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So your doctor has advised you to lose weight, or you've made the decision yourself; great start! And in this tech-happy world, you decide to use an online program to help you do so, or your doctor has recommended one to you.
But how good is the program? Does it make wild promises? Does it advise supplements not approved by the FDA for weight loss? How do you know, and is it a problem? Well, according to a new study published in the journal Obesity, it could be.
Led by Benjamin Bloom, a medical student at the University of Maryland School of Medicine in Baltimore, the authors sought to evaluate a number of online weight-loss programs in the Washington DC-Virginia-Maryland corridor. They identified 191 of them available to consumers in that area; and content analyses were performed on the sites. They also conducted telephone surveys with representatives of 52 randomly selected sites to ascertain how well the sites represented the programs.
The investigators evaluated how well the programs met with current guidelines set out by the American Heart Association, The Obesity Society, and the American College of Cardiology in terms of five main attributes:
- Program intensity: Reports offering a high-intensity intervention (14 sessions in 6 months)
- Dietary change: Reports recommending a moderate calorie deficit, using an evidence-based named diet, and/or providing meal replacements
- Physical activity: Reports encouraging increased physical activity of any type or duration
- Behavior modification: Reports recommending regular self-monitoring of weight, meal planning, food tracking, and/or exercise tracking
- Supplement use: Does not report dispensing or recommending supplements
Programs were graded "high" if they met all five criteria; they were considered "moderate" if they did not recommend supplements and met two of the other four criteria; programs considered "low" recommended supplements or met less than two of the other criteria.
The results of the evaluations were quite variable. Of the 191 program sites assessed, as one might expect most did advise some type of dietary change. The next most frequent categories of advice were program intensity, recommendation for increased physical activity, and use of a behavior modification strategy (59, 57, and 53 percent respectively. On the negative side, 34 percent recommended/or dispensed dietary supplements or alternative treatments of some type — such as vitamin B12 injections, or green tea products.
Overall, their evaluation of the 191 website programs was pretty dismal with respect to concordance with the guidelines. Only 1 percent were rated "high," 8 percent were rated "moderate" and a whopping 91 percent were rated "low."
However, the evaluation of the 52 sites' representatives contacted for telephone surveys to verify their programs was better. When the researchers were able to ascertain more information about the programs, they rated 19 percent as "high," 12 percent as "moderate" and 69 percent as "low." Still, not an outstanding record.
In sum, it seems that most programs do not provide enough information on their websites to allow a reader to determine how well they agree with guidelines, since contact with representatives greatly improved the evaluations. Further, it seems necessary for healthcare providers to investigate website programs carefully before advising their patients to use them.
