Health-minded people are turning to interactive Internet sites more and more these days to help them lose weight and keep it off. But do these programs work? A new study suggests they might, as long as participants stay plugged in. A little cyber prodding once in a while doesn't hurt, either.
The study, published online today in the Journal of Medical Internet Research, focused on people in the Weight Loss Maintenance Trial, devised to test the effectiveness of various long-term weight loss interventions. In the first six-month phase of the study, participants were focused on losing weight via diet and moderate exercise. They had to lose at least 9 pounds in order to take part in the second phase of the trial, which concentrated on weight loss maintenance. Information on good eating and exercise habits, plus weekly group meetings, helped them along.
Those who lost the weight were randomly assigned to one of three weight maintenance programs: one that was self-directed, one that involved monthly meetings with a health counselor or one that was Internet-based. The Internet program was interactive and designed to help people monitor their weight as well as get information on diet, exercise and goal-setting. Bulletin boards encouraged interaction and discussions. Internet users were encouraged to stay on the straight and narrow, and use the same diet and exercise strategies as in the first phase of the study.
The 348 people in the Internet group were encouraged to use the site often but were required to log their weight once a week on the site. If they didn't, they weren't allowed access to the rest of the site. The Internet intervention also had a slightly noodgy quality to it: automated e-mail prompts were sent and phone calls made if participants didn't log in.
Participants' use was rated in three categories: consistent, some and minimal. Most (61%) were consistent users. This group gained back the least amount of weight compared with those who used the site less. More people in this group (51%) also maintained that 9-pound weight loss, compared with 27% and 24% in the other groups.
Those in the consistent users group also tended to be older, male, not African American, more educated and had started the first phase of the study at a lower body weight and body mass index compared with minimal users.
More than 65% of those using the Internet were still active on the site 28 months after the beginning of the second phase of the study. The study authors chalk that up in part to a dynamic site that tailored messages to users and those e-mail and telephone reminders.
Those in the self-directed maintenance program gained an average 12 pounds back after 30 months, while those in the personal contact group gained an average 9 pounds, and those in the Internet group gained an average 11 pounds.
In the study, the authors wrote, "These observed Internet use associations do not prove causation. They are, however, consistent with our hypothesis that those who use a behaviorally based, interactive website more would be more successful at long-term weight maintenance."
"Consistency and accountability are essential in any weight maintenance program," said study lead author Kristine L. Funk in a news release. The researcher at the Kaiser Permanente Center for Health Research in Portland, Ore., added, "The unique part of this intervention was that it was available on the Internet, whenever and wherever people wanted to use it."
-- Jeannine Stein
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