Disseminating Effective Habits for Long-Term Weight Loss
Disseminating Effective Habits for Long-Term Weight Loss
The purpose of the study is to determine whether using a web-based weight loss website can
 help overweight individuals lose weight.
Overweight and obesity are serious threats to public health. Over the last 20 years, the
 percentage of overweight and obese Americans, as well as the rate of diabetes, have grown
 tremendously (Cowie, Rust et al. 2006).

 Few individuals are successful at long-term weight loss. Long-term weight loss is an elusive,
 yet sought after goal for many Americans (2000). Fewer than 5% of adults are successful in
 maintaining a 20 pound weight loss for at least 2 years (Klem, Wing et al. 1997). While
 medications can be effective, they produce only small amounts of weight loss, carry a
 significant cost and appear to be effective only while being taken (2000). Surgery is an
 effective option, though the procedure has tremendous costs and potential complications
 (2000). This points to the need for innovative and effective treatments that helps
 individuals over the longer-term.

 Some, but not all, web-based treatments for weight loss have been shown to be effective. A
 recent study by Tate and colleagues showed that individuals who received counseling emails
 from a human or automated emails from a computer lost more weight than individuals who
 received neither(7.3 kg lost v. 4.9 kg and 2.6 kg, respectively) (Tate, Jackvony et al. 2006)
 (Tate, Jackvony et al. 2003). The feedback in the emails was based on diet and physical
 activity information that the individuals entered online. Dr. Harvey-Berino and colleagues
 has shown that social support delivered via the Internet can help weight loss efforts to the
 same degree as in person support (Harvey-Berino, Pintauro et al. 2004). Other studies have
 been mixed in their effects (Williamson, Walden et al. 2006) (Gold, Burke et al. 2007) (Wing,
 Tate et al. 2006), though there has generally been an effect from human feedback delivered
 via a computer. Other than the recent study by Tate and colleagues, no fully automated
 website has been effective at producing weight loss. It is our belief that fully automated
 systems are needed to meet the needs, in a cost-effective manner, of the 80 million
 overweight Americans who will need life-long help in losing weight and in maintaining their
 weight loss.

 During an earlier phase of the study, 50 in-depth interviews were conducted with individuals
 who have been successful at losing weight and keeping it off. These individuals were asked
 specifically about which habits they use to maintain their weight loss, how these habits are
 implemented and how barriers to using these habits are overcome. These interviews were
 transcribed and the data entered into a website, to be used as part of the intervention to be
 tested in this clinical trial.
Inclusion Criteria:

 -  Age 21-65

 -  BMI 27-40 kg/m2

 -  Fluently speaks and reads English

 -  Access to the Internet at home or at work

 -  Valid email address

 -  Access to a scale for weekly weigh-ins

 -  Agree not to seek additional weight loss treatment

 -  Agree to come back regardless of amount of weight lost

 -  Participant in NCT00377208

 Exclusion Criteria:

 -  Current, planned, or previous pregnancy within 12 months

 -  Planned or past weight loss surgery

 -  Recent weight loss of >= 15 lbs in the past 6 months

 -  History of:

 -  Myocardial infarction

 -  Stroke

 -  Type 1 and Type 2 diabetes

 -  Unstable angina

 -  Congestive heart failure

 -  Inability to exercise due to severe arthritis or other musculoskeletal problems

 -  Cancer (except non-melanoma skin cancer)

 -  Evidence of severe cognitive impairment or major psychiatric illness

 -  Plans to move in the next 6 months

 -  Answering yes to any question on the Physical Activity Readiness Questionnaire (PAR-Q)