A Systematic Review Investigating the Effect of Internet-based Social Support on Long-term Weight Management in Adults

Abstract

Background: Obesity is recognised as being at the forefront of current ‘lifestyle diseases and without appropriate interventions the prevalence levels are projected to increase, Government Office for Science, [1]. A major challenge in the treatment of obesity is maintenance of weight loss. Wing et al. [2]. The aim of this systematic review is to investigate the effectiveness of internet-based social support as a cost effective method for aiding long-term weight loss maintenance in comparison to traditional methods.  Methods: Three health related databases, Medline, Web of Science and Embase, were searched for studies, reported in the English language, published between 2002 and 2012. Inclusion criteria for the study population was adults >18years who had completed a weight loss programme and then provided with internet based social support for at least a 6 month duration. BMI and weight change data needed to be available. The type of internet support could vary eg e-mails, on-line discussion forums. The quality of each paper meeting the inclusion criteria was assessed using an adapted Newcastle- Ottawa scale Wells et al. [3]; the highest score being 15. A second researcher independently assessed the selection and quality processes.  Results: Seven studies met the inclusion criteria (quality scores of 7-13); one showed a statistically significant effect of web-based social support in weight loss maintenance versus a traditional face-to-face approach (p=0.05). Three studies suggested a possible effect and three no effect. Attrition rates indicate that participant engagement in web-based programmes can be poor and that participant compatibility varied. The majority of subjects were women (1504/1959). Mean duration of follow up period for weight loss maintenance =55.1 weeks. The interventions included private and group e-mails, chat room and bulletin boards. It was suggested that web-based social support programmes could enhance traditional face-to-face communication methods, as opposed to replacing them.  Discussion: Given limited healthcare resources and obesity prevalence the internet could be a scalable vehicle for providing social support for weight loss maintenance. This review found mixed outcomes of the effectiveness of internet-based support. Different components of internet support may be more effective for different people. The studies were mainly comparing internet based support against traditional face-to-face support which is likely to be more costly. Conclusion: Further research in this area is required. Areas to explore include; for whom this type of weight loss maintenance support would be most appropriate and what methods of delivery/components of internet based support are more effective. Also how can this support be used alongside traditional face-to-face methods to achieve the best long-term weight loss outcomes most cost effectively.