Alka M. Kanaya, MD
Are behavioral interventions delivered in person, or remotely, better than a self-directed approach for weight loss in obese patients? Is in-person delivery better than remote delivery?
Randomized controlled trial (1 of 3 Practice-based Opportunities for Weight Reduction [POWER] trials). ClinicalTrials.gov NCT00783315.
Unclear allocation concealment.*
Blinded* (data collectors).
6 primary care practices in Baltimore, Maryland, USA.
415 patients ≥ 21 years of age (mean age 54 y, 64% women, mean weight 103 kg) who were obese and had ≥ 1 cardiovascular risk factor (hypertension, diabetes, or hypercholesterolemia), regular access to a computer, and basic computer skills. Exclusion criteria were recent weight loss ≥ 5% and use of medications that prevent weight loss or cause weight gain.
Behavioral weight-loss intervention with support provided by weight-loss coaches mainly through in-person individual and group sessions (in-person group, n = 138) or by telephone only (remote group, n = 139); or self-directed weight loss (n = 138). Both behavioral interventions included regular patient contact by e-mail, access to a study-specific Web site, and involvement of primary care providers in monitoring patient progress and providing encouragement.
Weight loss and proportion of patients who lost ≥ 5% of body weight.
94% (intention-to-treat analysis).
At 2 years, both behavioral interventions showed greater weight loss (around 5 kg) than a self-directed approach (around 1 kg); the 2 behavioral interventions did not differ (Table).
Behavioral interventions delivered in-person or remotely were better than a self-directed approach for weight loss at 2 years in obese patients.
†Abbreviations defined in Glossary. RBI, NNT, and CI calculated from event rates in article.
‡Adjusted for sex, age, race, and clinic.
§In-person and remote groups did not differ: mean weight loss, P = 0.63; weight loss ≥ 5%, P = 0.73.
Kanaya AM. In-person or remote behavioral interventions for obesity were better than a self-directed approach. Ann Intern Med. ;156:JC3–10. doi: 10.7326/0003-4819-156-6-201202210-02010
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Published: Ann Intern Med. 2012;156(6):JC3-10.
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