Can Online Weight Management Programs Combined with Nonclinical Staff Support Help Achieve Weight Loss?
BACKGROUND AND PURPOSE:
Baer et al. (JAMA, 2020) investigated the effectiveness of combining online weight reduction programs plus population health management (nonclinical support staff) to help overweight and obese individuals lose weight
Cluster randomized trial
Patients with a scheduled primary care visit
20 to 70 years
BMI between 27 and <40
Diagnosis of hypertension or type 2 diabetes
Patients mailed general information about weight management
Online program only
Videos on weight loss, sample meal plans, and tools for tracking weight, food intake, and physical activity
Population health management: Support from nonclinical staff | Outreach in person, check-in calls and direct messaging
Weight change at 12 months based on measured weights recorded in the electronic health record
Weight change at 18 months
840 enrolled participants
Mean age: 59.3 years | 60% female | 76.8% white
There was a significant difference in weight change at 12 months by group, with patients in the combined group having the greatest average weight loss (P<0.001)
Usual care: –1.2 kg (95% CI, –2.1 to –0.3 kg)
Online only: 1.9 kg (95% CI, –2.6 to –1.1 kg)
Combined: –3.1 kg (95% CI, –3.7 to –2.5 kg)
There was a significant difference in the weight change between
The combined group and the usual care group
–1.9 kg (97.5% CI, –2.9 to –0.9 kg; P < 0.001)
The combined group and the online only group
-1.2 kg (95% CI –2.2 to –0.3 kg; P = 0.01)
At 18 months the differences in weight loss between groups were maintained
Usual care: –1.9 kg (95% CI, –2.8 to –1.0 kg)
Online only: –1.1 kg (95% CI, –2.0 to –0.3 kg)
Combined: –2.8 kg (95% CI, –3.5 to –2.0 kg)
A combined program utilizing an online weight management program plus nonclinical staff support resulted in a small (approximately 3%) but significantly greater weight loss in patients with hypertension or diabetes
The authors acknowledged that clinical outcomes may have been impacted because the primary care physicians were minimally involved
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