|Haddock, C Keith|
|Van Brunt, David|
Submitted to: American Journal of Preventive Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/26/2007
Publication Date: 2/1/2008
Citation: Hunter, C.M., Peterson, A.L., Alvarez, L.M., Poston, W.C., Brundige, A.R., Haddock, C.K., Van Brunt, D.L., Foreyt, J.P. 2008. Weight management using the internet: A randomized controlled trial. American Journal of Preventive Medicine. 34(2):119-126. Interpretive Summary: The purpose of this study was to examine the effectiveness of an Internet-based program designed for weight loss and weight-gain prevention. Participants were overweight active-duty military personnel. Results indicate that individuals assigned to the Internet-based program achieved a modest weight loss, while those receiving only the usual care provided at a U.S. Air Force base gained a small amount of weight. Given the difficulty in maintaining weight loss, the prevention of weight gain is a useful and, perhaps, more realistic population-health-based goal. The findings of the current study suggest that Internet-based programs may be an effective platform for population-based weight management. Internet programs allow increased contact, tailored advice, and immediate feedback, all of which can be potent motivators for changing and maintaining health-related behaviors.
Technical Abstract: Most weight-loss research targets obese individuals who desire large weight reductions. However, evaluation of weight-gain prevention in overweight individuals is also critical as most Americans become obese as a result of a gradual gain of 1-2 pounds per year over many years. This study evaluated the efficacy of an Internet-based program for weight loss and weight-gain prevention with a two-group, prospective, randomized controlled trial. A military medical research center with a population of 17,000 active-duty military personnel supplied 446 overweight individuals (222 men; 224 women) with a mean age of 34 years and a mean BMI of 29. Recruitment and study participation occurred 2003-2005, and data were analyzed in 2006. Participants were randomly assigned to receive the 6-month behavioral Internet treatment (BIT, n=227) or usual care (n=224). Change in body weight, BMI, percent body fat, and waist circumference, presented as group by time interactions, were measured. After 6 months, completers who received BIT lost 1.3 kg while those assigned to usual care gained 0.6 kg (F((df=366))=24.17; I<0.001). Results were similar for the intention-to-treat model. BIT participants also had significant changes in BMI (-0.5 vs +0.2 kg/m(2); F((df=366))=24.58); percent body fat (-0.4 vs +0.6%; F((df=366))=10.45); and waist circumference (-2.1 vs -0.4 cm; F((df=366))=17.09); p<0.001 for all. Internet-based weight-management interventions result in small amounts of weight loss, prevent weight gain, and have potential for widespread dissemination as a population health approach.