J. Med. Internet Res. - Utilization patterns and user characteristics of an ad libitum Internet weight loss program.


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CKGROUND: The Internet holds promise for the delivery of evidence-based weight loss treatment to underserved populations. However, most studies do not reflect the more naturalistic and common ad libitum, or freely at will, use of the Internet. Randomized clinical trials, for example, typically include at least some direct contact with participants and often have restrictive selection criteria. There is a paucity of research examining utilization patterns of online weight loss programs, particularly in the rapidly expanding direct-to-consumer arena.OBJECTIVES: To examine self-reported characteristics (age, body mass index [BMI], gender), behaviors, and Internet site utilization patterns of a sample of users of a direct-to-consumer ad libitum Internet weight loss program.METHODS: This study is based on analysis of archival data from the initial 15 weeks of an ongoing, free, evidence-based, direct-to-consumer Internet weight loss program, the Healthy Weight Center, which included standard information about nutrition, fitness, and behavioral strategies; monitoring tools; and moderated support group message boards. Participants encountered the program through self-directed Internet searches and anonymously registered to utilize the site. Self-reported user characteristics and electronically tracked utilization data were extracted from existing program data, compiled, and examined. Pearson correlations were computed to examine the association of program utilization with age and BMI. One-way analysis of variance (ANOVA) was used for gender comparisons.RESULTS: We examined data from the first 204 adult users of the program who were classified as either overweight (BMI 25 to < 30 kg/m(2)) or obese (BMI > or = 30 kg/m(2)). The mean age of participants was 42.0 years (SD 11.7), 81.9% (167/204) were women, and mean BMI was 32.01 kg/m(2) (SD 6.26). The percent of participants who used program tools was as follows: 13.7%, meal planner; 10.8%, nutrition lookup: 17.6%, activity log; 14.2%, journal; and 22.1%, weight tracker. Participants also used the following educational resources: nutrition, 13.2%; fitness, 6.4%; and behavioral, 7.4%. Of the personal self-assessments available through the program, 57.8% of participants assessed personal barriers, and 50.5% assessed relationship with food. Only 7.8% used the support group message boards. No significant associations between site utilization and age, gender, or BMI were found. Reasons for wanting to lose weight were: health, 87%; appearance, 74%; mobility, 44%; doctor recommendation, 23%; and spouse/friend suggested, 12%. The age participants reported first becoming overweight was young adulthood, 31%; late adulthood, 28%; childhood, 22%; adolescence, 17%; and as a toddler, 3%. Self-perceived factors contributing to weight gain were lack of exercise for 70% of participants, emotions for 62%, overeating for 61%, and slow metabolism for 33%.CONCLUSIONS: Internet weight loss programs reach many people who cannot access traditional treatment. However, users appear not to be optimally utilizing key aspects of the weight loss intervention, such as education, monitoring, and support. This study provides insight into the patterns of ad libitum use of an online weight loss program across multiple treatment-related domains in a naturalistic Internet environment.

Resumo Limpo

ckground internet hold promis deliveri evidencebas weight loss treatment underserv popul howev studi reflect naturalist common ad libitum freeli will use internet random clinic trial exampl typic includ least direct contact particip often restrict select criteria pauciti research examin util pattern onlin weight loss program particular rapid expand directtoconsum arenaobject examin selfreport characterist age bodi mass index bmi gender behavior internet site util pattern sampl user directtoconsum ad libitum internet weight loss programmethod studi base analysi archiv data initi week ongo free evidencebas directtoconsum internet weight loss program healthi weight center includ standard inform nutrit fit behavior strategi monitor tool moder support group messag board particip encount program selfdirect internet search anonym regist util site selfreport user characterist electron track util data extract exist program data compil examin pearson correl comput examin associ program util age bmi oneway analysi varianc anova use gender comparisonsresult examin data first adult user program classifi either overweight bmi kgm obes bmi kgm mean age particip year sd women mean bmi kgm sd percent particip use program tool follow meal planner nutrit lookup activ log journal weight tracker particip also use follow educ resourc nutrit fit behavior person selfassess avail program particip assess person barrier assess relationship food use support group messag board signific associ site util age gender bmi found reason want lose weight health appear mobil doctor recommend spousefriend suggest age particip report first becom overweight young adulthood late adulthood childhood adolesc toddler selfperceiv factor contribut weight gain lack exercis particip emot over slow metabol conclus internet weight loss program reach mani peopl access tradit treatment howev user appear optim util key aspect weight loss intervent educ monitor support studi provid insight pattern ad libitum use onlin weight loss program across multipl treatmentrel domain naturalist internet environ

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