Testing an Internet-Based Turkish Obesity Behavioral Therapy Program: A Randomized Study.

OBJECTIVE

Behavioral treatment is recommended as the first line intervention for the prevention of health problems pertaining to obesity. Internet-based programs are used to provide cognitive behavioral therapy for psychiatric disorders and systemic diseases to a large number of patients at low cost. The aim of this study is to develop the first internet based Turkish obesity behavioral therapy program and test its short-term effectiveness.

METHOD

A Turkish web-based behavioral therapy program based on the behavioral strategies employed in the Diabetes Prevention Program was generated. In order to test the effectiveness of this internet-based program an eight week randomized study was conducted. A total of 101 overweight participants with body mass index in the 25-40 range were randomly assigned to an eight-week weight loss program using either the Internet Behavior Therapy (IBT, n=51) or e-mail education (EE, n=50). The participants in the IBT group were provided access to an Internet program that provided videos teaching behavioral weight-loss skills as well as a self-monitoring platform to calculate the daily calorie balance. The participants in the EE group received weekly e-mails with information on healthy eating, physical exercises and weight loss for eight weeks. The primary outcome measure was the observed weight change at the end of the 8 weeks.

RESULTS

In the analyses wherein baseline weight was carried forward for missing data, the IBT produced significantly larger mean weight loss in comparison to the EE at the end of the 8 weeks [2.28 kg (2.11) vs. 0.74 kg (1.57), p=0.001]. The participants in the IBT group, when compared to the EE group, were also more likely to achieve a clinically significant weight loss of 5% of their initial body weight at the end of the 8-week study period (17.6% vs. 2%, p=0.016).

CONCLUSION

The participants who received a structured IBT intervention lost significantly more weight after two months, compared to those who received weekly informational emails regarding weight loss. Internet-based behavioral therapy programs may have the potential to serve as a low-cost alternative for obese patients.