Weighing benefits

Weight loss telehealth intervention as effective as in-person programs

By Jill Pease

Participants in a behavioral weight loss program that transitioned to a remote format during the COVID-19 pandemic lost about the same amount of weight as participants in previous in-person programs, finds a PHHP study published in the journal Obesity.

The findings have important implications for policy, says lead investigator Kathryn Ross, Ph.D., an associate professor in the department of clinical and health psychology.

“These results directly support continued use of telehealth/videoconferencing for intervention delivery,” Ross said. “Other studies have shown that many individuals may prefer telehealth as it helps them overcome barriers to attendance like traffic, parking and child care. Taken together, I hope these results influence Centers for Medicare & Medicaid Services, insurance companies and other health care payers to support telehealth delivery of comprehensive weight management programs.”

In-person programs have long been considered the gold standard for behavioral weight loss interventions, but COVID-19 shutdowns necessitated the move to teleconferencing for an ongoing weight loss study Ross directed. The team quickly switched from in-person sessions to Zoom groups over the course of a few days.

“We really prioritized continuity of care when making this choice; it felt like the most logical way to keep the ‘feel’ of our in-person group sessions, as participants could still see each other and could still engage in group discussions and activities,” Ross said. “We didn’t really know, though, what impact it would have on weight loss outcomes.”

Participants included 160 adults with obesity who took part in a 16-week behavioral weight loss program. One group began in person and then transitioned to telehealth in week 11. A second group was conducted entirely remotely. By the end of the intervention, participants had lost an average of 7% of their body weight, a similar result to comparable in-person programs, which have an average 8% body weight loss.

Notably, weight loss in these telehealth groups happened during a time when many people struggled to maintain healthy behaviors. An American Psychological Association survey conducted in February 2021 found that 42% of U.S. adults reported undesired weight gain since the start of the pandemic, with an average gain of 29 pounds.

For those of us trying to get back on track with pre-pandemic behaviors, Ross has some advice: practice self-compassion.

“We have all had our choices restricted, whether by shortages and travel restrictions early in the pandemic, major job or income changes, or direct impacts of the virus on our health and caregiving responsibilities,” she said. “It is important not to be overly hard on yourself for not keeping up with healthy meal prep or exercise routines you may have had pre-pandemic. Realize that we are all surviving and doing our best.”

From there, Ross noted that one of the first steps to effective behavior change is to take stock of where you are and then set short-term, achievable goals. She suggests tracking the behavior that you are trying to change, and then setting a goal for the next week. For example, for a person who notices they have become largely inactive during the pandemic, she suggests setting a goal to add a brisk, 10-minute walk five out of seven days of the next week, rather than commit to an intensive new exercise program, especially if time is scarce.

“If you are successful in meeting your goal, ramp up from there,” she said. “This pattern of setting smaller, achievable goals can help you sustain your new habits and build motivation for achieving bigger goals long term.”

Funding for the UF study was provided by the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases.