Skip to main content
SpringerLink
Log in

Virtual small groups for weight management: an innovative delivery mechanism for evidence-based lifestyle interventions among obese men

  • Original Research
  • Published:
Translational Behavioral Medicine

Abstract

While group interventions for weight management have been shown to be efficacious, adherence is often low, especially among men. This pilot study seeks to test whether group interventions using web-based group video conferencing (VC) technology is effective for weight loss. We adapted a 12-week curriculum based on the Diabetes Prevention Program, and delivered this intervention to a small group of men (BMI ≥30 kg/m2), using web-based group VC. Participants were randomized to intervention (n = 32) or delayed-intervention control group (n = 32). The intervention group lost 3.5 % (95 % CI 2.1 %, 4.9 %) of their initial body weight. Difference in mean weight loss was 3.2 kg (p = 0.0002) and mean BMI decrease was 1.0 kg/m2 (p = 0.0010) between the two groups. Virtual small groups may be an effective means of allowing face-to-face group interaction, while overcoming some barriers to access.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Flegal KM et al. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012; 307(5): 491-7.

    Article  PubMed  Google Scholar 

  2. Rao G, Kirley K. The future of obesity treatment: comment on “integrating technology into standard weight loss treatment: a randomized controlled trial”. JAMA Int Med. 2013; 173(2): 111-112.

    Article  Google Scholar 

  3. Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the diabetes prevention program outcomes study. Lancet. 2009; 374(9702): 1677-86.

    Article  PubMed Central  Google Scholar 

  4. Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the look AHEAD trial. Arch Intern Med. 2010; 170(17): 1566-75.

    CAS  PubMed  Google Scholar 

  5. Sarwer DB et al. Behavior therapy for obesity: where are we now? Curr Opin Endocrinol Diabetes Obes. 2009; 16(5): 347-52.

    Article  PubMed  Google Scholar 

  6. Pi-Sunyer X et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care. 2007; 30(6): 1374-83.

    Article  PubMed  Google Scholar 

  7. Knowler WC et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346(6): 393-403.

    Article  CAS  PubMed  Google Scholar 

  8. Knowler WC et al. 10-year follow-up of diabetes incidence and weight loss in the diabetes prevention program outcomes study. Lancet. 2009; 374(9702): 1677-86.

    Article  PubMed  Google Scholar 

  9. Wadden TA et al. The look AHEAD study: a description of the lifestyle intervention and the evidence supporting it. Obesity (Silver Spring). 2006; 14(5): 737-52.

    Article  Google Scholar 

  10. DePue JD et al. Maintenance of weight loss: a needs assessment. Obes Res. 1995; 3(3): 241-8.

    Article  CAS  PubMed  Google Scholar 

  11. Verheijden MW et al. Role of social support in lifestyle-focused weight management interventions. Eur J Clin Nutr. 2005; 59(Suppl 1): S179-86.

    Article  PubMed  Google Scholar 

  12. Black DR, Gleser LJ, Kooyers KJ. A meta-analytic evaluation of couples weight-loss programs. Health Psychol. 1990; 9(3): 330-47.

    Article  CAS  PubMed  Google Scholar 

  13. Cohen S. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychol. 1988; 7(3): 269-97.

    Article  CAS  PubMed  Google Scholar 

  14. Paul-Ebhohimhen V, Avenell A. A systematic review of the effectiveness of group versus individual treatments for adult obesity. Obes Facts. 2009; 2(1): 17-24.

    Article  PubMed  Google Scholar 

  15. Appel LJ, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011

  16. Ockene IS et al. Outcomes of a Latino community-based intervention for the prevention of diabetes: the Lawrence Latino diabetes prevention project. Am J Public Health. 2012; 102(2): 336-342.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Palaniappan LP et al. Shared medical appointments: promoting weight loss in a clinical setting. J Am Board Fam Med. 2011; 24(3): 326-8.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Sabinsky MS et al. Overweight men’s motivations and perceived barriers towards weight loss. Eur J Clin Nutr. 2007; 61(4): 526-31.

    CAS  PubMed  Google Scholar 

  19. Wolfe BL, Smith JE. Different strokes for different folks: why overweight men do not seek weight loss treatment. Eat Disord. 2002; 10(2): 115-24.

    Article  PubMed  Google Scholar 

  20. Knowler WC et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346(11832527): 393-403.

    CAS  PubMed  Google Scholar 

  21. Orchard TJ et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the diabetes prevention program randomized trial. Ann Intern Med. 2005; 142(8): 611-9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. Wing RR et al. Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res. 2004; 12(15483207): 1426-1434.

    PubMed  Google Scholar 

  23. Hamman RF et al. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006; 29(9): 2102-7.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Ali MK, Echouffo-Tcheugui J, Williamson DF. How effective were lifestyle interventions in real-world settings that were modeled on the diabetes prevention program? Health Aff (Millwood). 2012; 31(22232096): 67-75.

    Article  Google Scholar 

  25. Tsai AG, Wadden TA. Systematic review: an evaluation of major commercial weight loss programs in the United States. Ann Intern Med. 2005; 142(1): 56-66.

    Article  PubMed  Google Scholar 

  26. Zickuhr K, Smith A, Home Broadband. Pew research center’s internet & American life project2013. Washington D.C: Pew Research Center; 2013.

    Google Scholar 

  27. Pew Internet & American Life Project. Latinos Online, 2006-2008: Narrowing the Gap. 2009 [cited 2010 January 5]; Available from: http://pewhispanic.org/files/reports/119.pdf.

  28. Sarasohn-Kahn J. How Smarphones Are Changing Health Care for Consumers and Providers, April 2010, California HealthCare Foundation.

  29. Birden H, Page S. Teaching by videoconference: a commentary on best practice for rural education in health professions. Rural Remote Health. 2005; 5(2): 356.

    PubMed  Google Scholar 

  30. Gagnon MP et al. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success? Implement Sci. 2006; 1: 18.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Moehr JR et al. Success factors for telehealth—a case study. Int J Med Inform. 2006; 75(10–11): 755-63.

    Article  CAS  PubMed  Google Scholar 

  32. Augestad KM, Lindsetmo RO. Overcoming distance: video-conferencing as a clinical and educational tool among surgeons. World J Surg. 2009; 33(7): 1356-65.

    Article  PubMed Central  PubMed  Google Scholar 

  33. McLean S et al. Telehealthcare for asthma. Cochrane Database Syst Rev. 2010; 10, CD007717.

    PubMed  Google Scholar 

  34. Vyzula R. Oncologists use a communication system for videoconferencing. Klin Onkol. 2010; 23(2): 124.

    CAS  PubMed  Google Scholar 

  35. Kitamura C, Zurawel-Balaura L, Wong RK. How effective is video consultation in clinical oncology? a systematic review. Curr Oncol. 2010; 17(3): 17-27.

    PubMed Central  CAS  PubMed  Google Scholar 

  36. Hassija C, Gray MJ. The effectiveness and feasibility of videoconferencing technology to provide evidence-based treatment to rural domestic violence and sexual assault populations. Telemed J Eng Health. 2011; 17(4): 309-15.

    Article  Google Scholar 

  37. Kobak KA, Williams JB, Engelhardt N. A comparison of face-to-face and remote assessment of inter-rater reliability on the Hamilton depression rating scale via videoconferencing. Psychiatry Res. 2008; 158(1): 99-103.

    Article  PubMed  Google Scholar 

  38. Kobak KA et al. Face-to-face versus remote administration of the Montgomery-Asberg depression rating scale using videoconference and telephone. Depression Anxiety. 2008; 25(11): 913-9.

    Article  PubMed  Google Scholar 

  39. Modai I et al. Cost effectiveness, safety, and satisfaction with video telepsychiatry versus face-to-face care in ambulatory settings. Telemed J Eng Health. 2006; 12(5): 515-20.

    Article  Google Scholar 

  40. O’Reilly R et al. Is telepsychiatry equivalent to face-to-face psychiatry? Results from a randomized controlled equivalence trial. Psychiatr Serv. 2007; 58(6): 836-43.

    Article  PubMed  Google Scholar 

  41. Strachan M et al. Home-based telehealth to deliver evidence-based psychotherapy in veterans with PTSD. Contemp Clin Trials. 2012; 33(2): 402-9.

    Article  PubMed  Google Scholar 

  42. Tuerk PW et al. A pilot study of prolonged exposure therapy for posttraumatic stress disorder delivered via telehealth technology. J Trauma Stress. 2010; 23(1): 116-23.

    PubMed  Google Scholar 

  43. E, D.E.W., et al. Implementing video conferencing in mental health practice. J Psychiatr Ment Health Nurs. 2012.

  44. Marhefka SL, et al. Interest in, concerns about, and preferences for potential video-group delivery of an effective behavioral intervention among women living with HIV. AIDS Behav. 2011.

  45. Verhoeven F et al. The contribution of teleconsultation and videoconferencing to diabetes care: a systematic literature review. J Med Internet Res. 2007; 9(5): e37.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Morland LA et al. Group cognitive processing therapy delivered to veterans via telehealth: a pilot cohort. J Trauma Stress. 2011; 24(4): 465-9.

    Article  PubMed  Google Scholar 

  47. Ahrendt AD, et al. The Effectiveness of Telemedicine for Weight Management in the MOVE! Program. J Rural Health : Off J Am Rural Health Assoc Natl Rural Health Care Assoc. 2013.

  48. Dehghani P et al. Management of adults with congenital heart disease using videoconferencing across Western Canada: a 3-year experience. Can J Cardiol. 2013; 29(7): 873-8.

    Article  PubMed  Google Scholar 

  49. Vadheim LM et al. Adapted diabetes prevention program lifestyle intervention can be effectively delivered through telehealth. Diabetes Educ. 2010; 36(4): 651-6.

    Article  PubMed  Google Scholar 

  50. Arain M et al. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol. 2010; 10(1): 67.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Kramer MK et al. Translating the diabetes prevention program: a comprehensive model for prevention training and program delivery. Am J Prev Med. 2009; 37(6): 505-11.

    Article  PubMed  Google Scholar 

  52. Kramer MK et al. A novel approach to diabetes prevention: evaluation of the group lifestyle balance program delivered via DVD. Diabetes Res Clin Pract. 2010; 90(3): e60-3.

    Article  PubMed  Google Scholar 

  53. Steinberg DM, et al. The efficacyof adaily self-weighing weight loss intervention using smart scales and email. Obesity. 2013.

  54. Blackburn G. Effect of degree of weight loss on health benefits. Obes Res. 1995; 3(2): 211s-216s.

    Article  PubMed  Google Scholar 

  55. The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care. 1999; 22(4): 623-34.

    Article  Google Scholar 

  56. The Diabetes Prevention Program (DPP). Description of lifestyle intervention. Diabetes Care. 2002; 25(12): 2165-71.

    Article  Google Scholar 

  57. Ogden CL, et al. Prevalence of obesity in the United States, 2009-2010. NCHS Data Brief, 2012(82): 1–8.

  58. Mozaffarian D et al. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011; 364(25): 2392-404.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  59. Volkmar FR et al. High attrition rates in commercial weight reduction programs. Arch Intern Med. 1981; 141(4): 426-8.

    Article  CAS  PubMed  Google Scholar 

  60. Anderson JW et al. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr. 2001; 74(5): 579-84.

    CAS  PubMed  Google Scholar 

  61. Dalle Grave R et al. Weight loss expectations in obese patients seeking treatment at medical centers. Obes Res. 2004; 12(12): 2005-12.

    Article  PubMed  Google Scholar 

  62. Venditti EM et al. First versus repeat treatment with a lifestyle intervention program: attendance and weight loss outcomes. Int J Obes. 2008; 32(10): 1537-44.

    Article  CAS  Google Scholar 

  63. Wadden TA, Butryn ML, Byrne KJ. Efficacy of lifestyle modification for long-term weight control. Obes Res. 2004; 12(Suppl): 151S-62S.

    Article  PubMed  Google Scholar 

  64. Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011; 111(21185970): 92-9102.

    Article  PubMed Central  PubMed  Google Scholar 

  65. McGuire MT et al. Behavioral strategies of individuals who have maintained long-term weight losses. Obes Res. 1999; 7(4): 334-41.

    Article  CAS  PubMed  Google Scholar 

  66. Steinberg DM et al. The efficacy of a daily self-weighing weight loss intervention using smart scales and e-mail. Obesity. 2013; 21(9): 1789-97.

    PubMed Central  PubMed  Google Scholar 

  67. Arem H, Irwin M. A review of web-based weight loss interventions in adults. Obes Rev. 2011; 12(20804523): 236-243.

    Article  Google Scholar 

  68. Centers for Medicare and Medicaid Services. Telehealth Services. 2009 [cited 2012 May]; Available from: http://www.telemedicine.com/pdfs/TelehealthSrvcsfctsht.pdf.

  69. National Conference of State Legislatures. State Coverage for Telehealth Services. 2013 [cited 2013 October]; Available from: http://www.ncsl.org/issues-research/health/state-coverage-for-telehealth-services.aspx.

  70. American Psychological Association Practice Organization. Reimbursement for telehealth services. 2011 [cited 2013 October]; Available from: http://www.apapracticecentral.org/update/2011/03-31/reimbursement.aspx.

  71. American Telemedicine Association. Telemedicine in the Patient Protection and Affordable Care Act 2010; Available from: http://www.americantelemed.org/docs/default-source/policy/telehealth-provisions-within-the-patient-protection-and-affordable-care-act.pdf?sfvrsn=14.

Download references

Acknowledgments

This was an investigator-initiated study funded by a grant from the Verizon Foundation. The funders played no role in the design, conduct, or analysis of the study, nor in the interpretation and reporting of the study findings. The researchers were independent from the funders. The authors would like to thank Marina Dolginsky, BS, for her help in the administrative support of this study.

Conflict of interest

All authors declare that they have no conflicts of interest.

Adherence to ethical principles

All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000

Author information

Authors and Affiliations

  1. Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA

    Kristen M. J. Azar R.N., B.S.N., M.S.N/.M.P.H., Magi Aurora B.S., Elsie J. Wang M.S., Amy Muzaffar M.D., Alice Pressman Ph.D., M.S. & Latha P. Palaniappan M.D., M.S.

Authors
  1. Kristen M. J. Azar R.N., B.S.N., M.S.N/.M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Magi Aurora B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elsie J. Wang M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amy Muzaffar M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alice Pressman Ph.D., M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Latha P. Palaniappan M.D., M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kristen M. J. Azar R.N., B.S.N., M.S.N/.M.P.H..

Additional information

Implications

Policy: Given the transformation of health care and payment models from being illness-centric to prevention-centric, the future of effective obesity treatment lies in the use of technology to improve clinical care.

Research: Video conferencing technology may be a cutting-edge alternative means of translating evidence-based, group behavioral weight management interventions into real-world setting.

Practice: Health care providers, peer support, and health services can be accessed in the convenience of your own home or office, providing the benefits of attending the in-person group meetings without the inconvenience of coming to the clinic.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Azar, K.M.J., Aurora, M., Wang, E.J. et al. Virtual small groups for weight management: an innovative delivery mechanism for evidence-based lifestyle interventions among obese men. Behav. Med. Pract. Policy Res. 5, 37–44 (2015). https://doi.org/10.1007/s13142-014-0296-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13142-014-0296-6

Keywords

Search

Navigation