- Healthcare providers have long struggled with engaging their patients in weight loss, finding that most efforts are unsuccessful and have low adherence rates. A multi-faceted patient engagement platform may help improve this issue, shows a recent study published in the journal Internet Interventions.
“Although it is well established that a reduction in weight of 5 - 10 percent substantially decreases the risk of morbidity and premature mortality, adherence to weight loss interventions is generally poor,” the investigators reported.
“Consequently, a reduction in obesity and/or obesity-related health conditions remains a serious challenge, in particular to primary care providers who receive limited training and support in obesity management but who are expected to counsel and treat the condition.”
According to the researchers, targeted weight loss engagement technologies have the potential to help patients not only reach weight loss goals, but to make permanent healthy lifestyle changes. Providers can scale these tools by offering them via tablet, computer, or smart phone, helping to increase their potentially positive impact.
“These types of interventions have the ability to reach individuals worldwide, including those in rural or remote locations or those with transportation limitations, provide support that is convenient and accessible 24-hours per day, offer multiple options for peer and health professional support, and be offered at a low cost,” the team said.
The research team tested this theory by introducing the Precision Nutrition Coaching Program, a commercially-available weight loss engagement tool, to a group of 68 middle-aged (average 40 years old) women categorized as overweight. Ultimately, 28 participants completed the 12-month intervention.
Study participants checked in with researchers at baseline and 12 months. During those check-ins, researchers measured determinants of weight loss and overall health such as weight, waist circumference, body fat mass, muscle mass, blood pressure, LDL and HLD cholesterol, triglycerides, C reactive protein, and fasting glucose.
According to baseline data, participants were primarily healthy with the exception of their weight, cholesterol, and body fat mass. Exceptions to that observation included those that did not complete the intervention, who on average had higher baseline weight, fat mass, and muscle mass.
At intervention completion, women who completed the program lost on average 16.52 pounds, or an 8.62 percent weight loss in 12 months. The investigators reported that this was largely due to fat loss, not muscle loss. This distinction is important, they said, because muscle loss tends to indicate a slowing metabolism, whereas fat loss indicates lowered cardiovascular risk factors.
Women also saw an average 3.56 inch waist circumference loss and lower blood pressure. The researchers did not identify any other significant health factor improvements, however attributed this pattern to participants’ high overall baseline health.
“Although we detected few significant changes in the health indicators collected for this study, many of the women presented with baseline values that fell within normal healthy ranges,” the team said.
“Thus, it was not surprising that we detected little improvements at follow up. However, it is noteworthy that the changes detected in diastolic blood pressure, HDL, and waist circumference may confer significant reductions in disease risk.”
According to the research team, the success of this weight loss platform may be credited to its multi-pronged approach, helping patients make overall lifestyle improvements.
“This finding supports the guidelines that suggest weight management interventions be multi-faceted and include self-monitoring, goal setting, behaviour change psychology, and coaching from a health professional (including regular tailored feedback),” the researchers said.
These factors contributed to adherence and success rates in this study, the researchers said. Although they did not see complete adherence (only 28 or the 68 recruited women completed the program), those who did have high adherence levels saw better results, highlighting the success of the intervention.
The lifestyle coaching included in the program likewise contributed to the prolonged weight loss maintained by study participants, a rare feat, research shows.
“Unlike the weight loss trajectory seen in this study, it is more common for participants in other interventions to lose weight for the first 3 to 6 months and then gradually regain weight as time goes on,” they said.
Overall, this study shows that targeted weight loss programs tend to be more successful than traditional goal setting strategies with primary care providers. Primary care providers do not have sufficient training in weight loss management and engagement, and likewise do not have enough time during appointments to properly address the issue with patients.
Ultimately, those impediments suggest a need for primary care providers to consider multi-faceted weight loss engagement tools to promote healthy lifestyles and eventual weight loss with overweight patient populations.
“Participation in the web-based multi-platform nutrition, exercise, and lifestyle coaching program for weight management, can support middle-aged women in experiencing significant weight loss and reducing disease-related risk factors,” the researchers concluded.
“Thus, this intervention may be a viable treatment option for individuals who are seeking support with weight management and who have similar characteristics to those in this pilot study.”