The Comparison of a Technology-based System and In-person Behavioral Weight Loss Intervention in the Severely Obese

A technology-based system incorporating a physical activity monitor and a web interface to monitor dietary intake and body weight combined with monthly telephone contact has been shown to be an effective intervention for weight loss. Whether this type of intervention is effective for individuals with Class II (BMI = 35.0 to <40.0 kg/m2) or III (BMI >40 kg/m2) obesity has not been examined. Continuous enhancements in technology require ongoing evaluation of the effectiveness of these interventions. PURPOSE: To examine weight loss in response to standard behavioral weight loss (SBWL), technology (TECH), and an enhanced technology (TECH-BT) interventions in adults with Class II or III obesity. METHODS: Subjects were 39 adults (age: 39.0±9.7, BMI: 39.5±2.8kg/m2) randomized to SBWL (n=14), TECH (n=12), or TECH-BT (n=13). The prescription for all subjects included decreases in energy intake (1500-2100kcal/d), and increases in physical activity (200min/wk). SBWL attended weekly in-person group intervention sessions. TECH was provided with a wearable activity monitor that interfaced with a web-based program to monitor dietary intake and body weight (BodyMedia FIT®), also with one 10-minute intervention telephone call per month. TECH-BT received the same component as TECH, with the technology enhanced with Bluetooth® capability to allow for real-time monitoring of energy balance (intake and expenditure)(BodyMedia LINK®). RESULTS: Body weight was significantly reduced (p<.001) from 110.9±9.1 to 107.7±8.8kg in SBWL (-3.2±3.1kg; -2.9±2.9%), 112.2±10.5 to 107.2±10.5kg in TECH (-5.0±3.7kg; 4.9±3.8%), and 108.8±15.0 to 104.0±16.2kg in TECH-BT (-3.3±4.2kg; 3.5±4.8%) from 0 to 3 months. However, weight loss was not significantly different between the intervention groups. While significant improvements (p<.05) were found in waist and hip circumferences, percent body fat, physical activity, and dietary intake, there were no group significant group differences. CONCLUSIONS: These findings suggest that significant short-term weight loss can be achieved in individuals with Class II or III obesity with less in-person contact using a technology-based system combined with monthly telephone contact. These findings may have significant clinical implications for effective delivery of weight loss interventions for severely obese adults. Whether these findings extend beyond the initial 3 months of intervention and the long-term acceptability of a technology-based intervention warrants further investigation