Weight loss programmes over the internet : opportunities and limitations

Abstract: Background: Overweight and obesity is increasing in Sweden and over the world. The societal resources to treat obesity are scarce. Eighty percent of the population in Sweden have access to a computer and hence the Internet. This provides an opportunity to use the Internet for weight reduction purposes. Aim: 1. To identify characteristics of individuals seeking help for their weight problem via an Internet-based programme (Paper I); 2. To identify indicators of long term success in such a programme (Paper I); 3. To compare the outcomes of younger and older members on weight loss and compliance (Paper II). Methods: An Internet-based weight club (www.viktklubb.se) was used consisting of standard algorithms for calculating BMI, food energy content, exercise energy cost. All members filled in basic data and could volunteer to fill in additional research related questions. Together with data on treatment success, attrition, and use of the various components of the programme, this information was automatically monitored and downloaded to a database. Results: Eighty-six percent of the members were female, and the age range was wide (range 18-101y; mean 40.3 ± 11.5y). At baseline, BMI of the entire group was 29.3 ± 5.1 kg/m2 with 39% obese and 45% overweight. Among the completers, 16% changed from overweight or obese to normal weight. This corresponded to 29% of the members losing 5-9.9% of their initial body weight and 20% losing ≥10% of their. The strongest predictors of weight loss were activity in the weight club as judged by number of logins and diary entries, and sex. Older members (>55y) lost significantly more weight, were more active and had lower dropout rates than younger members. Overall, the compliance with the programme was low. Conclusions: A sizeable, but seemingly random, dropout was observed, together with significant dose-response effects between activity in the internet-based program and weight-loss among completers. Older members in the internet weight club did as well or even better than younger members. This study provides indications that an Internet-based weight loss program is most successful in older and/or active members. Given its low cost and high accessibility at 24h/day, this form of programme delivery is interesting to evaluate and develop further, especially regarding attrition.