It is recognised that successful weight management programmes contain key elements1 that include:
Changing health behaviour is challenging and complicated. Key to success is fully engaging the user. A systematic review by Webb et al. (2010)2 suggests that the effectiveness of internet-based interventions is associated with more extensive use of behavioural change techniques and methods of interacting with participants.
Weight loss is one issue but it is important to bear in mind that once weight has been lost then the next challenge is to keep the weight off. The Weight Loss Maintenance Trial3 compared two long-term (2.5 years) weight-maintenance interventions. Consistent users (based on regularity and frequency of use) of an interactive behavioural website had less weight regain and were more likely to be successful at keeping the weight off. There is no standard definition for ‘successful maintenance of weight loss’ but in this study, it was identified as those who maintained a weight at least 8.8 lbs (4 kg) under their starting weight.
Internet weight management programmes, like most other programmes, are subject to variable outcomes depending on the user’s adherence to the programme. A review of web-based weight loss interventions in adults4 acknowledged that internet-based interventions do not have a uniform effect on weight. They found that weight loss varied from no weight loss at all, to an average of 16.75 lbs (7.6 kg). Again, consistency of use appeared to be a key driver of success with the authors acknowledging that there was a positive association between log in frequency and weight loss. In addition, they found that dropout rates were higher in those offering less education and less initial weight loss.
A well-designed internet weight loss programme that offers tailored support and e-mail counselling can be as effective as direct face-to-face counselling,5 with those who log on consistently benefiting from the motivation and encouragement, self-management techniques and personalised messaging they receive6. On a final note, a recent study of the Mon Special K program (website available in English or French) concluded that the advice and motivation offered by an interactive website, including consumption of breakfast cereals, results in significantly greater body mass and fat loss compared to the use of a standard website7.