People tend to lose a little more weight with online help than with traditional weight loss programs, according to a new study from Japan.
With obesity on the rise, there have been many attempts to take advantage of the Internet to help people lose weight, mainly because it's thought to be easier and less expensive.
But the effect of including online help in obesity treatment programs was pretty small in the new study.
Overall, patients in programs with a web component lost an average of a pound and a half more than participants in non-Web programs, the researchers reported in the International Journal of Obesity.
The findings are from a review of 23 studies that compared weight control programs with an Internet component to programs that didn't involve any online support.
Weight control programs
The Internet was used for a variety of purposes in the different weight control programs. These included individualised instruction, communication with lifestyle instructors, counselling, and keeping a record of food intake. In addition, the programs varied in how much participants used the Internet.
The research team, headed by Dr H. Sone of the University of Tsukuba Institute of Clinical Medicine in Ibaraki, Japan, did identify certain features that made web-based programs more or less effective.
For instance, they found that when the Internet replaced face-to-face counselling, people ended up weighing about three pounds more, on average, than their peers who weren't getting "help" from the Internet.
But weight-loss programs that used the Internet in addition to in-person counselling helped participants end up about two pounds lighter compared to people who didn't use the Web.
"An in-person contact approach is superior to a technology-based approach," the authors write. "An internet program needs to include the component of a face-to-face program for participants to achieve weight loss."
They also found that internet-based programs were more effective when the goal was to lose weight in the first place, and less effective when the goal was weight loss maintenance.
Not all good
Clearly, Web-based programs are not always better. The programs studied in the review differ in many more ways than just whether or not they used the internet or in how much time people spent online, said Dr Robert Jeffery, a researcher at the University of Minnesota in Minneapolis.
"It's premature to make generalisations," he said.
Still, the results are promising for patients who haven't had success with other programs, said James Christian, a researcher at Colorado State University who also works for PHCC, Inc., a Pueblo, Colorado-based company that designs online programs to help people make health changes in their lifestyle.
"People respond differently to different kinds of support," Christian said.
Dr Jean Harvey-Berino, chair of the Department of Nutrition and Food Sciences at the University of Vermont in Burlington, disagrees that face-to-face meetings are necessary for a weight program to be effective. They are not always "better enough to warrant the extra cost and aggravation," she said.
According to Dr Harvey-Berino, a good Internet program enables participants to communicate in groups, monitor their eating and exercise habits, and get regular feedback from peers and supervisors, while focusing on behaviour change.
Dr Harvey-Berino sees the Internet as an important tool to promote weight loss now and in the future. She said, "This is the next wave of public health intervention, and we can't stop now."
(Reuters Health, Eric Schultz, June 2011)