Paul Buzzell

Weight loss on the web: A pilot study comparing a structured behavioral intervention to a commercial program.

Objective: Internet weight loss programs have become widely available as alternatives to standard treatment, but few data are available on their efficacy. This study aimed to investigate the effectiveness of a structured behavioral weight loss website (VTrim) vs. a commercial weight loss website (eDiets.com).

Does using the Internet facilitate the maintenance of weight loss

OBJECTIVE: The purpose of this study was to investigate the effectiveness of a weight maintenance program conducted over the Internet.DESIGN: Longitudinal, clinical behavioral weight loss trial with 6-month in-person behavioral obesity treatment followed by a 12-month maintenance program conducted both in-person (frequent in-person support; F-IPS, minimal in-person support; M-IPS) and over the Internet (Internet support; IS).SUBJECTS: A total of 122 healthy, overweight adults (age=48.4±9.6, BMI=32.2±4.5 kg/m2, 18 male)MEASUREMENTS: Body weight, dietary intake, energy expended in physical activity, attendance, self-monitoring, comfort with technology.RESULTS: Results (n=101) showed that weight loss did not differ by condition during treatment (8.0±5 vs 11±6.5 vs 9.8±5.9 kg, P=0.27 for IS, M-IPS and F-IPS, respectively). The IS condition gained significantly more weight than the F-IPS group during the first 6 months of weight maintenance (+2.2±3.8 vs 0±4 kg, P<0.05) and sustained a significantly smaller weight loss than both in-person support groups at the 1 y follow-up (−5.7±5.9 vs −10.4±9.3 vs −10.4±6.3 kg, P<0.05 for IS, M-IPS and F-IPS, respectively). Attendance at maintenance meetings was greater for the F-IPS than the IS condition over the 1 y maintenance program (54 vs 39%, P=0.04). Acceptability of assigned condition was higher for subjects in the F-IPS than IS condition.CONCLUSION: The results of this study suggest that Internet support does not appear to be as effective as minimal or frequent intensive in-person therapist support for facilitating the long-term maintenance of weight loss.

The Accuracy of Weight Reported in a Web-Based Obesity Treatment Program

OBJECTIVE The overall goal of the study was to understand the accuracy of self-reported weight over a 6-month Web-based obesity program. MATERIALS AND METHODS As part of a larger study, subjects (n=323; 93% female; 28% African American) were randomized to a 6-month Internet-based behavioral weight loss program with weekly group meetings delivered either: (1) entirely by online synchronous chats or (2) by a combination of online chats plus monthly in-person group sessions. Observed weights were obtained at 0 and 6 months for all participants. Self-reported weights were submitted weekly to the study Web site. Differences in Observed and Reported weights were examined by gender, race, and condition. RESULTS Observed and Reported weight were significantly correlated at 0 and 6 months (r=0.996 and 0.996, ps <0.001 respectively). However, Reported weight underestimated Observed weight by 0.86 kg (p<0.001) at 6 months. Further, there was a significant weight loss effect (p<0.001) with those losing more weight more accurately estimating their Reported weight at 6 months. Additionally, 6-month Reported weight change differed from Observed weight change (difference=0.72 kg, p<0.001), with weight change using Reported weights estimating a slightly larger weight loss than Observed weights. CONCLUSIONS In general, the accuracy of self-reported weight is high for individuals participating in an Internet-based weight loss treatment program. Accuracy differed slightly by amount of weight lost and was not improved with periodic in-person assessment. Importantly, weight change by self-report was comparable to observed, suggesting that it is suitable for Web-based obesity treatment.

Evaluation of a Nutrition and Health Educational Online Computer Program for Older Adults

Background: Many older adults are at increased risk for nutritional deficiencies and foodborne illnesses. The objective of this study was to develop and evaluate the effectiveness of a user-friendly computer application that provides nutrition, food safety, and health information tailored to the needs of older adults. Methods: To determine the effectiveness of the program, a 12-month intervention study was conducted in which subjects were assigned to an experimental (HE-HA) group (access to the computer program) or a control (CON) group (no access to computer program). Computers were placed in each of two Vermont rural congregate meal sites. One site served as the HE-HA group site and the other as the CON site. Forty-one adults congregate meal users (HE-HA group: n=16; CON group: n=25) age ? 55, were recruited to participate in the study. The Nutrition Screening Initiative (NSI) checklist, food behavior checklist, and computer attitude surveys were completed by participants at baseline, 3, and 12 months. Focus groups were conducted between 8 and 9 months. Between and within group over time differences were statistically analyzed by Chi-square analyses and repeated measures ANOVA. Results and Conclusions: A significant positive impact of our program was noted on fruit and vegetable consumption (p < 0.005) and attitude regarding use of computers (p < 0.02). Focus group results indicated that all HE-HA participants claimed to have changed at least one aspect of his/her diet and that the Website contributed to this positive change. They also noted that the help of the “peer mentors” was a significant factor in their positive experience with using the Web application and with the use of computers in general. In this study, we demonstrated the successful use of a nutrition and health computer application in improving both nutrition behavior and computer skills and attitudes in older adults.