A randomized controlled trial testing an Internet delivered cost-benefit approach to weight loss maintenance

作者：Leahey Tricia M^*; Fava Joseph L; Seiden Andrew; Fernandes Denise; Doyle Caroline; Kent Kimberly; La Rue Molly; Mitchell Marc; Wing Rena R

来源：Preventive Medicine, 2016, 92: 51-57.

DOI：10.1016/j.ypmed.2016.04.013

• Weight loss maintenance
• Cost-benefit
• Incentives
• Internet
• E-coaching
• Peers
• Professionals
• Variety

Weight loss maintenance is a significant challenge in obesity treatment. During maintenance the "costs" of adhering to weight management behaviors may outweigh the "benefits." This study examined the efficacy of a novel approach to weight loss maintenance based on modifying the cost-benefit ratio. Individuals who achieved a 5% weight loss (N= 75) were randomized to one of three, 10-month maintenance interventions. All interventions were delivered primarily via the Internet. The Standard arm received traditional weight maintenance strategies. To increase benefits, or rewards, for maintenance behaviors, the two cost-benefit intervention conditions received weekly monetary rewards for self-monitoring and social reinforcement via e-coaching. To decrease behavioral costs (boredom) and increase novelty, participants in the cost-benefit conditions also monitored different evidence-based behaviors every two weeks (e.g., Weeks 1 & 2: steps; Week 3 & 4: red foods). The primary difference between the cost-benefit interventions was type of e-coach providing social reinforcement: Professional (CB Pro) or Peer (CB Peer). Study procedures took place in Providence, RI from 2013 to 2014. Retention was 99%. There were significant group differences in weight regain (p = .01). The Standard arm gained 3.5 +/- 5.7 kg. In contrast, participants in CB Pro and CB Peer lost an additional 1.8 +/- 7.0 kg and 0.5 +/- 6.4 kg, respectively. These results suggest that an Internet delivered cost-benefit approach to weight loss maintenance may be effective for long-term weight control. In addition, using peer coaches to provide reinforcement may be a particularly economic alternative to professionals. These data are promising and provide support for a larger, longer trial.

• 出版日期2016-11