Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. The addition of 3 or 12 weeks of telephone coaching for individuals with suboptimal response in an online weight loss program at 1 month improved weight loss outcomes compared to those not provided coaching.

Evidence Rating Level: 1 (Excellent)

Intensive behavioural programs revolving around counseling and lifestyle modifications are commonly used as effective interventions for obesity. However, such interventions are often difficult to access due to geographic constraints or financial barriers. While automated online behavioural weight loss (WL) programs may alleviate these barriers, such programs are often associated with lesser WL outcomes. This randomized controlled trial therefore sought to investigate the effect of additional telephone coaching for responders with suboptimal WL outcomes in a 12-month online WL program compared to those without coaching. 437 patients (mean [SD] age = 50.8 [11.4] years) were included in the analyzed sample, with 148 being assigned at baseline to receive extended coaching (telephone coaching for 12 weeks), 143 to brief coaching (telephone coaching for 3 weeks) and 146 to control (no coaching). Participants experiencing a suboptimal WL response (<4% WL) at 1 month in the brief or extended coaching groups received telephone coaching starting from week 5. At 4 months, percent WL was significantly greater in the extended coaching group [mean [SD] WL = -7.0% [5.1%]) and brief coaching group (mean [SD] WL = -6.2% [4.7%]) than the control group (mean [SD] WL = -4.5% [4.7%]) (P < 0.001). At 12 months, percent WL was significantly greater in the extended coaching group [mean [SD] WL = -5.5 [6.7%]) than the control group (mean [SD] WL = -3.9% [7.4%]) (P = 0.03). However, there was no difference in percent WL between the brief coaching group and control group at 12 months. Overall, this study showed that the addition of an intervention for individuals with suboptimal WL responses enrolled in an online WL program may be an effective alternative treatment for the management of obesity.

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