As most readers are probably well aware, there is an ever increasing number of internet and app-based weight management programs ranging in cost from virtually free with automated responses to moderately expensive virtual trainers.
But how effective are such programs really?
This is the subject of a recent Cochrane Review by Wieland and colleagues from the Maryland School of Medicine in Baltimore.
The authors looked at all randomized controlled or quasi-randomized controlled trials that evaluated interactive computer-based weight loss or weight maintenance programs in adults with overweight or obesity. Interventions of less than four week duration or with greater than 20% lost-to-follow-up were excluded.
The researchers identified 14 weight loss studies with a total of 2537 participants, and four weight maintenance studies with a total of 1603 participants with treatment durations ranging between four weeks and 30 months.
At six months, computer-based interventions led to an about 1.5 Kg greater weight loss than minimal interventions (e.g. handing the patient a brochure) but about 2 Kg less weight loss than in-person treatments.
At six months, computer-based interventions were marginally superior to a minimal control intervention in limiting weight regain (about -0.7 Kg) but not superior to infrequent in-person treatment (about 0.5 Kg).
Overall the authors note that they did not observe consistent differences in dietary or physical activity behaviors between intervention and control groups in either weight loss or weight maintenance trials.
Although several studies compared cost, the authors felt that either the costs were outdated or not representative of current programs.
The one study for which they presented the cost-effectiveness, the ratio for a weekly in-person weight loss intervention relative to a computer-based intervention was about US$ 7,000 per life year gained.
None of the studies reported data on adverse events, morbidity, complications or health-related quality of life.
Thus, the authors conclude that,
“Compared to no intervention or minimal interventions (pamphlets, usual care), interactive computer-based interventions are an effective intervention for weight loss and weight maintenance. Compared to in-person interventions, interactive computer-based interventions result in smaller weight losses and lower levels of weight maintenance. The amount of additional weight loss, however, is relatively small and of brief duration, making the clinical significance of these differences unclear.”
If you have experience with an internet or computer based weight management program, I’d certainly be interested in hearing about it.
Wieland LS, Falzon L, Sciamanna CN, Trudeau KJ, Brodney S, Schwartz JE, & Davidson KW (2012). Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people. Cochrane database of systematic reviews (Online), 8 PMID: 22895964