Support system is a must for weight loss programs
An Internet-based weight management program at IBM helped many employees to move into the normal weight category, with improved eating habits. A total of 7,743 IBM employees enrolled in the program between December 2004 and February 2006, and 74% were overweight or obese.
At six months, 1,639 of these employees had significantly increased healthy eating habits, with a 20% decrease in junk foods and 12% increase in fruits. The percentage of participants in the normal weight category increased from 27.0% to 29.8%, while average weight decreased from 182.6 to 180.2 lbs. At 12 months, a higher percentage of participants had moved into the normal weight category, compared with of non-participants.1
"The study's findings were consistent with other research, in the sense that eliciting weight management is difficult," says Stewart Sill, IBM's wellness program manager. "But it did show promise in reaching employees with a flexible, scalable intervention."
A web-based program could be an effective option for both smaller and larger worksites, according to Sill. "The Internet is particularly key for our large, dispersed workforce. But recent studies suggest web-based interventions can show effectiveness similar to that of more intensive programs," he says.
To measure the effectiveness of a web-based program, do pre and post assessments similar to the program assessment and independent health risk assessment used in this study, suggests Sill. "However, reach is important to limit self-selection bias," he says.
You'll want follow-up information from as many participants as possible, to draw the most valid conclusions. To get more employees to participate, Sill suggests offering incentives for completion of follow-up assessments.
"Also, being able to compare to non-participant groups is very beneficial," he says. "This is why we leveraged the health risk assessment, which was separate from the weight management program."
Health coach is key
Another study of 1032 overweight and obese adults shows that a combination of personal contact and web-based support are most effective for long-term weight loss.2
Two different weight loss maintenance programs were tested, one using personal health coaches and one using an interactive website. Both were effective at reducing weight re-gain for the first 18 months, after which the web site began to lose its effectiveness. The personal coaches continued to be effective over the entire 2 1/2 year follow-up period.
"The key finding is that to maintain weight loss, employees need some accountability," says Victor J. Stevens, PhD, one of the study's authors and a senior researcher at Kaiser Permanente's Center for Health Research. "In our study, we found that a personal health coach is the best way to do that."
Health coaches met with participants once a month for 2 1/2 years. Three contacts per year were in person and the remainder were by telephone. Each contact included the participant's report of weight, number of food diaries kept per week, number of minutes of exercise per week, and progress on other personal goals related to weight management.
Next, the participant and counselor discussed the participant's self-management efforts since their last contact, and the counselor encouraged the participant to develop specific plans for the next month. "The more specific the plans, the better," says Stevens.
If a health coach isn't feasible, Stevens recommends giving employees some type of support system, such as checking in with occupational health nurses each month.
This was the first randomized trial to show that interventions lasting longer than one year significantly improved long-term maintenance of weight loss. "This is an important finding, because there is a common misconception that nothing can be done to prevent weight gain following successful initial treatment," says Stevens.
Although short-term weight loss programs may produce good results, those results are more likely to be maintained over the long term if the participants continue to receive supportive intervention services indefinitely. "The main point is that people need support, and someone to be accountable to, in order to maintain their weight loss," says Stevens.
References
1. Petersen R, Sill S, Lu C, et al. Effectiveness of employee Internet-based weight management program. Journal of Occupational & Environmental Medicine 2008; 50(2):163-171.
2. Svetkey LP, Stevens VJ, Brantley PJ, et al. Comparison of strategies for sustaining weight loss: the weight loss maintenance randomized controlled trial. JAMA 2008; 299 (10):1139-1148.
Sources
For more information about the effectiveness of weight loss programs, contact:
- Stewart Sill, Wellness Program Manager, IBM, Research Triangle Park, NC. Phone: (919) 543-8567. E-mail: [email protected].
- Victor J. Stevens, PhD, Senior Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Phone: (503) 335-6751. Fax: (503) 335-2424. E-mail: [email protected]
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