A randomized controlled trial testing an Internet delivered cost-benefit approach to weight loss maintenance.
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±5.7kg. In contrast, participants in CB Pro and CB Peer lost an additional 1.8±7.0kg and 0.5±6.4kg, 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.
University of Connecticut, Department of Allied Health Sciences, 358 Mansfield Road, Unit 1101, Storrs, CT 06269-1101, USA; The Miriam Hospital/Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA. Electronic address: tricia.leahey@uconn.edu.
Tricia M
TM
Leahey
The Miriam Hospital/Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA.
Joseph L
JL
Fava
The Miriam Hospital/Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA.
Andrew
A
Seiden
The Miriam Hospital/Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA.
Denise
D
Fernandes
The Miriam Hospital/Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA.
Caroline
C
Doyle
The Miriam Hospital/Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA.
Kimberly
K
Kent
The Miriam Hospital/Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA.
Molly
M
La Rue
University of Toronto, University Health Network, Toronto Rehabilitation Institute, 347 Rumsey Road, Toronto M4G 1R7, Canada.
Marc
M
Mitchell
The Miriam Hospital/Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA.
Rena R
RR
Wing
D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008611:Mentors; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D010379:Peer Group; D012648:Self Care; D015431:Weight Loss
Cost–benefit; E-coaching; Incentives; Internet; Peers; Professionals; Variety; Weight loss maintenance