A Comparison of a Web-based versus Face-to-Face Social Support-enhanced Weight Loss Program in Nurses: A Pilot Randomized Clinical Trial

Abstract

Abstract Background: Over one third of the United States population is classified as obese or overweight and obesity rates have remain unchanged over the last decade. Obesity and being overweight is the fifth leading causes of deaths globally. Lifestyle changes involving diet and activity can be difficult to initiate and even more difficult to maintain. Therefore, achieving and maintaining weight loss remains difficult for many overweight and obese people. Preliminary studies have shown success with weight loss programs that use social support methods other than face-to-face, such as individual support via telephone calls or remote personal support via web-based methods, as an adjunct intervention for weight loss. Objective: The aims of this study were to determine the feasibility and efficacy of a web-based (WB) versus face-to-face (F2F) social-support enhanced weight loss intervention. Method: Registered nurses who had a body mass index (BMI) of over 25 kg/m2 were asked to participate. Participants were randomized to either WB or F2F social support- enhanced weight loss intervention. All participants followed the Dietary Approach to Stop Hypertension, and attended 12 weekly sessions with a social support component delivered via web-based or face-to-face. End points for feasibility were attendance, adherence with nutrition diary, and satisfaction level. End points for efficacy were weight, BMI, blood pressure (BP), and waist to hip ratio (WHR), and were measured at weeks one, five, eight, and twelve. Data were analyzed for between group differences using non-parametric tests. Results: A total of nine participants were enrolled in the study. Participants were all females, with a median age of 42.5 years in the F2F group and 36 years for the WB group. There were no differences between groups for the feasibility end points of attendance, adherence, and satisfaction levels. There were no differences between groups in all efficacy endpoints of anthropomorphic and BP measurements (except WHR) for all time points. WHR was significantly different between groups, with better outcomes in the WB group. The median weight loss in the WB group was 2.4 kg, and the F2F group 3.8 kg. The change in BMI for the WB group was 0.80 kg/m2 and for the F2F group 1.54 kg/m2. Conclusions: The similar feasibility endpoints of attendance, adherence, and satisfaction levels suggest that a WB social support-enhanced weight loss intervention may be acceptable and feasible alternative to a F2F social support-enhanced weight loss intervention. Conclusions regarding efficacy cannot be formed due to the small sample size and lack of power to detect clinically meaningful differences between groups. The lack of differences between groups is encouraging, and two participants in the F2F group achieved clinically meaningful weight loss of 4.7 and 14.6 kg. Overall findings of this study are consistent with previous studies. Continued studies in web-based methods of social support as an adjunct intervention for weight loss are needed.