Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people
Once considered a problem only in high-income countries, overweight and obesity are now dramatically on the rise in low and middle-income countries, particularly in urban settings. The World Health Organization (WHO) estimates that the number of overweight and obese individuals worldwide could increase from 1 billion in 2010 to 1.5 billion in 2015. Overweight and obesity increase the risks for many chronic medical conditions, including diabetes, heart disease, hypertension and stroke, with attendant public health consequences.
Modest reductions in weight can lead to important health benefits. The standard treatment for overweight and obesity is to help patients change diet and exercise habits. Treatment programs in which patients interact with a computer may help people make these changes, and improve their ability to lose weight and keep it off.
A team of Cochrane researchers identified 14 studies in which 2,537 participants were randomised to either an interactive computer program or another treatment for weight loss, plus another four studies where 1,603 participants were assigned to the same interventions for weight maintenance purposes. In the weight loss studies, participants randomized to computer interventions lost more weight after six months than those receiving no intervention or minimal interventions, but less than those who received treatment in person. Similarly, participants who took part in computer interventions for weight maintenance were more successful at keeping off weight than those receiving no or minimal interventions, but less so than those receiving face-to-face treatment. Minimal interventions included handing out pamphlets or providing usual care.
L. Susan Wieland, PhD, based at the University of Maryland School of Medicine in Baltimore, US, was the lead author of the study. “Computer or web-based weight management programmes may be less effective than face-to-face interventions, but healthcare providers may have limited opportunities to provide these interventions, so lower impact treatment approaches need to be considered,” said Wieland.
“These large-scale systematic reviews are helpful to determine – using available peer-reviewed studies – what works and what doesn’t work, so healthcare providers can make evidence-based recommendations,” said Karina W. Davidson, PhD, director, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, and an author of the study. “Since more patients are participating in online weight loss or management programs, these results reveal that computer-based delivery can be effective.”
According to the researchers, although their review did not cover smartphones, these could now take the place of desktop computers or laptops in delivering online weight management programmes. “Since we started the review, smartphones have become capable of functioning like fully mobile computers with interactive potential similar to that of laptops and desktops,” said Wieland. “We hope to include trials of smartphones when we update this review.”