Critical review and meta-analysis of multicomponent behavioral e-health interventions for weight loss.

Abstract

Multicomponent behavioral e-health interventions are seen as an alternative to in-person treatment for weight loss. However, these estimates may be optimistic at best. This is the first meta-analysis to investigate the relative efficacy of multicomponent behavioral e-health interventions for weight loss against separate groups of active in-person treatment and passive controls (e.g., waitlist, no care, usual care, or placebo group). Forty-seven randomized controlled trials on multicomponent e-health interventions for weight loss in overweight and/or obese adults were included. A random-effects model was used for pooling the effect sizes, which were calculated for weight and behavioral outcomes at posttreatment and follow-up. Standard active treatment was more effective than e-health interventions with respect to weight (g = -0.31, 95% CI [-0.43 to -0.20]). There was a statistically significant, albeit small effect size favoring e-health interventions relative to passive control groups for weight (g = 0.34, 95% CI [0.24 to 0.44]) and behavioral outcomes (g = 0.17, 95% CI [0.07 to 0.27]). Several potential moderator variables were examined and discussed. Overall, the findings raise concerns regarding the current potential of multicomponent behavioral e-health interventions as first-line treatment for weight-loss. Other limitations and possible implications are discussed. (PsycINFO Database Record