J. Med. Internet Res. - Weight change in a commercial web-based weight loss program and its association with website use: cohort study.

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Resumo

CKGROUND: There is a paucity of information in the scientific literature on the effectiveness of commercial weight loss programs, including Web-based programs. The potential of Web-based weight loss programs has been acknowledged, but their ability to achieve significant weight loss has not been proven.OBJECTIVE: The objectives were to evaluate the weight change achieved within a large cohort of individuals enrolled in a commercial Web-based weight loss program for 12 or 52 weeks and to describe participants' program use in relation to weight change.METHOD: Participants enrolled in an Australian commercial Web-based weight loss program from August 15, 2007, through May 31, 2008. Self-reported weekly weight records were used to determine weight change after 12- and 52-week subscriptions. The primary analysis estimated weight change using generalized linear mixed models (GLMMs) for all participants who subscribed for 12 weeks and also for those who subscribed for 52 weeks. A sensitivity analysis was conducted using the last observation carried forward (LOCF) method. Website use (ie, the number of days participants logged on, made food or exercise entries to the Web-based diary, or posted to the discussion forum) was described from program enrollment to 12 and 52 weeks, and differences in website use by percentage weight change category were tested using Kruskal-Wallis test for equality of populations.RESULTS: Participants (n = 9599) had a mean (standard deviation [SD]) age of 35.7 (9.5) years and were predominantly female (86% or 8279/9599) and obese (61% or 5866/9599). Results from the primary GLMM analysis including all enrollees found the mean percentage weight change was -6.2% among 12-week subscribers (n = 6943) and -6.9% among 52-week subscribers (n = 2656). Sensitivity analysis using LOCF revealed an average weight change of -3.0% and -3.5% after 12 and 52 weeks respectively. The use of all website features increased significantly (P < .01) as percentage weight change improved.CONCLUSIONS: The weight loss achieved by 12- and 52-week subscribers of a commercial Web-based weight loss program is likely to be in the range of the primary and sensitivity analysis results. While this suggests that, on average, clinically important weight loss may be achieved, further research is required to evaluate the efficacy of this commercial Web-based weight loss program prospectively using objective measures. The potential association between greater website use and increased weight loss also requires further evaluation, as strategies to improve participants' use of Web-based program features may be required.

Resumo Limpo

ckground pauciti inform scientif literatur effect commerci weight loss program includ webbas program potenti webbas weight loss program acknowledg abil achiev signific weight loss provenobject object evalu weight chang achiev within larg cohort individu enrol commerci webbas weight loss program week describ particip program use relat weight changemethod particip enrol australian commerci webbas weight loss program august may selfreport week weight record use determin weight chang week subscript primari analysi estim weight chang use general linear mix model glmms particip subscrib week also subscrib week sensit analysi conduct use last observ carri forward locf method websit use ie number day particip log made food exercis entri webbas diari post discuss forum describ program enrol week differ websit use percentag weight chang categori test use kruskalw test equal populationsresult particip n mean standard deviat sd age year predomin femal obes result primari glmm analysi includ enrolle found mean percentag weight chang among week subscrib n among week subscrib n sensit analysi use locf reveal averag weight chang week respect use websit featur increas signific p percentag weight chang improvedconclus weight loss achiev week subscrib commerci webbas weight loss program like rang primari sensit analysi result suggest averag clinic import weight loss may achiev research requir evalu efficaci commerci webbas weight loss program prospect use object measur potenti associ greater websit use increas weight loss also requir evalu strategi improv particip use webbas program featur may requir

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