Effectiveness of Web-based interventions in Achieving Weight Loss and Maintenance in Overweight and Obese Adults: A Systematic Review.

Abstract

Review Question/Objective The primary objective of this review is to identify the effectiveness of web-based interventions on weight loss and maintenance. The second objective is to identify the effectiveness of web-based interventions on behaviours associated with weight loss (eating and physical activity). The third objective is to identify what components of web-based interventions are associated with greater weight loss and maintenance, as well as lower attrition rates. Criteria for Inclusion Types of participants The quantitative component of this review will consider studies that include overweight and/or obese adults, aged greater than 18 years. Overweight and obesity will be defined as a body mass index (BMI) greater than or equal to 25(kg/m2). Types of intervention(s) The quantitative component of the review will consider studies that evaluate web-based interventions with the primary aim of achieving weight loss or weight maintenance following weight loss. This includes studies with the aim of achieving positive dietary and physical activity behaviour change for participants that include overweight/obesity outcome measures. However, if the stated aim is to achieve positive dietary and physical activity behaviour change for participants, and they do not include overweight/obesity outcome measures they will be excluded. At least one arm of the study must include a web-based intervention. A web-based intervention will be based around a website that participants receive information from and directly interface with. They are not required to input information into the website for the intervention to be included. Types of outcomes This review will consider studies that include the following outcome measures: Primary Outcome: Overweight/obesity related outcomes: weight (kg), % body weight lost, BMI, waist measurements, % body fat, % lost 5% of body weight. Secondary Outcomes: Dietary behaviours: energy intake, core food group intake (e.g. number of serves of fruit per day), macronutrient composition of diet (e.g. fat intake per day) Physical activity behaviours: energy expenditure, time spent in activity, steps per day. Effect modifiers/confounders: Compliance/engagement with website: website logins, completion of self-monitoring diaries, attendance at meetings/group discussions, retention etc Adjuncts to web-based intervention (e.g. contact with professional/face to face contact, other eHealth technology such as SMS, email, CD-Rom, Personal Digital Assistant (PDA) and use of rewards/prizes) Intervention based on theoretical models Intensity of web-based intervention: type and number of features included (e.g. self-monitoring diary, chat room, discussion board)