Medically Reviewed by Robert Jasmer, MD
Patients in online programs had less weight loss than those who had in-person treatment.
Tracking weight loss on a computer helps patients shed more pounds than other hands-off advice, but won't top in-person interventions, a new review found.
Over 6 months, computer-based interventions led to greater weight loss than minimal interventions such as a brochure on how to lose weight, Louise Falzon, MD, of Columbia University Medical Center, and colleagues wrote in a Cochrane Review.
But patients in these programs had less weight loss than those who had in-person treatment, they reported.
"Computer-based interventions have a positive effect on short-term weight loss and short-term weight loss maintenance," they wrote, but they "result in smaller losses and lower levels of weight maintenance" than in-person counseling.
Research has started to show that treatment programs in which patients interact with the computer may help them make changes in lifestyle and diet in order to lose weight. These programs include online goal setting and online logging of caloric intake and exercise.
So to assess how these programs compare with more traditional in-person interventions, they reviewed randomized controlled studies involving computer-based weight loss or weight maintenance programs through May 2011. A total of 14 studies on weight loss involved 2,537 patients, and four studies with 1,603 patients focused on weight maintenance.
Although the computer-based interventions led to greater weight loss than minimal interventions such as pamphlets, they couldn't top the weight loss seen with in-person treatments, the researchers reported.
"While interactive computer-based interventions appear to be more effective than a minimal or no-treatment control, they do not appear to be more effective than in-person treatments, even in cases where the in-person contacts are infrequent," they wrote.
Fewer trials in the review looked at computer interventions for maintenance of weight loss, but these still "consistently led to lower levels of weight regain when compared to a minimal or no treatment condition," the researchers reported.
Again, these were not superior to infrequent, in-person therapy.
Few interventions led to changes in caloric intake, physical activity, or waist circumference, the researchers cautioned, but the outcomes weren't reported in all studies. Also, no studies reported information on health-related quality of life, morbidity, complications, or adverse events.
One study reported the cost-effectiveness of weekly in-person weight loss sessions to a computer-based intervention at $7,177 per life-year gained, though it's unclear if that number can be extrapolated to other studies, the researchers said.
They added that greater adherence to computer interventions was associated with greater amounts of weight loss, "though it was not clear what intervention elements would best encourage greater use or whether encouraging greater use would lead to larger effects."
The study was limited because it didn't assess the longer-term impacts of computer interventions, but Falzon and colleagues concluded that even though in-person programs may offer better weight loss, providers "have few options to offer their patients, so programs of less impact are still potentially important to consider as treatment options."
