This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (180)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Informatics/ Internet in Medicine  • Internet  • Patient-Physician Relationship/ Care  • Patient Education/ Health Literacy  • Alert me on articles by topic  Social Bookmarking   What's this?

Deborah F. Tate, PhD; Rena R. Wing, PhD; Richard A. Winett, PhD

JAMA. 2001;285:1172-1177.

Context  Rapid increases in access to the Internet have made it a viable mode for public health intervention. No controlled studies have evaluated this resource for weight loss.

Objective  To determine whether a structured Internet behavioral weight loss program produces greater initial weight loss and changes in waist circumference than a weight loss education Web site.

Design  Randomized, controlled trial conducted from April to December 1999.

Setting and Participants  Ninety-one healthy, overweight adult hospital employees aged 18 to 60 years with a body mass index of 25 to 36 kg/m². Analyses were performed for the 65 who had complete follow-up data.

Interventions  Participants were randomly assigned to a 6-month weight loss program of either Internet education (education; n = 32 with complete data) or Internet behavior therapy (behavior therapy; n = 33 with complete data). All participants were given 1 face-to-face group weight loss session and access to a Web site with organized links to Internet weight loss resources. Participants in the behavior therapy group received additional behavioral procedures, including a sequence of 24 weekly behavioral lessons via e-mail, weekly online submission of self-monitoring diaries with individualized therapist feedback via e-mail, and an online bulletin board.

Main Outcome Measures  Body weight and waist circumference, measured at 0, 3, and 6 months, compared the 2 intervention groups.

Results  Repeated-measures analyses showed that the behavior therapy group lost more weight than the education group (P = .005). The behavior therapy group lost a mean (SD) of 4.0 (2.8) kg by 3 months and 4.1 (4.5) kg by 6 months. Weight loss in the education group was 1.7 (2.7) kg at 3 months and 1.6 (3.3) kg by 6 months. More participants in the behavior therapy than education group achieved the 5% weight loss goal (45% vs 22%; P = .05) by 6 months. Changes in waist circumference were also greater in the behavior therapy group than in the education group at both 3 months (P = .001) and 6 months (P = .005).

Conclusions  Participants who were given a structured behavioral treatment program with weekly contact and individualized feedback had better weight loss compared with those given links to educational Web sites. Thus, the Internet and e-mail appear to be viable methods for delivery of structured behavioral weight loss programs.

Author Affiliations: Brown Medical School/Miriam Hospital, Providence, RI (Drs Tate and Wing) and Virginia Polytechnic Institute and State University, Blacksburg, Va (Dr Winett).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED ARTICLE

March 7, 2001
JAMA. 2001;285(9):1229-1230.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Efficacy of an Internet-Based Behavioral Intervention for Adults With Insomnia
Ritterband et al.
Arch Gen Psychiatry 2009;66:692-698.
ABSTRACT | FULL TEXT  

Experiences of Self-Monitoring: Successes and Struggles During Treatment for Weight Loss
Burke et al.
Qual Health Res 2009;19:815-828.
ABSTRACT  

Comparison of Methods for Delivering a Lifestyle Modification Program for Obese Patients: A Randomized Trial
Digenio et al.
ANN INTERN MED 2009;150:255-262.
ABSTRACT | FULL TEXT  

Evaluation of an interactive, Internet-based weight loss program: a pilot study
Booth et al.
Health Educ Res 2008;23:371-381.
ABSTRACT | FULL TEXT  

Food, Fun and Fitness Internet program for girls: influencing log-on rate
Thompson et al.
Health Educ Res 2008;23:228-237.
ABSTRACT | FULL TEXT  

State of the Art Reviews: Using the Internet to Promote Physical Activity and Healthy Eating in Youth
Whiteley et al.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:159-177.
ABSTRACT  

Themed Review: Lifestyle Management of Obesity
Tyler et al.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2007;1:423-429.
ABSTRACT  

State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health
O'Neil and Nicklas
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2007;1:457-481.
ABSTRACT  

Recommendations for Treatment of Child and Adolescent Overweight and Obesity
Spear et al.
Pediatrics 2007;120:S254-S288.
ABSTRACT | FULL TEXT  

Interactive Behavior Change Technology to Support Diabetes Self-Management: Where do we stand?
Piette
Diabetes Care 2007;30:2425-2432.
FULL TEXT  

Meta-analysis: The Effect of Dietary Counseling for Weight Loss
Dansinger et al.
ANN INTERN MED 2007;147:41-50.
ABSTRACT | FULL TEXT  

Effectiveness of an online computer-tailored physical activity intervention in a real-life setting
Spittaels et al.
Health Educ Res 2007;22:385-396.
ABSTRACT | FULL TEXT  

Why do obese patients not lose more weight when treated with low-calorie diets? A mechanistic perspective
Heymsfield et al.
Am. J. Clin. Nutr. 2007;85:346-354.
ABSTRACT | FULL TEXT  

Child and Parental Self-Monitoring as Determinants of Success in the Treatment of Morbid Obesity in Low-Income Minority Children
Germann et al.
J Pediatr Psychol 2007;32:111-121.
ABSTRACT | FULL TEXT  

A self-regulation program for maintenance of weight loss.
Wing et al.
NEJM 2006;355:1563-1571.
ABSTRACT | FULL TEXT  

Clinical Management After Bariatric Surgery: Value of a Multidisciplinary Approach
McMahon et al.
Mayo Clin Proc. 2006;81:S34-S45.
ABSTRACT | FULL TEXT  

A Randomized Trial Comparing Human e-Mail Counseling, Computer-Automated Tailored Counseling, and No Counseling in an Internet Weight Loss Program.
Tate et al.
Arch Intern Med 2006;166:1620-1625.
ABSTRACT | FULL TEXT  

Website physical activity interventions: preferences of potential users
Ferney and Marshall
Health Educ Res 2006;21:560-566.
ABSTRACT | FULL TEXT  

A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus
Shea et al.
J. Am. Med. Inform. Assoc. 2006;13:40-51.
ABSTRACT | FULL TEXT  

Evaluating an Internet weight loss program for diabetes prevention
McCoy et al.
HEALTH PROMOT INT 2005;20:221-228.
ABSTRACT | FULL TEXT  

Innovative techniques to address retention in a behavioral weight-loss trial
Goldberg and Kiernan
Health Educ Res 2005;20:439-447.
ABSTRACT | FULL TEXT  

Harnessing the potential of the Internet to promote chronic illness self-management: diabetes as an example of how well we are doing
Bull et al.
Chronic Illness 2005;1:143-155.
ABSTRACT  

The Effect of Web-Based, Personalized, Osteoarthritis Quality Improvement Feedback on Patient Satisfaction With Osteoarthritis Care
Sciamanna et al.
American Journal of Medical Quality 2005;20:127-137.
ABSTRACT  

Systematic Review: An Evaluation of Major Commercial Weight Loss Programs in the United States
Tsai and Wadden
ANN INTERN MED 2005;142:56-66.
ABSTRACT | FULL TEXT  

Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease: A Statement for Professionals From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation
Klein et al.
Circulation 2004;110:2952-2967.
ABSTRACT | FULL TEXT  

Email consultations in health care: 1--scope and effectiveness
Car and Sheikh
BMJ 2004;329:435-438.
FULL TEXT  

An internet behavioural counselling weight loss programme reduced weight and BMI in patients at risk of type 2 diabetes
Kudva
Evid. Based Med. 2003;8:181-181.
FULL TEXT  

The internet and mental health practice
Christensen and Griffiths
Evid. Based Ment. Health 2003;6:66-69.
FULL TEXT  

Using Innovative Video Doctor Technology in Primary Care to Deliver Brief Smoking and Alcohol Intervention
Gerbert et al.
Health Promot Pract 2003;4:249-261.
ABSTRACT  

Effects of Internet Behavioral Counseling on Weight Loss in Adults at Risk for Type 2 Diabetes: A Randomized Trial
Tate et al.
JAMA 2003;289:1833-1836.
ABSTRACT | FULL TEXT  

An Automated Treatment for Jet Lag Delivered Through the Internet
Lieberman
Psychiatr. Serv. 2003;54:394-396.
ABSTRACT | FULL TEXT  

The doctor, the patient and the world-wide web: how the internet is changing healthcare
Powell et al.
JRSM 2003;96:74-76.
FULL TEXT  

Collecting behavioural data using the world wide web: considerations for researchers
Rhodes et al.
J. Epidemiol. Community Health 2003;57:68-73.
ABSTRACT | FULL TEXT  

Behavioral Medicine in the Prevention and Treatment of Cardiovascular Disease
Graves and Miller
Behav Modif 2003;27:3-25.
ABSTRACT  

How will Internet Use Affect the Patient? A Review of Computer Network and Closed Internet-based System Studies and the Implications in Understanding How the Use of the Internet Affects Patient Populations
Bauerle Bass
J Health Psychol 2003;8:25-38.
ABSTRACT  

Columbia University's Informatics for Diabetes Education and Telemedicine (IDEATel) Project: Rationale and Design
Shea et al.
J. Am. Med. Inform. Assoc. 2002;9:49-62.
ABSTRACT | FULL TEXT  

Other Articles Noted
Evid. Based Nurs. 2001;4:E1-11.
FULL TEXT  

Other articles noted
Evid. Based Ment. Health 2001;4:72-72.
FULL TEXT  

Can Patients Lose Weight by Sitting in Front of Computers?
Journal Watch Dermatology 2001;2001:12-12.
FULL TEXT  

Can Patients Lose Weight by Sitting in Front of Computers?
JWatch General 2001;2001:3-3.
FULL TEXT