Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA.
Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 2nd Floor, Washington, DC 20052, USA.
Transl Behav Med. 2021 Apr 26;11(4):970-980. doi: 10.1093/tbm/ibab017.
Weight loss outcomes among young adults in technology-based programs have been equivocal. The purpose of this study was to deliver digital weight loss treatments to young adults and examine the 6, 12, and 18 month effects on weight loss. Young adults with overweight/obesity (N = 459; 23.3 ± 4.4 years) were recruited from two university sites and randomly assigned to receive through Facebook and text messaging either personalized (TAILORED; n = 150) or generic (TARGETED; n = 152) weight loss information, messages, and feedback or general healthy body content (e.g., body image, sleep; CONTROL; n = 157). The study was powered to detect a 2.1-kg difference at all time points with the primary outcome being 18 months. There was no overall effect of treatment group on 6, 12, or 18 month weight loss (ps = NS). However, at 6 months, those in TAILORED who were highly engaged (completing >66%) lost more weight compared to CONTROL (-2.32 kg [95% confidence intervals: -3.90, -0.74]; p = .004), with the trend continuing at 12 months. A significant baseline body mass index (BMI) by treatment group interaction (p = .004) was observed at 6 months. Among participants in the lowest baseline BMI category (25-27.5 kg/m2), those in TAILORED lost 2.27 kg (-3.86, -0.68) more, and those in TARGETED lost 1.72 kg (-3.16, -0.29) more than CONTROL after adjusting for covariates. Among participants with a BMI between 27.5 and 30 kg/m2, those in TAILORED lost 2.20 kg (-3.90, -0.51) more than participants in TARGETED. Results did not persist over time with no treatment interaction at 12 or 18 months. Initial body weight should be considered when recommending weight loss treatments for young adults. More intensive interventions or stepped care approaches may be needed for young adults with obesity.
基于技术的项目中年轻人的减肥效果一直存在争议。本研究的目的是为年轻人提供数字减肥治疗，并研究减肥在 6、12 和 18 个月时的效果。从两个大学地点招募了超重/肥胖的年轻人（N = 459；23.3 ± 4.4 岁），并随机分配通过 Facebook 和短信接收个性化（定制化；n = 150）或通用（目标化；n = 152）的减肥信息、消息和反馈，或接受一般的健康身体内容（例如，身体形象，睡眠；对照组；n = 157）。该研究的目的是在所有时间点检测出 2.1 公斤的差异，主要结果是 18 个月。治疗组对 6、12 或 18 个月的体重减轻没有总体影响（p = NS）。然而，在 6 个月时，高度参与（完成> 66%）的定制化组比对照组体重减轻更多（-2.32 公斤[95%置信区间：-3.90，-0.74]；p =.004），这一趋势在 12 个月时仍在继续。在 6 个月时观察到体重指数（BMI）与治疗组之间的显著交互作用（p =.004）。在最低基线 BMI 类别（25-27.5 kg/m2）的参与者中，定制化组体重减轻 2.27 公斤（-3.86，-0.68），目标化组体重减轻 1.72 公斤（-3.16，-0.29），而对照组体重增加。在 BMI 为 27.5 至 30 kg/m2 之间的参与者中，定制化组比目标化组体重减轻 2.20 公斤（-3.90，-0.51）。在 12 或 18 个月时，治疗组之间没有交互作用，结果也没有持续。在为年轻人推荐减肥治疗时，应考虑初始体重。可能需要更密集的干预措施或分阶段护理方法来治疗肥胖的年轻人。
