BACKGROUND: Most weight-loss research targets obese individuals who desire large weight reductions. However, evaluation of weight-gain prevention in overweight individuals is also critical as most Americans become obese as a result of a gradual gain of 1 to 2 pounds per year over many years. METHOD: This study evaluated the efficacy of an internet-based program for weight-loss and weight-gain prevention with a two-group, prospective, randomized controlled trial. A military medical research center with a population of 17,000 active-duty military personnel supplied 446 overweight individuals (222 men; 224 women) with a mean age of 34 years and a mean BMI of 29. Recruitment and study participation occurred 2003 to 2005 and data were analyzed in 2006. Participants were randomly assigned to receive the 6-month behavioral internet treatment (BIT, n = 227) or usual care (n = 224). Change in body weight, BMI, percent body fat, and waist circumference; presented as group by time interactions, were measured. RESULTS: After 6 months, completers who received BIT lost 1.3 kg while those assigned to usual care gained 0.6 kg (F[366] = 24.17; I < 0.001). Results were similar for the intention-to-treat model. BIT participants also had significant changes in BMI (-0.5 versus +0.2 kg/m2; F[366] = 24.58); percent body fat (-0.4 versus +0.6%; F[366] = 10.45); and waist circumference (-2.1 versus -0.4 cm; F[366] = 17.09); p < 0.001 for all. CONCLUSIONS: Internet-based weight-management interventions result in small amounts of weight loss, prevent weight gain, and have potential for widespread dissemination as a population health approach. TRIAL REGISTRATION: NCT00417599.

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