Background:
Innovative, feasible and effective treatment strategies are urgently needed to address the obesity epidemic. While group interventions for weight loss have been shown to be efficacious, adherence is often low due to participant burden in attending in-person weekly meetings. Technology offers the potential for highly scalable intervention strategies that can be disseminated in diverse settings, and may improve access and adherence. This study assessed the feasibility and effectiveness of using virtual small groups for weight loss treatment.
Methods:
Obese men (BMI ≥30kg/m
2
) age 21-60 years, were recruited within a primary care clinic. We delivered an adapted Group Lifestyle Balance curriculum
,
based on the Diabetes Prevention Program lifestyle intervention, for 3-months using synchronous, encrypted, web-based video conferencing. Each session allowed for 8 participants and 1 facilitator, all attending from their own personal computer. Body weight was remotely monitored weekly using wireless scales. Participants (n= 48) were randomized to receive the intervention immediately following the baseline assessment, or 3-months later, as a delayed intervention control group. The main outcome of mean change in body weight was compared between intervention and control groups using student’s t-test.
Results:
Baseline characteristics did not differ between the intervention (n = 25) and delayed intervention control groups (n = 23). Intervention participants lost more weight than those in the delayed intervention control group, losing on average 4.3% (95% CI: -5.9%, -2.6%,
P
= 0.0004) of their initial body weight. The decrease in body weight was greater among men in the intervention group than in the delayed control group, with a mean difference of -3.9 kg (-5.9kg, -1.9kg,
P
= 0.0003) and mean difference for BMI of-1.2 kg/m
2
(-1.9 kg/m
2
,-0.4 kg/m
2
, P =
0.0021). On average, of the 12 weeks of the intervention, participants transmitted weekly weights 10.2 times (9.1,11.3) and attended 9.0 sessions (7.9, 10.0), or 74.7% (9 of 12) of total sessions offered.
Conclusion:
This pilot study is the first attempt to our knowledge to evaluate the delivery of a group behavior weight loss intervention via video conferencing in a primary care setting. Virtual small groups may be an effective means of healthcare service delivery and allow for face-to-face group interaction, while overcoming some barriers to access that a participant of an in-person program may face.
