The Internet for weight control in an obese sample: results of a randomised controlled trial

McConnon, Áine; Kirk, Sara F. L.; Cockroft, Jennie E.; Harvey, Emma; Greenwood, Darren C.; Thomas, James; Ransley, Joan K; Bojke, Laura

doi:10.1186/1472-6963-7-206

Cited by 116 publications

(208 citation statements)

References 23 publications

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“…age and BMI were 46 (±6) years and 32 (±3) kg m À2 , respectively. Of the 22 studies that provided the study-specific minimum BMI to define overweight or obesity, the value was X25 kg m À2 to o 30 kg m À2 except in three studies 26,35,38 that used a BMI o25 kg m À2 cut-off value for being overweight and three studies 28,32,36 that exclusively targeted participants with a BMI X30 kg m À2 . Most of the studies (17 studies) used an intent-to-treat analysis.…”

Section: Data Synthesismentioning

confidence: 99%

“…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.…”

Section: Data Synthesismentioning

confidence: 99%

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

et al. 2011

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Objective: Web-based treatment programs are attractive in primary care because of their ability to reach numerous individuals at low cost. Our aim of this meta-analysis is to systematically review the weight loss or maintenance effect of the Internet component in obesity treatment programs. Methods: MEDLINE and EMBASE literature searches were conducted to identify studies investigating the effect of Web-based individualized advice on lifestyle modification on weight loss. Randomized controlled trials that consisted of a Web-user experimental and non-Web user control group were included. Weight changes in the experimental group in comparison with the control group were pooled with a random-effects model. Results: A total of 23 studies comprising 8697 participants were included. Overall, using the Internet had a modest but significant additional weight-loss effect compared with non-Web user control groups (À0.68 kg, P ¼ 0.03). In comparison with the control group, stratified analysis indicated that using the Internet as an adjunct to obesity care was effective (À1.00 kg, Po0.001), but that using it as a substitute for face-to-face support was unfavorable ( þ 1.27 kg, P ¼ 0.01). An additional effect on weight control was observed when the aim of using the Internet was initial weight loss (À1.01 kg; P ¼ 0.03), but was not observed when the aim was weight maintenance ( þ 0.68 kg; P ¼ 0.26). The relative effect was diminished with longer educational periods (P-trend ¼ 0.04) and was insignificant (À0.20 kg; P ¼ 0.75) in studies with educational periods of 12 months or more. Conclusion: The current meta-analysis indicates that the Internet component in obesity treatment programs has a modest effect on weight control. However, the effect was inconsistent, largely depending on the type of usage of the Internet or the period of its use.

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Section: Data Synthesismentioning

confidence: 99%

Section: Data Synthesismentioning

confidence: 99%

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

et al. 2011

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“…One compared automated online advice and education delivered with or without church-based supports (e.g., prompts and reminders from the pulpit and in church bulletins) to a control arm, finding minimal weight change in any arm at the end of 16 months followup (46) . The other study found that automated tailored advice and email reminders showed no difference in weight change from usual care over one year (47) .…”

Section: Summary Of the Interventionsmentioning

confidence: 99%

“…9 kg; P = 0 . 56) (47) . Two 24-month studies, as described earlier, also focused on primary care patients.…”

Section: Data Specific To the Primary Care Settingmentioning

confidence: 99%

“…The interventions varied considerably in design, with the internet used in some to deliver an automated intervention while in others it enabled remote communication with lifestyle experts or supplemented in-person counselling or community-based support. The most commonly reported online programme elements include self-monitoring of weight, dietary intake and/or physical activity (41,(44)(45)(46)(48)(49)(50)(51)(52) , automated advice (44,(46)(47)(48)(50)(51)(52) , structured education (41,44,46,48,49,52) , problem-solving support (45,46,(48)(49)(50) , online lifestyle coaching (41,44,48,51) and reminder emails (41,44,47,51) . A few programmes reported additional features such as links to community or internet resources (41,45,46) , online peer-topeer support (48,51) , participant contests (48) , physician feedback (45) or counselling by telephone (44,45) .…”

Section: Summary Of the Interventionsmentioning

confidence: 99%

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Use of the internet in the treatment of obesity and prevention of type 2 diabetes in primary care

McTigue

Conroy

2012

Proc. Nutr. Soc.

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Cardiovascular prevention, including emphasising healthy diet and physical activity patterns for weight loss and diabetes prevention, is an important focus of primary care medicine, yet provision of intensive lifestyle counselling in the primary care setting remains uncommon. Online approaches for providing lifestyle counselling are emerging as a new avenue for bringing support to outpatient patient populations. Features of successful programmes include the use of a structured behavioural programme, electronic counselling support and feedback, and uncomplicated user interfaces. Online tools may be used independently or to complement in-person approaches. Limited data also suggest that the internet can be used to support the maintenance of weight loss. In addition, the internet may help overcome various clinical barriers to lifestyle support, including significant time limitations, a need to prioritise acute care and maintain clinical workflow, and the high cost of counselling. Furthermore, the continuity of the primary care patient–provider(s) relationship provides an established source of long-term support which has been difficult to create in other community settings. As the field of online lifestyle counselling matures, nutrition and physical activity experts will face new challenges in providing asynchronous counselling without the assistance of traditional non-verbal communication cues. However, the potential for reaching a wider population in a convenient and accessible manner also creates unique opportunities for providing lifestyle support.

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Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people

Wieland

Falzon

Sciamanna

et al. 2012

Cochrane Database of Systematic Reviews

172

215

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Background The World Health Organization (WHO) estimates that the number of obese or overweight individuals worldwide will increase to 1.5 billion by 2015. Chronic diseases associated with overweight or obesity include diabetes, heart disease, hypertension and stroke. Objectives To assess the effects of interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people. Search methods We searched several electronic databases, including CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO, through 25 May 2011. We also searched clinical trials registries to identify studies. We scanned reference lists of included studies and relevant systematic reviews. Selection criteria Studies were included if they were randomized controlled trials or quasi-randomized controlled trials that evaluated interactive computer-based weight loss or weight maintenance programs in adults with overweight or obesity. We excluded trials if the duration of the intervention was less than four weeks or the loss to follow-up was greater than 20% overall. Data collection and analysis Two authors independently extracted study data and assessed risk of bias. Where interventions, control conditions, outcomes and time frames were similar between studies, we combined study data using meta-analysis. Main results We included 14 weight loss studies with a total of 2537 participants, and four weight maintenance studies with a total of 1603 participants. Treatment duration was between four weeks and 30 months. At six months, computer-based interventions led to greater weight loss than minimal interventions (mean difference (MD) −1.5 kg; 95% confidence interval (CI) −2.1 to −0.9; two trials) but less weight loss than in-person treatment (MD 2.1 kg; 95% CI 0.8 to 3.4; one trial). At six months, computer-based interventions were superior to a minimal control intervention in limiting weight regain (MD −0.7 kg; 95% CI −1.2 to −0.2; two trials), but not superior to infrequent in-person treatment (MD 0.5 kg; 95% −0.5 to 1.6; two trials). We did not observe consistent differences in dietary or physical activity behaviors between intervention and control groups in either weight loss or weight maintenance trials. Three weight loss studies estimated the costs of computer-based interventions compared to usual care, however two of the studies were 11 and 28 years old, and recent advances in technology render these estimates unlikely to be applicable to current or future interventions, while the third study was conducted in active duty military personnel, and it is unclear whether the costs are relevant to other settings. One weight loss study reported the cost-effectiveness ratio for a weekly in-person weight loss intervention relative to a computer-based intervention as USD 7177 (EUR 5678) per life year gained (80% CI USD 3055 to USD 60,291 (EUR 2417 to EUR 47,702)). It is unclear whether this could be extrapolated to other studies. No data were identified on adverse events, morbidity, complications or health-rel...

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The Internet for weight control in an obese sample: results of a randomised controlled trial

Cited by 116 publications

References 23 publications

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

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

Use of the internet in the treatment of obesity and prevention of type 2 diabetes in primary care

Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people

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