Maintenance of Weight Loss in Overweight Middle‐aged Women Through the Internet

Abstract

Objective: The purpose of this study was to compare weight regain in a group of perimenopausal women (48.0 ± 4.4 years old), randomized to a 12-month weight maintenance Internet intervention or to self-directed weight maintenance after a 4-month weight loss treatment. Methods and Procedures: After a 4-month behavioral weight loss program, 135 women were randomized to either Internet or self-directed groups. The Internet group (n = 66) used a website to gain information and complete logs concerning their weight, diet, and exercise progress over a 12-month follow-up. The 69 self-directed women had no contact with study staff. All women were measured for weight and body composition, and diet intake, and were interviewed using the 7-day physical activity questionnaires at baseline, 4 months, and 16 months. Results: At the end of the 12-month follow-up, the Internet and self-directed groups had regained on average 0.4 ± 5.0 kg and 0.6 ± 4.0 kg, respectively (P = 0.5). In within-group analyses, Internet diet-log entries were correlated with follow-up weight change (r = −0.29; P < 0.05) and moderately with change in exercise energy expenditure (EEE; r = 0.44; P < 0.01). Follow-up weight change was not correlated with change in dietary intake. Discussion: While significant weight loss was maintained over follow-up by both groups of women, Internet use did not surpass self-direction in helping to sustain weight loss. Among Internet users, Internet use was related to weight change and EEE.

Effect of web-based lifestyle modification on weight control: a meta-analysis

“…Moreover, another finding from the stratified analyses was that the Web-based programs did not have a significant additional weight-loss effect unless their use was combined with face-to-face support. These results suggest that an in-person contact 29 Instruction, self-monitoring and counseling Counseling, self-monitoring or only material Maintenance Cussler et al 30 Instruction, self-monitoring and counseling Self-directed Maintenance Hunter et al 31 Instruction, self-monitoring and counseling Counseling via phone Self-help Loss Digenio et al 32 Counseling Material Material with counseling (via phone or face-to-face) or only material Loss Patrick et al 18 Instruction Counseling Material Loss van Wier et al 19 Instruction and counseling Material Material Loss Morgan et al 33 Instruction and self-monitoring Material Loss Ueki et al 34 Instruction and self-monitoring Instruction via fax/mail and supplemental food (jelly) Effect of lifestyle modification on weight control S Kodama et al approach is superior to a technology-based approach from the viewpoint of the amount of weight loss; if used, an Internet program needs to include the component of a faceto-face program for participants to achieve weight loss. It is known that social support is one of the important aspects of behavioral obesity treatment and is associated with better weight-loss outcomes.…”

“…Table 2 shows details of the obesity treatment programs in each included study. To summarize the study-specific Webbased programs in terms of the role of the Internet, 16 studies [18][19][20][23][24][26][27][28][30][31][33][34][35][36][38][39] used the Internet as an adjunct to the non-Web-based obesity care support provided in both control and experimental groups. One study 25 used it as a substitute for face-to-face counseling.…”

Adaptive e-learning to improve dietary behaviour: a systematic review and cost-effectiveness analysis.

“…Other interventions sought to increase fibre intake, 44,45,55,59,[80][81][82] Comparators used in included studies Table 4 shows a summary of comparators used in the studies. Fourteen studies 44,[48][49][50][51]53,54,56,59,69,74,77,79,80 trialled the intervention against a non-intervention control group. Three studies 47,55,58 used attention controls, whereby participants in the control group received non-adaptive information on a similar topic, or received a similarly interactive intervention, but on an unrelated health topic.…”

“…All e-learning interventions were delivered in high-income countries, and the majority of interventions were delivered in the USA [42][43][44][45][47][48][49][50][51][52][53]55,56,58,59,62,64,66,[70][71][72][73][74][75][80][81][82][83][84] research groups dedicated to e-learning and diet research; hence, the geographic clustering of studies. For example, a single large e-learning research group produced all eight RCTs set in the Netherlands and Belgium.…”

The Effect of Computers for Weight Loss: A Systematic Review and Meta-analysis of Randomized Trials

“…[15][16][17][18] To overcome some of these barriers, an increasing number of weight loss interventions have used computer technology to deliver education, support, and self-monitoring strategies. [19][20][21][22] It has been suggested that the interactive nature of computers provides a persuasive advantage when compared to other media 23 and assists social learning by providing users with feedback, modeling of desired attitudes or behaviors, and social dynamics and support. 24,25 Such interventions have been found to be useful in treating a variety of conditions including depression 26 and post-traumatic stress disorder, 27 and in promoting self-management of chronic disease.…”