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Effect of web-based lifestyle modification on weight control: a meta-analysis |
Kodama S, Saito K, Tanaka S, Horikawa C, Fujiwara K, Hirasawa R, Yachi Y, Iida KT, Shimano H, Ohashi Y, Yamada N, Sone H |
International Journal of Obesity 2012 May;36(5):675-685 |
systematic review |
OBJECTIVE: Web-based treatment programs are attractive in primary care because of their ability to reach numerous individuals at low cost. Our aim of this meta-analysis is to systematically review the weight loss or maintenance effect of the internet component in obesity treatment programs. METHODS: Medline and Embase literature searches were conducted to identify studies investigating the effect of web-based individualized advice on lifestyle modification on weight loss. Randomized controlled trials that consisted of a web-user experimental and non-web user control group were included. Weight changes in the experimental group in comparison with the control group were pooled with a random-effects model. RESULTS: A total of 23 studies comprising 8,697 participants were included. Overall, using the internet had a modest but significant additional weight-loss effect compared with non-web user control groups (-0.68 kg, p = 0.03). In comparison with the control group, stratified analysis indicated that using the internet as an adjunct to obesity care was effective (-1.00 kg, p < 0.001), but that using it as a substitute for face-to-face support was unfavorable (+1.27 kg, p = 0.01). An additional effect on weight control was observed when the aim of using the internet was initial weight loss (-1.01 kg; p = 0.03), but was not observed when the aim was weight maintenance (+0.68 kg; p = 0.26). The relative effect was diminished with longer educational periods (p-trend = 0.04) and was insignificant (-0.20 kg; p = 0.75) in studies with educational periods of 12 months or more. CONCLUSION: The current meta-analysis indicates that the internet component in obesity treatment programs has a modest effect on weight control. However, the effect was inconsistent, largely depending on the type of usage of the internet or the period of its use. A brief summary and a critical assessment of this review may be available at DARE |