Turkkila Eero, Pekkala Taru, Merikallio Heta, Merikukka Marko, Heikkilä Laura, Hukkanen Janne, Oinas-Kukkonen Harri, Salonurmi Tuire, Teeriniemi Anna-Maria, Jokelainen Terhi, Savolainen Markku J
Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland.
Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
Int J Obes (Lond). 2025 May;49(5):949-953. doi: 10.1038/s41366-025-01742-4. Epub 2025 Mar 15.
The weight regain after successful weight loss is a common challenge. This study aimed to assess the long-term effectiveness of a web-based health behaviour change support system (HBCSS) utilizing persuasive systems design (PSD) and methods of cognitive behavioural therapy (CBT). We have previously demonstrated the two-year effectiveness of the HBCSS.
In total, 532 participants with overweight or obesity (BMI 27-35 kg m) were split into three groups with different intensities of intervention: CBT-based group counselling, self-help guidance (SHG), and usual care. These groups were further divided into HBCSS and non-HBCSS groups. The HBCSS was a 52-week programme. The follow-up took five years in total.
Mean weight change (%) (95% CI) from baseline among HBCSS and non-HBCSS users was 1.5 (-0.02 to 2.9), p = 0.056 and 1.9 (0.3-3.3), p = 0.005, respectively, at five years. Of the six groups, the SHG group without HBCSS had a statistically significant increase in weight (%) from baseline at five years (3.1, 95% CI 0.6 to 5.6, p = 0.010). The other groups did not have a significant increase in weight. There was no significant difference between groups at five years in weight. Fewer blood pressure medications were started over the five-year period in HBCSS group (p = 0.046).
The 12-month HBCSS intervention was not able to maintain reduced weight better than non-HBCSS at 5 years. However, there were significant weight difference favouring HBCSS over the whole 5-year period. The decrease in the need for antihypertensives suggests that the significant weight loss by HBCSS at early years has a health-promoting legacy effect.
成功减重后体重反弹是一个常见的挑战。本研究旨在评估利用说服系统设计（PSD）和认知行为疗法（CBT）方法的基于网络的健康行为改变支持系统（HBCSS）的长期有效性。我们之前已经证明了HBCSS的两年有效性。
总共532名超重或肥胖参与者（BMI 27 - 35 kg/m）被分为三组，干预强度不同：基于CBT的团体咨询、自助指导（SHG）和常规护理。这些组进一步分为HBCSS组和非HBCSS组。HBCSS是一个为期52周的项目。随访共持续五年。
五年时，HBCSS和非HBCSS使用者从基线开始的平均体重变化（%）（95%CI）分别为1.5（-0.02至2.9），p = 0.056和1.9（0.3 - 3.3），p = 0.005。在六组中，五年时未使用HBCSS的SHG组体重从基线开始有统计学显著增加（3.1，95%CI 0.6至5.6，p = 0.010）。其他组体重没有显著增加。五年时各组之间体重无显著差异。HBCSS组在五年期间开始使用的降压药物较少（p = 0.046）。
为期12个月的HBCSS干预在五年时未能比非HBCSS更好地维持减重效果。然而，在整个五年期间，HBCSS的体重有显著差异。抗高血压药物需求的减少表明，HBCSS早年显著的体重减轻具有促进健康的遗留效应。
