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Maintaining Weight Loss Through Self-Regulation

Face-to-face and Internet-based interventions were compared in a rigorous randomized controlled trial lasting 18 months.

Few rigorous studies have compared strategies for maintaining weight loss. To add to the evidence base, researchers enrolled 314 people (mean age, 51; 81% women) who had lost at least 10% of their body weight in the previous 2 years in an 18-month randomized trial of a face-to-face intervention, an Internet intervention, and a control strategy.

The face-to-face and Internet interventions, identical in content, were designed to teach participants to monitor and regulate body weight. Both intervention groups were provided with scales and with instruction in a simple weight-monitoring system. The control group received only a quarterly newsletter with information about diet, exercise, and weight control.

Meetings with intervention staff occurred weekly for the first month and monthly thereafter (in person for the face-to-face group, in chat rooms for the Internet group). Weights were submitted weekly via either an automated telephone system (face-to-face group) or a web-based system (Internet group). Internet participants were provided with laptop computers and Internet connections.

Assessments at 18 months were completed by 93% of participants. Mean absolute weight gain was significantly lower in the face-to-face group (2.5 kg) than in the control group (4.9 kg), and nonsignificantly lower than in the Internet group (4.7 kg). At least 2.3 kg of weight was gained by significantly fewer patients in the face-to-face group (46%) and the Internet group (55%), compared with the control group (72%). In both intervention groups, daily self-weighing was associated with significantly reduced risk for weight gain of at least 2.3 kg.

Comment: Two self-regulation strategies helped people to maintain weight loss effectively, with a modest advantage of a face-to-face strategy over an Internet strategy. The generalizability of the findings remains to be tested. Nevertheless, this is the type of trial that we need to build an evidence base for programs and recommendations for maintaining weight loss nonpharmacologically.

— Harlan M. Krumholz, MD, SM

Published in Journal Watch Cardiology October 11, 2006

Citation(s):

Wing RR et al. A self-regulation program for maintenance of weight loss. N Engl J Med 2006 Oct 12; 355:1563-71.

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