Researchers created a website called AchieveTogether and evaluated the weight-loss success of users. They compared users with a group of people attempting to lose weight on their own, and then allowed that second group access to the site 12 weeks later.
"Internet-based weight loss programs could help address the obesity epidemic, as they can be widely shared and used with low costs," said Jennifer L. Kraschnewski, M.D., M.P.H., assistant professor of medicine and public health sciences. "Existing Internet-based weight-loss strategies have largely promoted weight-loss strategies designed by health professionals, including goal-setting and features to promote social interaction. These programs have had modest short-term effects, suggesting that exploring alternative approaches may be beneficial."
The researchers used positive deviance to design their Web-based program. Positive deviance is the idea that solutions to problems exist within a population experiencing that problem. By generalizing what behaviors or approaches work for those who are most successful -- typically the top 10 percent -- strategies are developed that may help the general population achieve certain goals.
"Positive deviance has been used in diverse health-related interventions, but has not previously been used in weight-loss interventions," Kraschnewski said.
For AchieveTogether, users were educated on 36 weight-loss behaviors identified in a previous study of people who maintained a weight loss of at least 30 pounds. These behaviors were evaluated by a physician for safety.
Participants logged in to the site at least once a week and were asked to record their weight, height and frequency of using the weight loss practices. They were matched to three role models closest to them for gender, age and target body weight and could then view their role model's strategies for weight loss.
Participants developed a weight-loss plan by choosing as many of the strategies as they wanted and were encouraged to choose at least one.
"At each log in, participants received tailored feedback to help them choose which practices to keep doing or learned ways to adapt them based on their own activity," Kraschnewski said.
Users of the AchieveTogether website lost about 4.5 pounds more weight than the control group. Results were published in American Journal of Preventative Medicine.
"While this is modest weight loss, it is in the range we have seen for other Internet-based weight loss programs, including those with more human contact," Kraschnewski said. "Because AchieveTogether, or a similar program, can be offered free, it could increase physician referrals for weight management and be a cost effective way to promote weight loss on a public health scale."
Future research will look at how to increase engagement with the website, examine individual characteristics associated with different outcomes and explore best how to use the experience of a diverse group to build a more complete program of weight loss interventions and management.
Other researchers on the project were Heather L. Stuckey, D. Ed., Liza S. Rovniak, Ph.D., M.P.H., Jennifer M. Poger, M.Ed., and Christopher Sciamanna, M.D., M.P.H., Department of Medicine, Penn State College of Medicine; Erik B. Lehman, M.S., and Donna K. Kephart, M.H.A., Department of Public Health Sciences, Penn State College of Medicine; Madhu Reddy, Ph.D., College of Information Sciences and Technology, Penn State; and Elliot J. Coups, Ph.D., Department of Health Education and Behavioral Science, University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School.
This study was funded under a grant with the Pennsylvania Department of Health using Tobacco CURE Funds and by the National Institutes of Health.
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