J. Med. Internet Res. - Determinants of successful weight loss after using a commercial web-based weight reduction program for six months: cohort study.

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Resumo

CKGROUND: The Internet is widely available and commonly used for health information; therefore, Web-based weight loss programs could provide support to large parts of the population in self-guided weight loss. Previous studies showed that Web-based weight loss interventions can be effective, depending on the quality of the program. The most effective program tools are visual progress charts or tools for the self-monitoring of weight, diet, and exercises. KiloCoach, a commercial program currently available in German-speaking countries, incorporates these features. A previous investigation showed that the program effectively supports users in losing weight.OBJECTIVE: We investigated weight loss dynamics stratified by weight loss success after 6-month use of KiloCoach. Furthermore, we analyzed possible associations between intensity of program use and weight loss. The results are intended for tailoring user recommendations for weight-loss Internet platforms.METHODS: Datasets of KiloCoach users (January 1, 2008 to December 31, 2011) who actively used the platform for 6 months or more were assigned to this retrospective analysis. Users (N=479) were 42.2% men, mean age of 44.0 years (SD 11.7), with a mean body mass index (BMI) of 31.7 kg/m? (SD 3.2). Based on the weight loss achieved after 6 months, 3 success groups were generated. The unsuccessful group lost <5%, the moderate success group lost 5%-9.9%, and the high success group lost =10% of their baseline body weight. At baseline, the unsuccessful (n=261, 54.5%), moderate success (n=133, 27.8%), and high success (n=85, 17.8%) groups were similar in age, weight, BMI, and gender distribution.RESULTS: After 6 months, the unsuccessful group lost 1.2% (SD 2.4), the moderate success group lost 7.4% (SD 1.5), and the high success group lost 14.2% (SD 3.8) of their initial weight (P<.001). Multivariate regression showed that early weight loss (weeks 3-4), the total number of dietary protocols, and the total number of weight entries were independent predictors for 6-month weight reduction (all P<.001) explaining 52% of the variance in weight reduction. Sensitivity analysis by baseline carried forward method confirmed all independent predictors of 6-month weight loss and reduced the model fit by only 11%. The high success group lost weight faster and maintained weight loss more efficiently than the other groups (P<.001). Early weight loss was associated with weight maintenance after 1 year and 2 years (both P<.001). Weight dynamics did not differ between men and women over 6 months when adjusted for baseline and usage parameters (P=.91). The percentage of male long-term users was unusually high (42.2%).CONCLUSIONS: Our results suggest that early weight loss and close program adherence (ie, 5 dietary protocols per week and weekly entering of current weight), especially in the early phase of program usage, can improve weight loss outcome.

Resumo Limpo

ckground internet wide avail common use health inform therefor webbas weight loss program provid support larg part popul selfguid weight loss previous studi show webbas weight loss intervent can effect depend qualiti program effect program tool visual progress chart tool selfmonitor weight diet exercis kilocoach commerci program current avail germanspeak countri incorpor featur previous investig show program effect support user lose weightobject investig weight loss dynam stratifi weight loss success month use kilocoach furthermor analyz possibl associ intens program use weight loss result intend tailor user recommend weightloss internet platformsmethod dataset kilocoach user januari decemb activ use platform month assign retrospect analysi user n men mean age year sd mean bodi mass index bmi kgm sd base weight loss achiev month success group generat unsuccess group lost moder success group lost high success group lost baselin bodi weight baselin unsuccess n moder success n high success n group similar age weight bmi gender distributionresult month unsuccess group lost sd moder success group lost sd high success group lost sd initi weight p multivari regress show earli weight loss week total number dietari protocol total number weight entri independ predictor month weight reduct p explain varianc weight reduct sensit analysi baselin carri forward method confirm independ predictor month weight loss reduc model fit high success group lost weight faster maintain weight loss effici group p earli weight loss associ weight mainten year year p weight dynam differ men women month adjust baselin usag paramet p percentag male longterm user unusu high conclus result suggest earli weight loss close program adher ie dietari protocol per week week enter current weight especi earli phase program usag can improv weight loss outcom

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