Web Helps Military, Public Lose Weight for Good

VANCOUVER, BRITISH COLUMBIA—The Internet is helping military personnel and the public lose weight and keep it off, according to two new studies presented in mid-October at the 2005 Annual Scientific Meeting of North American Association for the Study of Obesity (NAASO), The Obesity Society.

In one study of 452 overweight U.S. Air Force personnel, significantly more participants who supplemented their weight loss efforts with a Minimal Contact Behavioral Internet Therapy (MCBIT) met the five percent or more weight loss goal than those who relied on usual care alone. All of the participants studied were five pounds or more below the Air Force's Maximum Allowable Weight (MAW). Although there is a general perception that military personnel are fit and at a healthy weight, the prevalence of overweight and obesity in that population is similar to the general public, with 57 percent of the U.S. Air Force overweight or obese.

"Despite how commonplace it is, there is a stigma in the military about being overweight and joining a weight loss program," said Christine Hunter, chief, Air Force Substance Abuse Program Development, who led the study. "Finding programs that offer a private atmosphere to promote healthy weight management and overcome the barriers to attending a group program are essential to ensure the health and readiness of military personnel."

The MCBIT group received a comprehensive weight loss program consisting of a self-help book, two motivational phone calls and an interactive Internet weight loss program where they received weekly feedback of food and exercise diaries. The usual care group selected their own weight loss program, such as Weight Watchers or a military-sponsored program.

Over 24 weeks, the MCBIT group lost weight compared to a weight gain seen in the traditional care group, and the Internet group experienced significantly more favorable changes in waist circumference and body fat. Specifically, 23 percent of those participants who were above MAW lost at least five percent of initial body weight compared to only 7 percent of the usual care group.

"An Internet-based program may be of particular importance for military personnel who relocate frequently or who are deployed out of the country," Hunter said.

A second study found that an Internet-based counseling program helped participants who recently lost a significant amount of weight prevent regain. According to Rena Wing, lead investigator of the study, about 80 percent of people who lose a large amount of weight regain it over time.

Wing and colleagues compared face-to-face, Internet and newsletter interventions to prevent regain over 18 months in 314 individuals who had recently lost an average of 44 pounds.

The face-to-face and Internet programs had identical comprehensive content that included the same frequency of face-to-face or online group meetings/counseling, respectively. Median weight regain was 2.5 pounds in the face-to-face group, 6.0 pounds in the Internet group and 10.4 pounds in the newsletter group.

"While the participants receiving face-to-face counseling fared the best, our study suggests that Internet-based weight maintenance programs can provide a level of personal counseling, skill-building and motivation important in helping people sustain weight loss," said Wing, professor of psychiatry and human behavior at Brown Medical School in Providence, RI.

Many of the strategies employed in the face-to-face and Internet interventions were gleaned from the National Weight Control Registry, a registry of more than 4,000 individuals who have successfully lost and kept off weight. Among these strategies was daily weighing, which helped alert participants if they were headed into the "red zone" of gaining more than five pounds. More participants in the face-to-face and Internet groups weighed themselves daily (71 percent and 65.2 percent, respectively) compared to just 28.9 percent of the newsletter group. Daily weighing was associated with prevention of weight regain - but only in the Internet and face-to-face conditions. Researchers say this suggests that participants in those two groups were able to use the information from the scale to make constructive changes in their eating and exercise behaviors.