Personalized Coaching vs. Activity Monitor for Weight Loss in Obese Adults

Abstract

PURPOSE: There is little consensus on the best approach to promote weight loss. Guided weight loss programs (GWLP) have shown positive results, but they can be time-consuming and expensive. Online programs based on self-monitoring devices such as the SenseWear Armband (SWA) may provide a more cost-effective strategy for promoting weight loss. The purpose of this study was to compare the relative effectiveness of a GWLP to a self-monitoring group provided with access to the SWA over 8 weeks. METHODS: Seventy-eight obese adults (31 male and 47 female) were randomized to one of the two program options [GWLP or SWA] or to a combined group receiving both treatments [GWLP + SWA]. The GWLP participants attended weekly visits with a personal health coach. SWA participants had 2 visits with a health coach and received SWA instructions. Combination participants received the same curriculum as the GWLP group, as well as the SWA monitor. Standard weight loss outcomes (BMI, percent body fat, waist circumference (WC), blood pressure (BP), and fasting lipids and glucose) were assessed at baseline and at the end of 8 weeks to evaluate the relative effectiveness of the three options. A two-way (Group x Gender) ANOVA was used to examine treatment effects and interactions. Differences in group effects were reported as Effect Sizes (ES) to facilitate interpretation. RESULTS: Significant trial effects were found for weight ((-4.21 ± 3.08 kg, p < 0.0001), BMI (p < 0.0001), percent fat (p = 0.0008), WC (p < 0.0001), diastolic BP ((p = 0.0004), glucose (p = 0.0001), Total Cholesterol (p = 0.0003), and Triglycerides (p = 0.0001). All groups experienced a significant weight reduction. Larger effects were seen in the combination group for both weight loss [ES (GWLP+SWA vs. GWLP) = -0.37; ES (GWLP+SWA vs. SWA) = -0.27] and metabolic syndrome score [ES (GWLP+SWA vs. GWLP) = -0.76; ES (GWLP+SWA vs. SWA) = -0.54). CONCLUSIONS: The SWA may be as beneficial as in-person health coaching to facilitate weight loss; however, combination of SWA and health coaching may provide additional benefits.