Online obesity treatment programs show promise

Computer and web-based weight management programmes may provide a cost effective way of addressing the growing problem of obesity, according to a team of seven researchers who undertook a Cochrane systematic review. The researchers, from Maryland, Massachusetts, New York, Pennsylvania and Rhode Island, USA, found that delivering weight loss or weight maintenance programmes online or by computer helped overweight and obese patients lose and/or maintain weight.

Being overweight or obese can increase a person's risk of diabetes, heart disease, high blood pressure, stroke and other chronic medical conditions. The World Health Organization predicts that the number of obese and overweight people in the world will reach 1.5 billion by 2015. Computer or internet-based weight management programmes may be a cost-effective approach to treating overweight or obese people, with the potential to have a major impact on public health.

The review focuses on 14 studies of weight loss involving a total of 2,537 people and four weight maintenance studies involving a further 1,603 people. Those who took part were selected based on having a body mass index (BMI) over a certain limit. In weight loss studies, participants lost more weight after six months than those receiving no intervention or minimal interventions, but less than those who received treatment face-to-face. Similarly, participants who took part in weight maintenance studies were more successful at keeping off weight than those receiving no or minimal interventions, but less so than those receiving face-to-face treatment. Minimal interventions included handing out pamphlets or providing usual care.

L. Susan Wieland, PhD, based at the University of Maryland School of Medicine in Baltimore, US, was the lead author of the study. "Computer or web-based weight management programmes may be less beneficial than face-to-face interventions, but health care providers have limited opportunities to provide this care, so lower impact treatment approaches need to be considered," said Wieland.

"These large-scale systematic reviews are helpful to determine – using available peer-reviewed studies – what works and what doesn't work, so health care providers can make evidence-based recommendations," said Karina W. Davidson, PhD, director, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, and an author of the study. "Since more patients are participating in online weight loss or management programs, these results reveal that computer-based delivery can be effective."

According to the researchers, although their review did not cover smartphones, these could now take the place of desktop computers or laptops in delivering online weight management programmes. "Since we started the review, smartphones have become capable of functioning like fully mobile computers with interactive potential similar to that of laptops and desktops," said Wieland. "We hope to include trials of smartphones when we update this review."