Online Behavioral Training Helps Weight Loss

[Guest guest]

Community-wide weight-loss campaigns

<http://www.medpagetoday.com/PrimaryCare/Obesity/23062?utm_content=GroupCL & utm_m\

edium=email & impressionId=1288591144908 & utm_campaign=DailyHeadlines & utm_source=mS\

poke & userid=134896>can

be enhanced by incorporating behavioral interventions delivered over the

Internet at little cost, researchers in Rhode Island found.

Weight loss was significantly greater (6.8 lbs versus 2.6 lbs, *P*<0.01)

when video lessons, daily self-monitoring, and automated feedback were added

to a 12-week community intervention called Shape Up RI, according to Rena

Wing, PhD, of Brown University in Providence, R.I., and colleagues.

The proportion of participants who lost at least 5% of their excess body

weight was significantly greater as well (36.6% versus 11.1%, *P*<0.01), the

researchers reported online in the *American Journal of Public Health*.

" Our study may provide a model for a cost-effective community approach to

weight control, " they wrote.

" Although the weight losses achieved in these studies were much smaller than

those typically seen in face-to-face clinic-based programs, the advantage of

programs such as Shape Up RI is their ability to attract large numbers of

participants, " they continued.

Intensive lifestyle programs that require face-to-face counseling on diet,

exercise, and behavioral modification result in weight loss, but are costly,

time-intensive, and limited in the number of patients they can reach,

according to the researchers.

Community weight-loss campaigns that involve team-based competition target a

larger number of people but result in more modest weight reduction.

To find out whether adding pieces of the more intensive programs into a

community program would help, Wing and her colleagues recruited participants

of Shape Up RI, a 12-week, online, team-based weight-loss program in that

state. The program did not involve any behavioral counseling, but

participants submitted regular reports of activity and weight loss online.

Wing and her colleagues conducted two randomized trials.

The first assigned participants to the standard Shape Up RI program or to an

enhanced program that included weekly video lessons on losing weight derived

from the Diabetes Prevention Program; there were 179 participants overall

(mean baseline BMI 33.8).

The second study assigned participants to the standard program or to an

enhanced program that included the weekly video lessons plus daily

self-monitoring of weight, diet, and exercise and computer-generated

feedback to help participants meet their goals. There were 128 participants

(mean BMI 33.9) in this study.

Retention in the two studies was excellent, according to the researchers --

93.9% in the first study and 87.5% in the second.

In the first study, adding video lessons alone did not result in greater

weight loss after 12 weeks than the standard program in the

intention-to-treat analysis (4.2 lbs versus 2.9 lbs, *P*=0.20). The findings

were similar in an analysis of study completers only.

Adding more pieces of intensive behavioral training in the second study did,

however, result in greater weight loss than the standard program (6.8 lbs

versus 2.6 lbs, *P*<0.01), and tripled the proportion of participants who

lost at least 5% of their excess body weight.

Participants in the second study were adherent to the self-monitoring aspect

of the study, submitting records on 78% of days.

Adherence was significantly related to weight loss, although the study could

not identify which component of the intervention was most important,

according to the researchers.

The analysis was limited, they acknowledged, by the lack of a direct

comparison between the two enhanced programs, the low numbers of

participants, the lack of long-term outcomes data, and the fact that most of

the participants were white, female, and college-educated.

The authors reported that they did not have any conflicts of interest.

*Primary source: *American Journal of Public Health

Source reference:

Wing R, et al " Improving weight loss outcomes of community interventions by

incorporating behavioral strategies " *Am J Public Health* 2010; DOI:10.2105/

AJPH.2009.183616.<http://ajph.aphapublications.org/cgi/content/abstract/AJPH.200\

9.183616v1>

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

* " Older Dietitians " - seasoned to PERFECTION**

*

" *Art is meant to upset people, science reassures them*. "

*--*