Distributed April 8, 2003
News Service Contact: Kristen Cole
Internet weight loss program effective among adults at risk for diabetes
In a 12-month study of an Internet weight loss program, overweight adults at risk for type 2 diabetes lost enough weight to reduce their chances of getting the disease. Those who received regular e-mail counseling from a therapist experienced the greatest success. The study, led by Deborah F. Tate of the Brown Medical School, is in the April 9, 2003, Journal of the American Medical Association.
PROVIDENCE, R.I. — Overweight adults at risk for the most common form of diabetes lost an average of 10 pounds in a recent yearlong Internet weight loss study – an amount of weight likely to reduce their risk of getting the disease.
The study – the longest Internet weight loss study to date – is published in the April 9, 2003, issue of the Journal of the American Medical Association (JAMA). It was led by Deborah F. Tate, assistant professor of psychiatry and human behavior in the Brown Medical School; Tate is based at Miriam Hospital.
“Internet behavioral programs may offer an alternative to more burdensome clinic programs,” said Tate. “This study demonstrated Internet interventions could be used for longer periods of time, a necessary model for treatment of chronic diseases.”
The study, which began in September 2001, included 92 adults whose average age was 48 and who were about 40 pounds overweight with two or more risk factors for type 2 diabetes. Some 10 million Americans are at high risk for type 2 diabetes, which is the main cause of kidney failure, limb amputations and new onset blindness in adults, and a major cause of heart disease and stroke.
Participants were randomly assigned to either of two treatment groups: a basic Internet program and the basic program coupled with e-mail counseling. (The Web site developed for this study is not commercially available, and was password protected.)
The basic group had access to the Web site that provided a tutorial on weight loss, a new tip and link each week, and a directory of selected Internet weight loss resources. Each week, participants received an e-mail reminder to submit his or her weight.
Participants in the e-mail counseling group had the same program plus additional e-mail communication with an assigned weight loss counselor. They were instructed to report calorie and fat intake, exercise energy expenditure, and any comments or questions for the therapist via a Web-based diary.
Therapists who communicated with the e-mail counseling group had masters or doctoral degrees in health education, nutrition or psychology. They e-mailed participants five times a week during the first month and weekly for the remaining months. E-mail counseling included feedback on the self-monitoring record, reinforcement and recommendations for change, answers to questions, and general support.
The e-mail counseling group lost more than twice as much weight as the basic group. At 12 months, participants in the e-mail counseling group lost an average 10 pounds (or 5 percent of their initial body weight) compared to participants in the basic group, who lost an average 4 pounds (or 2 percent of their initial body weight). E-mail counseling participants also showed greater increases in exercise during the first three months and a greater reduction in their consumption of fat calories over the course of the year. Use of the Web site was associated with weight loss in both groups. Those who spent more time at the Web site lost more weight.
This study enabled researchers to isolate the role of the therapist and e-mail counseling in online weight loss programs. It expands on Tate’s earlier research on the use of information technology to aid initial weight loss, a six-month study reported in the March 7, 2001, issue of JAMA. Although that study – the first of its kind – enabled researchers to determine the feasibility of an online weight loss program, it was unable to pinpoint which component of the online program was most successful.
“With this study we were able to determine the importance of the therapist,” said Tate. “The weekly contact with a therapist and the recommendations and support they provided helped keep people on track.”
Tate collaborated on the study with Elizabeth H. Jackvony, the study’s project coordinator at Miriam Hospital, and Rena Wing, professor of psychiatry and human behavior in the Brown Medical School. Funding for this research was provided by a Clinical Research Award from the American Diabetes Association.