Combining in-person and online weight loss programs may help obese patients lose more weight

04 Nov 2020 --- Weight loss might be more effective when combining different intervention programs, according to a new JAMA-published study.

It found that combining outreach from non-clinical staff – known as population health management – with an online program helped patients with overweight or obesity and hypertension or Type 2 diabetes (T2D) lose more weight on average than the online program only or usual care.

“The use of telehealth has increased recently and patients and providers are becoming much more comfortable with it. This has the potential to make the interventions in our study even more popular,” co-author Dr. Heather Baer, tells NutritionInsight. She is an associate epidemiologist in the general internal medicine and primary care division at the Brigham and Women’s Hospital, where the study was conducted.

The study authors highlight that online programs are underutilized in weight loss programs and have not been widely implemented in routine primary care.

Her research further maintains that combined intervention facilitates potentially helps sustain weight loss in the long term.

Combining usual care with an online program helped participants lose more weight than the two groups alone.“We knew that online weight loss programs can be more convenient, accessible and cheaper for patients, but now both physicians and patients have become more comfortable with the idea of care being delivered virtually,” Baer explains.

Small, but statistically significant results
The researchers recruited 840 patients who were overweight, obese or diagnosed with hypertension or T2D. 

Usual care test subjects received general information about weight management in the mail. Participants in the online program only group and the combined intervention group were registered for the online program. 

The combined intervention group participants also received weight-related population health management, which included additional support from non-clinical staff who monitored their progress in the online program and conducted periodic outreach.

The mean weight loss at 12 months was 1.2 kg in the usual care group, 1.9 kg in the online program only group and 3.1 kg in the combined online program with population health management group.

The combined approach resulted in “small but statistically significant” weight loss results after a year. It also helped patients in the combined group stay on track of their weight half a year after the intervention.

At 18 months, the mean weight change was -1.9 kg in the usual care group, -1.1 kg in the online program only group and -2.8 kg in the combined intervention group.

Online programs have reportedly not been widely implemented in routine primary care.Personalizing weight loss
Using technology in combination with advice from dietitians also improved adults’ dietary intake in a separate study. There it was found that more personalized diet plans leading to better results. 

The holistic approach to weight management is accelerating as a trend. A growing number of consumers are becoming less concerned with losing weight and more interested in maintaining a healthy weight for overall health and well-being.

With personalized nutrition on the fast track of industry trends, ready meals are also entering the arena, especially as COVID-19 lockdowns reduce consumers’ mobility. Weight loss, senior nutrition and plant-based options are also proliferating themes in these convenient options.

In this space, Nutrisystem launched Nutrisystem Partner Plan in September – a meal subscription program designed to enable two people living in the same household to support each other on a shared weight loss journey.

Innova Market Insights recently released its top trends for 2021, with “Tailored to Fit” claiming bronze. The Innova Consumer Survey 2020 shows that 64 percent of global consumers have found more ways to tailor their life and products to their individual styles, beliefs and needs.

“Virtual care is going to stay with us post-pandemic,” Baer predicts.Telehealth for everyone?
Further research is needed to understand the generalizability, scalability and durability of these findings, the authors of the latest study write. 

The generalizability of the team’s findings is limited given that the majority of participants were white, well-educated and English-speaking, notes Baer. 

“Healthcare institutions and providers could do more widespread outreach to all patients, as well as targeted outreach to specific groups. In addition, making the online program available in multiple languages would help,” she underscores.

For online programs to be effective, they need to be high-quality and evidenced-based. On the receipient’s end, people need to have regular access to the Internet, which is “not true for everyone.”

More involvement from primary care providers might also make the combined intervention even more effective – but primary care providers have “many other things on their plates, so this is difficult,” says Baer.

Nevertheless, the combined intervention approach may offer an effective form of weight management that is more easily available to some patients who may face barriers in accessing traditional in-person care, she adds.

Health disparities were also spotted in a recent study that identified significantly lower levels of vitamin D levels among Black pregnant women. In June, a Public Health England review highlighted how the pandemic sheds light on existing health inequalities depending on patients’ age, gender, socioeconomic background and ethnicity.

By Anni Schleicher

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