June 20, 2012 in Overweight and Obesity (Medical
Xpress) -- A Web-based program featuring successful strategies of others who
have lost weight may be an effective strategy for weight loss, according to
Penn State College of Medicine researchers. Researchers created a website called
AchieveTogether and evaluated the weight-loss success of users. They compared
users with a group of people attempting to lose weight on their own, and then
allowed that second group access to the site 12 weeks later. "Internet-based
weight loss programs could help address the obesity epidemic, as they can be
widely shared and used with low costs," said Jennifer L. Kraschnewski,
M.D., M.P.H., assistant professor of medicine and public health sciences.
"Existing Internet-based weight-loss strategies have largely promoted
weight-loss strategies designed by health professionals, including goal-setting
and features to promote social interaction. These programs have had modest
short-term effects, suggesting that exploring alternative approaches may be
beneficial." The researchers used positive deviance to design their
Web-based program. Positive deviance is the idea that solutions to problems
exist within a population experiencing that problem. By generalizing what
behaviors or approaches work for those who are most successful -- typically the
top 10 percent – strategies are developed that may help the general population
achieve certain goals. "Positive deviance has been used in diverse
health-related interventions, but has not previously been used in weight-loss
interventions," Kraschnewski said. For AchieveTogether, users were
educated on 36 weight-loss behaviors identified in a previous study of people
who maintained a weight loss of at least 30 pounds. These behaviors were
evaluated by a physician for safety. Participants logged in to the site at
least once a week and were asked to record their weight, height and frequency
of using the weight loss practices. They were matched to three role models
closest to them for gender, age and target body weight and could then view
their role model's strategies for weight loss. Participants developed a
weight-loss plan by choosing as many of the strategies as they wanted and were
encouraged to choose at least one. "At each log in, participants received
tailored feedback to help them choose which practices to keep doing or learned
ways to adapt them based on their own activity," Kraschnewski said. Users
of the AchieveTogether website lost about 4.5 pounds more weight than the
control group. Results were published in American Journal of Preventative
Medicine. "While this is modest weight loss, it is in the range we have
seen for other Internet-based weight loss programs, including those with more
human contact," Kraschnewski said. "Because AchieveTogether, or a
similar program, can be offered free, it could increase physician referrals for
weight management and be a cost effective way to promote weight loss on a
public health scale." Future research will look at how to increase
engagement with the website, examine individual characteristics associated with
different outcomes and explore best how to use the experience of a diverse
group to build a more complete program of weight loss interventions and
management. Other researchers on the project were Heather L. Stuckey, D. Ed.,
Liza S. Rovniak, Ph.D., M.P.H., Jennifer M. Poger, M.Ed., and Christopher
Sciamanna, M.D., M.P.H., Department of Medicine, Penn State College of
Medicine; Erik B. Lehman, M.S., and Donna K. Kephart,M.H.A., Department of
Public Health Sciences, Penn State College of Medicine; Madhu Reddy, Ph.D.,
College of Information Sciences and Technology, Penn State; and Elliot J.
Coups, Ph.D., Department of Health Education and Behavioral Science, University
of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School. This
study was funded under a grant with the Pennsylvania Department of Health using
Tobacco CURE Funds and by the National Institutes of Health. Provided by Pennsylvania State University
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