Context Weight loss programs on the Internet appear promising for short-term
weight loss but have not been studied for weight loss in individuals at risk
of type 2 diabetes; thus, the longer-term efficacy is unknown.
Objective To compare the effects of an Internet weight loss program alone vs with
the addition of behavioral counseling via e-mail provided for 1 year to individuals
at risk of type 2 diabetes.
Design, Setting, and Participants A single-center randomized controlled trial conducted from September
2001 to September 2002 in Providence, RI, of 92 overweight adults whose mean
(SD) age was 48.5 (9.4) years and body mass index, 33.1 (3.8).
Interventions Participants were randomized to a basic Internet (n = 46) or to an Internet
plus behavioral e-counseling program (n = 46). Both groups received 1 face-to-face
counseling session and the same core Internet programs and were instructed
to submit weekly weights. Participants in e-counseling submitted calorie and
exercise information and received weekly e-mail behavioral counseling and
feedback from a counselor.
Main Outcome Measures Measured weight and waist circumference at 0 and 12 months.
Results Intent-to-treat analyses showed the behavioral e-counseling group lost
more mean (SD) weight at 12 months than the basic Internet group (−4.4
[6.2] vs −2.0 [5.7] kg; P = .04), and had greater
decreases in percentage of initial body weight (4.8% vs 2.2%; P = .03), body mass index (−1.6 [2.2] vs −0.8 [2.1]; P = .03), and waist circumference (−7.2 [7.5] vs
−4.4 [5.7] cm; P = .05).
Conclusion Adding e-mail counseling to a basic Internet weight loss intervention
program significantly improved weight loss in adults at risk of diabetes.