Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, Mito, Ibaraki, Japan.
Int J Obes (Lond). 2012 May;36(5):675-85. doi: 10.1038/ijo.2011.121. Epub 2011 Jun 21.
Web-based treatment programs are attractive in primary care because of their ability to reach numerous individuals at low cost. Our aim of this meta-analysis is to systematically review the weight loss or maintenance effect of the Internet component in obesity treatment programs.
MEDLINE and EMBASE literature searches were conducted to identify studies investigating the effect of Web-based individualized advice on lifestyle modification on weight loss. Randomized controlled trials that consisted of a Web-user experimental and non-Web user control group were included. Weight changes in the experimental group in comparison with the control group were pooled with a random-effects model.
A total of 23 studies comprising 8697 participants were included. Overall, using the Internet had a modest but significant additional weight-loss effect compared with non-Web user control groups (-0.68 kg, P=0.03). In comparison with the control group, stratified analysis indicated that using the Internet as an adjunct to obesity care was effective (-1.00 kg, P<0.001), but that using it as a substitute for face-to-face support was unfavorable (+1.27 kg, P=0.01). An additional effect on weight control was observed when the aim of using the Internet was initial weight loss (-1.01 kg; P=0.03), but was not observed when the aim was weight maintenance (+0.68 kg; P=0.26). The relative effect was diminished with longer educational periods (P-trend=0.04) and was insignificant (-0.20 kg; P=0.75) in studies with educational periods of 12 months or more.
The current meta-analysis indicates that the Internet component in obesity treatment programs has a modest effect on weight control. However, the effect was inconsistent, largely depending on the type of usage of the Internet or the period of its use.
基于网络的治疗方案在初级保健中具有吸引力，因为它们能够以低成本覆盖众多人群。我们的目的是系统地回顾互联网组件在肥胖治疗方案中对减肥或维持效果的影响。
进行了 MEDLINE 和 EMBASE 文献检索，以确定研究互联网个性化建议对生活方式改变对减肥效果的影响的研究。纳入了包括互联网使用者实验组和非互联网使用者对照组的随机对照试验。实验组与对照组的体重变化采用随机效应模型进行汇总。
共纳入 23 项研究，包含 8697 名参与者。总体而言，与非互联网使用者对照组相比，使用互联网具有适度但显著的额外减肥效果（-0.68kg，P=0.03）。与对照组相比，分层分析表明，将互联网作为肥胖治疗的辅助手段是有效的（-1.00kg，P<0.001），但将其作为面对面支持的替代手段则不利（+1.27kg，P=0.01）。当使用互联网的目的是初始体重减轻时，观察到对体重控制的额外影响（-1.01kg；P=0.03），但当目的是体重维持时则没有观察到（+0.68kg；P=0.26）。随着教育期的延长，相对效果降低（P 趋势=0.04），在教育期为 12 个月或更长时间的研究中，效果不显著（-0.20kg；P=0.75）。
本荟萃分析表明，肥胖治疗方案中的互联网组件对体重控制有适度的影响。然而，效果不一致，主要取决于互联网的使用类型或使用期限。
