of a web-based weight loss intervention among 101 primary care patients with obesity and hypertension. Patients had access to a comprehensive website that used a moderate-intensity weight loss approach designed specifically for web-based implementation. Patients also participated in four (two in-person and two telephonic) counseling sessions with a health coach. Intent-to-treat analysis showed greater weight loss at 3 months (−2.56 kg; 95% CI −3.60, −1.53) among intervention participants (−2.28 ± 3.21 kg), relative to usual care (0.28 ± 1.87 kg). Similar findings were observed among intervention completers (−3.05 kg; 95% CI −4.24, −1.85). High rates of participant retention (84%) and website utilization were observed, with the greatest weight loss found among those with a high frequency of website logins (quartile 4 vs. 1: −4.16 kg; 95% CI −1.47, −6.84). The intervention's approach promoted moderate weight loss at 12 weeks, though greater weight loss was observed among those with higher levels of website utilization. Efficacious web-based weight loss interventions can be successfully offered in the primary care setting.

Interest in a Twitter-delivered weight loss program among women of childbearing age

“…We found that a greater proportion of women were interested in reading about other women's progress via their tweets (83 %) than were interested in tweeting about their own progress (71 %). Despite evidence that engagement is strongly related to outcomes [35][36][37][38][39][40], waning use is common in web-based behavioral interventions [41]. More frequent engagement in an online social network for weight loss is associated with better outcomes [22].…”

Economic Analyses of the Be Fit Be Well Program: A Weight Loss Program for Community Health Centers

“…The BFBW intervention was an evidence-based, moderate intensity, pragmatic intervention, 28,29 designed to produce weight loss through the modification of obesogenic lifestyle behaviors. Participants received tailored behavior change goals and tailored "prescriptions" for weight-related behavior changes signed by their provider.…”

“…It was challenging to accurately estimate the computer and IVR costs for the project, partially because the Webbased program was largely adapted from prior work; 28 and the fact that the IVR contract included costs for piloting, implementation, quality control, data transfer and overhead costs that did not vary by the number of users. We conservatively estimated that only the latter three categories would be needed for replication of the intervention, so the combined eHeath Technology cost (for both Web and IVR) was estimated at $32,499.…”

Can metabotyping help deliver the promise of personalised nutrition?

“…There is a wealth of studies examining the effect of personalised programmes on weight loss (18)(19)(20)(21)(22)(23) as depicted in Table 2. Bennett et al conducted a 12-week randomised controlled trial among obese primary care patients with hypertension (n 101) (20) .…”