Effects of a general practice guided web-based weight reduction program - results of a cluster-randomized controlled trial

Background: Preliminary findings suggest that web-based interventions may be effective in achieving significant weight loss and weight loss maintenance. To date only few findings within primary care patients and especially the involvement of general practitioners are available. The aim of this trial was to examine the short-term effectiveness of a web-based coaching program in combination with an accompanied telephone counselling regarding weight reduction in a primary care setting. Methods: The study was a cluster-randomized trial with an observation period of 12 weeks. Individuals recruited by general practitioners randomized to the intervention group participated in a web-based coaching program based on education, motivation, exercise guidance, daily SMS reminding, weekly feedback through internet and active monitoring by general practitioners. Participants in the control group received usual care and advice from their practitioner without the web-based coaching program. The main outcome was weight change between admission and after 12 weeks. Results: 186 participants (109 intervention group, 77 control group) were recruited into study. For 76 participants from the intervention group and 72 participants from the control group weight measurements were available both at baseline and 12 weeks. Weight decreased on average by 4.2 kg in the intervention group and 1.7 kg in the control group (mean group difference 2.5 kg; 95%CI 1,1; 3,8; p < 0.001). Reductions for waist circumference and BMI were also significantly larger within intervention. Conclusion: Findings of the present trial suggest that the tested web-based coaching program for weight loss is effective in short-term. Further RCT's are desirable in order to confirm present findings in larger populations and to investigate long-term outcomes.