Nutrition and Health Program, Commonwealth Scientific and Industrial Research Organisation, Adelaide, Australia.
Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, Sydney, Australia.
J Med Internet Res. 2021 Jun 7;23(6):e20981. doi: 10.2196/20981.
Obesity is a global public health challenge, and there is a need for more evidence-based self-management programs that support longer-term, sustained weight loss.
This study used data from the Commonwealth Scientific and Industrial Research Organisation (CSIRO) Total Wellbeing Diet Online program to determine the reach and weight loss results over its first 5 years.
Participants were adults who joined the commercial weight loss program of their own volition between October 2014 and September 2019 (N=61,164). Information collected included year of birth, sex, height, weight, and usage data (eg, entries into the food diary, views of the menu, and program content). Weight loss and percentage of starting body weight lost were calculated. Members were divided into 2 groups for analysis: "stayers" were members who signed up for at least 12 weeks of the program and recorded a weight entry at baseline and at the end of the program, while "starters" began the program but did not record a weight after 12 weeks. Descriptive statistics and multiple linear regression were used to describe weight loss and determine the member and program characteristics associated with weight loss.
Data were available from 59,686 members for analysis. Members were predominately female (48,979/59,686, 82.06%) with an average age of 50 years (SD 12.6). The average starting weight was 90.2 kg (SD 19.7), and over half of all members (34,195/59,688, 57.29%) were classified as obese. At week 12, 94.56% (56,438/59,686) of the members had a paid program membership, which decreased to 41.48% (24,756/59,686) at 24 weeks. At week 12, 52.03% (29,115/55,958) of the remaining members were actively using the platform, and by week 24, 26.59% (14,880/55,958) were using the platform. The average weight loss for all members was 2.8 kg or 3.1% of their starting body weight. Stayers lost 4.9 kg (5.3% of starting body weight) compared to starters, who lost 1.6 kg (1.7% of starting body weight). Almost half (11,082/22,658, 48.91%) the members who stayed on the program lost 5% or more of their starting body weight, and 15.48% (3507/22,658) achieved a weight loss of 10% or more. Of the members who were classified as class 1 obese when they joined the program, 41.39% (3065/7405) who stayed on the program were no longer classified as obese at the end, and across all categories of obesity, 24% (3180/13,319) were no longer classified as obese at the end of the program. Based on multiple linear regression, platform usage was the strongest predictor of weight loss (β=.263; P<.001), with higher usage associated with greater weight loss.
This comprehensive evaluation of a commercial, online weight loss program showed that it was effective for weight loss, particularly for members who finished the program and were active in using the platform and tools provided. If the results demonstrated here can be achieved at an even greater scale, the potential social and economic benefits will be extremely significant.
肥胖是一个全球性的公共卫生挑战，我们需要更多基于证据的自我管理项目来支持长期、持续的体重减轻。
本研究使用澳大利亚联邦科学与工业研究组织（CSIRO）全健康饮食在线项目的数据，确定其在头 5 年的覆盖范围和减肥效果。
参与者是在 2014 年 10 月至 2019 年 9 月期间自愿参加商业减肥计划的成年人（N=61164）。收集的信息包括出生年份、性别、身高、体重和使用数据（例如，进入食物日记、查看菜单和程序内容的次数）。计算体重减轻和起始体重百分比的减少。成员分为两组进行分析：“留用者”是至少注册了 12 周该计划并在基线和计划结束时记录体重的成员，而“启动者”开始了该计划，但在 12 周后没有记录体重。使用描述性统计和多元线性回归来描述体重减轻，并确定与体重减轻相关的成员和计划特征。
有 59686 名成员的数据可用于分析。成员主要为女性（48979/59686，82.06%），平均年龄为 50 岁（SD 12.6）。平均起始体重为 90.2 公斤（SD 19.7），超过一半的成员（34195/59688，57.29%）被归类为肥胖。在第 12 周，94.56%（56438/59686）的成员有付费计划会员资格，到第 24 周时降至 41.48%（24756/59686）。在第 12 周，52.03%（29115/55958）的剩余成员仍在积极使用该平台，到第 24 周，有 26.59%（14880/55958）的成员在使用该平台。所有成员的平均体重减轻了 2.8 公斤或起始体重的 3.1%。留用者比启动者体重减轻了 4.9 公斤（起始体重的 5.3%），启动者体重减轻了 1.6 公斤（起始体重的 1.7%）。几乎一半（11082/22658，48.91%）继续参加该计划的成员体重减轻了 5%或更多，15.48%（3507/22658）的体重减轻了 10%或更多。在加入该计划时被归类为 1 类肥胖的成员中，有 41.39%（3065/7405）的人在结束时不再被归类为肥胖，在所有肥胖类别中，有 24%（3180/13319）的人在计划结束时不再被归类为肥胖。基于多元线性回归，平台使用是体重减轻的最强预测因素（β=.263；P<.001），使用频率越高，体重减轻越多。
这项对商业在线减肥计划的全面评估表明，该计划在减肥方面是有效的，特别是对于完成计划并积极使用平台和提供的工具的成员。如果这里展示的结果能够达到更大的规模，那么潜在的社会和经济效益将是极其显著的。
