Abstract
BackgroundThe Internet provides a widely accessible platform for weight loss interventions. Automated tools can allow self-guided monitoring of food intake and other target behaviours that are established correlates of weight change. Many programmes also offer social support from the virtual community. The aim of this research was to assess associations between engagement with self-monitoring tools and social support, and weight loss in an online weight-control programme.MethodsThis paper describes a retrospective analysis of weight change among 3621 subscribers to a commercial Internet-based weight loss programme. Participants were all subscribers (2979 women; 642 men) joining the programme between July 2005 and November 2008 with two or more recorded weights spanning at least 28 days of participation in the programme. Engagement was indexed with frequency of using online diet and exercise diaries and with use of the social support forums.ResultsProgramme engagement was associated with weight loss in both men and women after controlling for initial BMI and duration of participation. The three engagement variables accounted for 13% of variance in percentage weight loss in women (p < .001) and 19% in men (p < .001). In analyses including all the engagement variables, exercise diary use was an independent predictor of weight loss among men, but non-significant in women. In contrast, use of the online forums was associated with weight loss in women but not in men. Among participants who were overweight or obese, those in the highest tertile of engagement with food diaries (vs the lowest) were more likely to achieve clinically significant (> 5%) weight loss (men: OR = 3.45 p < .001; women: OR = 5.05 p < .001). Being in the highest tertile of engagement with exercise diaries was associated with clinically significant weight loss in men (OR = 3.48 p < .001) and, less strongly, in women (OR = 1.46 p < .05).ConclusionsUse of self-monitoring tools and participation in online support are predictive of weight loss in the context of a commercial, online weight control programme.
Highlights
The desire to lose weight is widespread in affluent western countries and efforts to achieve a neutral or negative energy balance are appropriate both for overweight/obese adults who are trying to lose weight and those of normal weight who wish to avoid weight gain [1,2]
In this study we examined associations between several aspects of programme engagement and weight loss in 3621 people enrolled in Nutracheck: a direct-to-consumer, Internet weight loss programme centred around self-monitoring of diet and physical activity and provision of social support through an online message forum
Almost twice as many women as men posted messages on the online support forums (35% vs. 19% respectively, c2 = 61.5, p < .001)
Summary
The desire to lose weight is widespread in affluent western countries and efforts to achieve a neutral or negative energy balance are appropriate both for overweight/obese adults who are trying to lose weight and those of normal weight who wish to avoid weight gain [1,2]. Alongside services offered by healthcare providers that are typically directed towards more severely overweight groups, a wide array of commercial weight loss programmes is available [3]. People seeking assistance with weight control can choose from programmes using a variety of formats including books, DVDs, Internet sites and weight loss clubs, and offering a range of tools, services and types of support. This makes it possible for consumers to match their preferred approach to weight control to the service of a particular provider. The aim of this research was to assess associations between engagement with self-monitoring tools and social support, and weight loss in an online weight-control programme
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