If you can’t get face-to-face counseling for weight loss, will a computer-based program do? An independent review of previous research by the Cochrane Library suggests that it’s a useful second choice.
Computer-based and online programs helped people lose weight and keep it off better than if they used no weight-loss interventions whatsoever, but such digital stand-ins weren’t as effective as real-life counseling, the study found.
For the review, the research team analyzed 14 studies comparing weight loss in overweight or obese people who used computer-based programs, face-to-face counseling, or no intervention or minimal weight-loss care (like reading a pamphlet about weight loss at the doctor’s office); the studies involved a total of 2,537 participants. The researchers also looked at four studies focusing on weight maintenance, which included a total of 1,603 participants. All treatments ranged from four weeks to 30 months.
The researchers found that at six months, people relying on computer-based programs lost weight — more than people in no-intervention control groups or groups using minimal intervention methods. But they didn’t lose nearly as much as those in in-person treatment, who were able to shed about 7% to 10% of their body weight on average over 26 weeks.
Similarly, those using online or computer-based weight maintenance plans were able to keep the weight off better than people with little to no weight maintenance assistance, but face-to-face treatments were still the most successful.
Although computer-based programs weren’t as effective as in-person treatments, they still offered encouraging results: in five trials involving 430 participants, for example, people using computer-based interventions lost an average of 5 lbs. more than non-intervention control groups.
“Online programs are a good option for people looking to lose weight because they’re accessible or more accessible than trying to get to a face-to-face meeting with someone,” says study author Dr. Suzanne Brodney, a research associate at the Foundation for Informed Medical Decision Making. “Often providers have few options when they see someone struggling with weight in their office. This could be accessible to a lot more people.”
Typically, computer-based programs use strategies that mimic those of effective in-person treatment, such as helping dieters set goals, keep diaries of eating and exercise and learn how to steer clear of situations likely to cause overeating. Online chat sessions and message boards often try to replicate the support offered in face-to-face group counseling sessions.
These days, such programs are even more convenient than before because of smartphones and other gadgets that allow users to log in from anywhere. When the current review was planned, the researchers had excluded any studies involving cell phones because they were still a relatively new technology at the time, and their small screens were ill-equipped to handle all facets of a digital weight-loss program. “Since we started working on this review, the technology has really changed,” says Dr. Brodney. “Now more and more people have smartphones, and that makes an online type of program even more accessible to people.”
Not only that, but smartphones also let people check email or receive texts anywhere — and make use of supportive weight-loss apps. The review authors found that the more people engaged with their online program, either by logging in more frequently or sending and receiving emails, the more weight they tended to lose. That suggests that weight-loss counseling supported by e-mail or automated communication can increase the effectiveness of computer-based interventions even further, Brodney said.