J. Med. Internet Res. - A 12-week commercial web-based weight-loss program for overweight and obese adults: randomized controlled trial comparing basic versus enhanced features.

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Resumo

CKGROUND: The development and use of Web-based programs for weight loss is increasing rapidly, yet they have rarely been evaluated using randomized controlled trials (RCTs). Interestingly, most people who attempt weight loss use commercially available programs, yet it is very uncommon for commercial programs to be evaluated independently or rigorously.OBJECTIVE: To compare the efficacy of a standard commercial Web-based weight-loss program (basic) versus an enhanced version of this Web program that provided additional personalized e-feedback and contact from the provider (enhanced) versus a wait-list control group (control) on weight outcomes in overweight and obese adults.METHODS: This purely Web-based trial using a closed online user group was an assessor-blinded RCT with participants randomly allocated to the basic or enhanced 12-week Web-based program, based on social cognitive theory, or the control, with body mass index (BMI) as the primary outcome.RESULTS: We enrolled 309 adults (129/309, 41.8% male, BMI mean 32.3, SD 4 kg/m(2)) with 84.1% (260/309) retention at 12 weeks. Intention-to-treat analysis showed that both intervention groups reduced their BMI compared with the controls (basic: -0.72, SD 1.1 kg/m(2), enhanced: -1.0, SD 1.4, control: 0.15, SD 0.82; P < .001) and lost significant weight (basic: -2.1, SD 3.3 kg, enhanced: -3.0, SD 4.1, control: 0.4, SD 2.3; P < .001) with changes in waist circumference (basic: -2.0, SD 3.5 cm, enhanced: -3.2, SD 4.7, control: 0.5, SD 3.0; P < .001) and waist-to-height ratio (basic: -0.01, SD 0.02, enhanced: -0.02, SD 0.03, control: 0.0, SD 0.02; P < .001), but no differences were observed between the basic and enhanced groups. The addition of personalized e-feedback and contact provided limited additional benefits compared with the basic program.CONCLUSIONS: A commercial Web-based weight-loss program can be efficacious across a range of weight-related outcomes and lifestyle behaviors and achieve clinically important weight loss. Although the provision of additional personalized feedback did not facilitate greater weight loss after 12 weeks, the impact of superior participant retention on longer-term outcomes requires further study. Further research is required to determine the optimal mix of program features that lead to the biggest treatment impact over time.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): 12610000197033.

Resumo Limpo

ckground develop use webbas program weight loss increas rapid yet rare evalu use random control trial rcts interest peopl attempt weight loss use commerci avail program yet uncommon commerci program evalu independ rigorouslyobject compar efficaci standard commerci webbas weightloss program basic versus enhanc version web program provid addit person efeedback contact provid enhanc versus waitlist control group control weight outcom overweight obes adultsmethod pure webbas trial use close onlin user group assessorblind rct particip random alloc basic enhanc week webbas program base social cognit theori control bodi mass index bmi primari outcomeresult enrol adult male bmi mean sd kgm retent week intentiontotreat analysi show intervent group reduc bmi compar control basic sd kgm enhanc sd control sd p lost signific weight basic sd kg enhanc sd control sd p chang waist circumfer basic sd cm enhanc sd control sd p waisttoheight ratio basic sd enhanc sd control sd p differ observ basic enhanc group addit person efeedback contact provid limit addit benefit compar basic programconclus commerci webbas weightloss program can efficaci across rang weightrel outcom lifestyl behavior achiev clinic import weight loss although provis addit person feedback facilit greater weight loss week impact superior particip retent longerterm outcom requir studi research requir determin optim mix program featur lead biggest treatment impact timetri registr australian new zealand clinic trial registri anzctr

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