An Interdisciplinary Online Weight Loss Program Delivered Clinically Meaningful Weight Loss and High Participation
From Nouf Alfouzan
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From Nouf Alfouzan
Objective: We hypothesized that 1) adapting the in-person program to online would increase participation and reduce attrition, and 2) collaborating with behavioral and medical professionals would improve weight loss efficacy by addressing non-dietary barriers to weight loss.
Methods: Thirty-one patients with BMI ≥ 25 kg/m2 and one or more comorbidities were recruited from Carle Clinics and enrolled in a two- year ongoing weight loss study, called EMPOWER. EMPOWER is comprised of 19 online sessions (eText) and individual or group coaching sessions (Zoom) by nutrition, lifestyle, or medical professionals. Participants weighed daily using a Wi-Fi -enabled-scale. Body composition and waist circumference were collected at baseline and at six months. A Food frequency questionnaire (FFQ) was obtained at baseline to assess participants’ dietary habits. Monthly 24-hr diet records were collected to evaluate diet changes. The focus of dietary changes in EMPOWER was increasing protein and fiber intake while reducing energy intake.
Results: At six-months from baseline, 30 participants remained (96%) and 81% completed at least 15 sessions. The mean weight loss was -6.6±5.8%(mean±SD) (p <.001), whereas mean weight loss in the previous iDip study (n=22) was -5.8± 6.3% (p <.001). In EMPOWER, 16 out of 30 participants (53.3%) achieved clinically meaningful weight loss >5% of initial body weight, whereas in iDip, eight out of 22 participants (36%) achieved >5% weight loss. No statistical differences were observed in the magnitude of weight loss between the two studies (p =0.3). Mean weight loss of the top, middle, and bottom tertiles (n=10 each) of EMPOWER was -13±2.9%, -5.8±1.9%, and -0.6±2.4%, respectively. Protein/kcal and fiber/kcal assessed by FFQ at baseline did not differ among tertiles. Monthly 24-hr records found a significantly higher protein/kcal intake in the top and+middle tertiles than in the bottom tertile (6.6 vs. 5.3 g/100 kcal, p <.05). Although higher intake in fiber/kcal was observed in the top and+middle tertiles than in the bottom tertile, it did not reach statistical significance (1.71 vs. 1.58 g/100 kcal, p =0.5).
Conclusions: The EMPOWER program resulted in weight loss as effective as in the previous study. EMPOWER also achieved low attrition and high participation. The success of weight loss was accompanied by a successful increase in protein/kcal in diets.
Acknowledgments: Supported in part by USDA NIFA ILLU-698-908 and SACM scholarship.