Abstract
The main objectives of this systematic review and meta-analysis study include evaluating the methodological quality of existing randomized controlled trials (RCTs) for weight loss and features of online intervention [OI]s in each trial, examining the associations between the methodological quality, intervention features and the effectiveness of OIs, and comparing the effectiveness of OIs and other intervention modalities through systematic review and meta-analysis. Systematic searches were conducted using PubMed, Cochrane Library, CINAHL, and PsycINFO in the past two decades (2000 through 2019). Inclusion criteria includes Online intervention (intervention modality), middle-aged adults with overweight or obesity, at least six months or longer study period, an RCT, and 70% plus retention rate. Risk of Bias was assessed using Miller et al. in (Hester, Miller (eds) Handbook of alcoholism treatment approaches: Effective alternatives (3rd ed.). Allyn & Bacon, Boston, 2003)’s Methodological Quality Rating Scale (MQRS) and GRADE. MOOSE guidelines was referred for data synthesis. In total, 29 OIs were evaluated using 10 criteria for methodological quality and eight criteria for intervention features. Results revealed that the mean methodological quality score of the RCTs was 12.1 (out of 16), and the mean intervention features score was 6.6 (out of 8). RCTs with higher scores were more effective in weight loss than those with lower scores. Results of meta-regression showed that methodological quality was more important than intervention features to increase the effectiveness. Results of meta-analysis showed that OIs were significantly more effective than controls. Compared to OIs only, OIs with interactions with others and professionals were more effective. The study limitation includes assessing ‘effectiveness’ based on weight only due to lack of other indicators to compare between studies; some results are self-reported; and feedback from intervention participants were hard to review. Nevertheless, this study may contribute to improving the effectiveness of existing OIs for weight loss considering methodological quality and better intervention features.
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Almeida, F. A., You, W., Harden, S. M., Blackman, K. C., Davy, B. M., Glasgow, R. E., Hill, J. L., Linnan, L. A., Wall, S. S., Yenerall, J., & Zoellner, J. M. (2015). Effectiveness of a worksite-based weight loss randomized controlled trial: The worksite study. Obesity, 23(4), 737–745. https://doi.org/10.1002/oby.20899
Al-Zahrani, M. S., Bissada, N. F., & Borawski, E. A. (2003). Obesity and periodontal disease in young, middle-aged, and older adults. Journal of Periodontology, 74(5), 610–615. https://doi.org/10.1902/jop.2003.74.5.610
Ameratunga, Devini (2023). ROB2_IRPG_beta_v9.xlsm. figshare. Dataset. https://doi.org/10.6084/m9.figshare.22300303.v1
Andersson, G., Carlbring, P., & Lindefors, N. (2016). History and current status of ICBT. Guided internet-based treatments in psychiatry, 1–16.
Apovian, C. M. (2016). Obesity: Definition, comorbidities, causes, and burden. The American Journal of Managed Care, 22(7), s176–s185.
Arnold, M., Pandeya, N., Byrnes, G., Renehan, P. A. G., Stevens, G. A., Ezzati, P. M., Ferlay, J., Miranda, J. J., Romieu, I., Dikshit, R., Forman, D., & Soerjomataram, I. (2015). Global burden of cancer attributable to high body-mass index in 2012: A population-based study. The Lancet. Oncology, 16(1), 36–46. https://doi.org/10.1016/S1470-2045(14)71123-4
Bandura, A. (1999). Social cognitive theory: An agentic perspective. Asian Journal of Social Psychology, 2(1), 21–41.
Bauer, K., Lau, T., Schwille-Kiuntke, J., Schild, S., Hauner, H., Stengel, A., Zipfel, S., & Mack, I. (2020). Conventional weight loss interventions across the different BMI obesity classes: A systematic review and quantitative comparative analysis. European Eating Disorders Review, 28(5), 492–512. https://doi.org/10.1002/erv.2741
Borenstein, M. (2005). Chapter 11: Software for Publication Bias. In H.R. Rothstein, A.J. Sutton and M. Borenstein (Eds.), Publication Bias in Meta-Analysis—Prevention, Assessment and Adjustments (pp. 193–220).
Bramer, W. M., Rethlefsen, M. L., Kleijnen, J., & Franco, O. H. (2017). Optimal database combinations for literature searches in systematic reviews: A prospective exploratory study. Systematic Reviews, 6(1), 245. https://doi.org/10.1186/s13643-017-0644-y
Bray, G. A. (2004). Medical consequences of obesity. Journal of Clinical Endocrinology and Metabolism, 89(6), 2583–2589. https://doi.org/10.1210/jc.2004-0535
Burke, L. E., Styn, M. A., Sereika, S. M., Conroy, M. B., Ye, L., Glanz, K., Sevick, M. A., & Ewing, L. J. (2012). Using mHealth technology to enhance self-monitoring for weight loss: A randomized trial. American Journal of Preventive Medicine, 43(1), 20–26. https://doi.org/10.1016/j.amepre.2012.03.016
National Center for Chronic Disease Prevention and Health Promotion: Division of Population Health. (2019). Programs: Obesity Interventions. https://www.cdc.gov/workplacehealthpromotion/health-strategies/obesity/interventions/programs.html. Accessed May 31, 2022.
Centers for Disease Control and Prevention (2021). Adult overweight causes and consequences. Accessed December 1, 2022. www.cdc.gov/obesity/adult/causes.htmlwww.cdc.gov/obesity/adult/causes.html
Centers for Disease Control and Prevention (CDC) (2022). Data & Statistics: Adult Obesity Facts. https://www.cdc.gov/obesity/data/adult.html#:~:text=Obesity%20affects%20some%20groups%20more%20than%20others&text=The%20obesity%20prevalence%20was%2039.8,adults%20aged%2060%20and%20older, accessed in November 30, 2022 , accessed in November 30, 2022
Chang, T., Chopra, V., Zhang, C., & Woolford, S. J. (2013). The role of social media in online weight management: Systematic review. Journal of Medical Internet Research, 15(11), e262. https://doi.org/10.2196/jmir.2852
Collins, C. E., Morgan, P. J., Hutchesson, M. J., & Callister, R. (2013). Efficacy of standard versus enhanced features in a Web-based commercial weight-loss program for obese adults, part 2: Randomized controlled trial. Journal of Medical Internet Research, 15(7), e140. https://doi.org/10.2196/jmir.2626
Cruizineer Innovation: Differences Between Web 1.0, Web 2.0, and Web 3.0 Standards. (2020). http://www.cruzine.com/2011/02/14/web-3-web-2-standards/. Accessed May 31, 2022.
Cui-hong, H. (2012). Research on Web3. 0 application in the resources integration portal. In 2012 Second International Conference on Business Computing and Global Informatization; 728–730. Institute of Electrical and Electronics Engineers (IEEE).
Cussler, E. C., Teixeira, P. J., Going, S. B., Houtkooper, L. B., Metcalfe, L. L., Blew, R. M., Ricketts, J. R., Lohman, J. F., Stanford, V. A., & Lohman, T. G. (2008). Maintenance of weight loss in overweight middle-aged women through the Internet. Obesity, 16(5), 1052–1060. https://doi.org/10.1038/oby.2008.19
Daramola, O. O., & Rhee, J. S. (2011). Rating evidence in medical literature. AMA Journal of Ethics, 13(1), 46–51. https://doi.org/10.1001/virtualmentor.2011.13.1.pfor2-1101. PMID: 23121817.
de Souza, R. J., Eisen, R. B., Perera, S., Bantoto, B., Bawor, M., Dennis, B. B., Samaan, Z., Thabane, L. (2016). Best (but oft-forgotten) practices: Sensitivity analyses in randomized controlled trials. The American Journal of Clinical Nutrition, 103(1), 5–17.
Eccleston, C., Fisher, E., Thomas, K. H., Hearn, L., Derry, S., Stannard, C., Knaggs, R., & Moore, R. A. (2017). Interventions for the reduction of prescribed opioid use in chronic non-cancer pain. The Cochrane Database of Systematic Reviews, 11(11), CD010323. https://doi.org/10.1002/14651858.CD010323.pub3
Fryar, C.D., & Carroll, M.D. (2020). Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats.
Gold, B. C., Burke, S., Pintauro, S., Buzzell, P., & Harvey-Berino, J. (2007). Weight loss on the web: A pilot study comparing a structured behavioral intervention to a commercial program. Obesity, 15(1), 155–155. https://doi.org/10.1038/oby.2007.520
Granja, C., Janssen, W., & Johansen, M. A. (2018). Factors determining the success and failure of ehealth interventions: Systematic review of the literature. Journal of Medical Internet Research, 20(5), e10235. https://doi.org/10.2196/10235
Green, B. B., Anderson, M. L., Cook, A. J., Catz, S., Fishman, P. A., McClure, J. B., & Reid, R. J. (2014). e-Care for heart wellness: A feasibility trial to decrease blood pressure and cardiovascular risk. American Journal of Preventive Medicine, 46(4), 368–377. https://doi.org/10.1016/j.amepre.2013.11.009
Harvey-Berino, J., West, D., Krukowski, R., Prewitt, E., VanBiervliet, A., Ashikaga, T., & Skelly, J. (2010). Internet delivered behavioral obesity treatment. Preventive Medicine, 51(2), 123–128. https://doi.org/10.1016/j.ypmed.2010.04.018
Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J. & Welch, V. A. (editors). (2022). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane. Available from www.training.cochrane.org/handbook.
Hu, R., van Velthoven, M. H., & Meinert, E. (2020). Perspectives of people who are overweight and obese on using wearable technology for weight management: Systematic review. JMIR mHealth and uHealth, 8(1), e12651. https://doi.org/10.2196/12651
Hunter, C. M., Peterson, A. L., Alvarez, L. M., Poston, W. C., Brundige, A. R., Haddock, C. K., Van Brunt, D. L., & Foreyt, J. P. (2008). Weight management using the internet: A randomized controlled trial. American Journal of Preventive Medicine, 34(2), 119–126. https://doi.org/10.1016/j.amepre.2007.09.026
Joanna Briggs Institute. (2014). Joanna Briggs Institute reviewers’ manual: 2014 edition. The Joanna Briggs Institute, 88–91. Available from: http://joannabriggs.org/assets/docs/sumari/ReviewersManual-2014.pdf.
Kaldo-Sandström, V., Larsen, H. C., & Andersson, G. (2004). Internet-based cognitive-behavioral self-help treatment of tinnitus: Clinical effectiveness and predictors of outcome. American Journal of Audiology, 13, 185–192. https://doi.org/10.1044/1059-0889(2004/023)
Kupila, S. K., Joki, A., Suojanen, L. U., & Pietiläinen, K. H. (2023). The effectiveness of ehealth interventions for weight loss and weight loss maintenance in adults with overweight or obesity: A systematic review of systematic reviews. Current Obesity Reports, 12, 371–394.
Laing, B. Y., Mangione, C. M., Tseng, C. H., Leng, M., Vaisberg, E., Mahida, M., Bholat, M., Glazier, E., Morisky, D. E., & Bell, D. S. (2014). Effectiveness of a smartphone application for weight loss compared with usual care in overweight primary care patients: A randomized, controlled trial. Annals of Internal Medicine, 161(10), S5–S12. https://doi.org/10.7326/M13-3005
Lau, N., O’Daffer, A., Colt, S., Joyce, P., Palermo, T. M., McCauley, E., & Rosenberg, A. R. (2020). Android and iPhone mobile apps for psychosocial wellness and stress management: Systematic search in app stores and literature review. JMIR mHealth and uHealth, 8(5), e17798. https://doi.org/10.2196/17798
Lewis, K. (2014). Weight watchers for the Facebook era—How does it compare to the do-it-yourself approach? Journal of Clinical Outcomes Management, 21(3), 1143.e19–24.
Maciel Santos, M. E. S., Rocha, N. S., Laureano Filho, J. R., Ferraz, E. M., & Campos, J. M. (2009). Obstructive sleep apnea–Hypopnea syndrome—The role of bariatric and maxillofacial surgeries. Obesity surgery, 19, 796–801. https://doi.org/10.1007/s11695-008-9773-7
Mamalaki, E., Poulimeneas, D., Tsiampalis, T., Kouvari, M., Karipidou, M., Bathrellou, E., Collins, C. E., Panagiotakos, D. B., & Yannakoulia, M. (2022). The effectiveness of technology-based interventions for weight loss maintenance: A systematic review of randomized controlled trials with meta-analysis. Obesity Reviews, 23(9), e13483. https://doi.org/10.1111/obr.13483. PMID: 35686875.
Review Manager (RevMan). (2012). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration.
Manzoni, G. M., Pagnini, F., Corti, S., Molinari, E., & Castelnuovo, G. (2011). Internet-based behavioral interventions for obesity: An updated systematic review. Clinical Practice and Epidemiology in Mental Health, 7(1), 19–28. https://doi.org/10.2174/1745017901107010019
Merrill, R. M. (2013). Fundamentals of epidemiology and biostatistics: Combining the basics. Jones & Bartlett Publishers.
Miller, W. R., Wilbourne, P. L., & Hettema, J. E. (2003). What Works? A summary of alcohol treatment outcome research. In R. K. Hester & W. R. Miller (Eds.), Handbook of alcoholism treatment approaches: Effective alternatives (3rd ed.). Allyn & Bacon.
Morgan, P. J., Callister, R., Collins, C. E., Plotnikoff, R. C., Young, M. D., Berry, N., McElduff, P., Burrows, T., Aguiar, E., & Saunders, K. L. (2013). The SHED-IT community trial: A randomized controlled trial of internet-and paper-based weight loss programs tailored for overweight and obese men. Annals of Behavioral Medicine, 45(2), 139–152. https://doi.org/10.1007/s12160-012-9424-z
Morgan, P. J., Lubans, D. R., Collins, C. E., Warren, J. M., & Callister, R. (2011). 12-month outcomes and process evaluation of the SHED-IT RCT: An internet-based weight loss program targeting men. Obesity, 19(1), 142–151. https://doi.org/10.1038/oby.2010.119
Nath, O. (2022). Web 2 vs. Web 3: What’s the difference and why it matters. Spiceworks. https://www.spiceworks.com/tech/tech-general/articles/web-2-vs-web-3/#:~:text=The%20fundamental%20distinction%20is%20that,users%20while%20simultaneously%20enhancing%20cybersecurity.
National Health and Medical Research Council (NHMRC). (2013). Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. http://www.worldobesity.org/site_media/uploads/Aust_Clinical.pdf. Accessed May 31, 2022.
Neve, M., Morgan, P. J., Jones, P. R., & Collins, C. E. (2010). Effectiveness of web-based interventions in achieving weight loss and weight loss maintenance in overweight and obese adults: A systematic review with meta-analysis. Obesity Reviews, 11(4), 306–321. https://doi.org/10.1111/j.1467-789X.2009.00646.x
Norman, G. J., Zabinski, M. F., Adams, M. A., Rosenberg, D. E., Yaroch, A. L., & Atienza, A. A. (2007). A review of eHealth interventions for physical activity and dietary behavior change. American Journal of Preventive Medicine, 33(4), 336–345. https://doi.org/10.1016/j.amepre.2007.05.007
Page, M. J., & Moher, D. (2017). Evaluations of the uptake and impact of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement and extensions: A scoping review. Systematic Reviews, 6(1), 263. https://doi.org/10.1186/s13643-017-0663-8
Pellegrini, C. A., Verba, S. D., Otto, A. D., Helsel, D. L., Davis, K. K., & Jakicic, J. M. (2012). The comparison of a technology-based system and an in-person behavioral weight loss intervention. Obesity, 20(2), 356–363. https://doi.org/10.1038/oby.2011.13
Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17(5), 941–964. https://doi.org/10.1038/oby.2008.636
Raudenbush, S. W., & Liu, X. (2000). Statistical power and optimal design for multisite randomized trials. Psychological Methods, 5(2), 199. https://doi.org/10.1037/1082-989x.5.2.199
Rethlefsen, M. L., Kirtley, S., Waffenschmidt, S., Ayala, A. P., Moher, D., Page, M. J., Koffel, J. B., PRISMA-S Group. (2021). PRISMA-S: An extension to the PRISMA statement for reporting literature searches in systematic reviews. Systematic Reviews, 10, 1–19. https://doi.org/10.1186/s13643-020-01542-z
Ryan, K., Dockray, S., & Linehan, C. (2019). A systematic review of tailored eHealth interventions for weight loss. Digital Health, 5, 2055207619826685. https://doi.org/10.1177/2055207619826685
Schroder, K. E. (2009). Computer-assisted dieting: Effects of a randomised controlled intervention. Psychology and Health, 25(5), 519–534. https://doi.org/10.1080/08870440902812013
Seidell, J. C., & Flegal, K. M. (1997). Assessing obesity: Classification and epidemiology. British Medical Bulletin, 53(2), 238–252.
Siemieniuk, R., & Guyatt, G. (2019). What is GRADE. BMJ J Best Practice, 10, 77–85.
Sniehotta, F. F., Evans, E. H., Sainsbury, K., Adamson, A., Batterham, A., Becker, F., Brown, H., Dombrowski, S. U., Jackson, D., Howell, D., & Ladha, K. (2019). Behavioural intervention for weight loss maintenance versus standard weight advice in adults with obesity: A randomised controlled trial in the UK (NULevel Trial). PLoS Medicine, 16(5), e1002793. https://doi.org/10.1371/journal.pmed.1002793
Spring, B., Duncan, J. M., Janke, E. A., Kozak, A. T., McFadden, H. G., DeMott, A., Pictor, A., Epstein, L. H., Siddique, J., Pellegrini, C. A., & Buscemi, J. (2013). Integrating technology into standard weight loss treatment: A randomized controlled trial. JAMA Internal Medicine, 173(2), 105–111. https://doi.org/10.1001/jamainternmed.2013.1221
Spring, B., Pellegrini, C. A., Pfammatter, A., Duncan, J. M., Pictor, A., McFadden, H. G., Siddique, J., & Hedeker, D. (2017). Effects of an abbreviated obesity intervention supported by mobile technology: The ENGAGED randomized clinical trial. Obesity, 25(7), 1191–1198. https://doi.org/10.1002/oby.21842
Steinberg, D. M., Tate, D. F., Bennett, G. G., Ennett, S., Samuel-Hodge, C., & Ward, D. S. (2013). The efficacy of a daily self-weighing weight loss intervention using smart scales and e-mail. Obesity, 21(9), 1789–1797. https://doi.org/10.1002/oby.20396
Sterne, J. A., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., Cates, C. J., Cheng, H. Y., Corbett, M. S., Eldridge, S. M., & Emberson, J. R. (2019). RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ, 366, 14898. https://doi.org/10.1136/bmj.l4898
Stevens, V. J., Funk, K. L., Brantley, P. J., Erlinger, T. P., Myers, V. H., Champagne, C. M., Bauck, A., Samuel-Hodge, C. D., & Hollis, J. F. (2008). Design and implementation of an interactive website to support long-term maintenance of weight loss. Journal of Medical Internet Research, 10(1), e1. https://doi.org/10.2196/jmir.931
Stroup, D. F., Berlin, J. A., Morton, S. C., Olkin, I., Williamson, G. D., Rennie, D., Moher, D., Becker, B. J., Sipe, T. A., & Thacker, S. B. (2000). Meta-analysis of observational studies in epidemiology: A proposal for reporting. JAMA, 283(15), 2008–2012. https://doi.org/10.1001/jama.283.15.2008
Sullivan, D. K., Goetz, J. R., Gibson, C. A., Washburn, R. A., Smith, B. K., Lee, J., Gerald, S., Fincham, T., & Donnelly, J. E. (2013). Improving weight maintenance using virtual reality (Second Life). Journal of Nutrition Education and Behavior, 45(3), 264–268. https://doi.org/10.1016/j.jneb.2012.10.007
Svetkey, L. P., Stevens, V. J., Brantley, P. J., Appel, L. J., Hollis, J. F., Loria, C. M., Vollmer, W. M., Gullion, C. M., Funk, K., Smith, P., Samuel-Hodge, C., Myers, V., Lien, L. F., Laferriere, D., Kennedy, B., Jerome, G. J., Heinith, F., Harsha, D. W., Evans, P., et al. (2008). Comparison of strategies for sustaining weight loss: The weight loss maintenance randomized controlled trial. JAMA, 299(10), 1139–1148. https://doi.org/10.1001/jama.299.10.1139
Tate, D. F., Jackvony, E. H., & Wing, R. R. (2003). Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: A randomized trial. JAMA, 289(14), 1833–1836. https://doi.org/10.1001/jama.289.14.1833
Tate, D. F., Jackvony, E. H., & Wing, R. R. (2006). A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an Internet weight loss program. Archives of Internal Medicine, 166(15), 1620–1625. https://doi.org/10.1001/archinte.166.15.1620
Tate, D. F., Wing, R. R., & Winett, R. A. (2001). Using Internet technology to deliver a behavioral weight loss program. JAMA, 285(9), 1172–1177. https://doi.org/10.1001/jama.285.9.1172
Thomas, J. G., Leahey, T. M., & Wing, R. R. (2015). An automated internet behavioral weight-loss program by physician referral: A randomized controlled trial. Diabetes Care, 38(1), 9–15. https://doi.org/10.2337/dc14-1474
Thomas, J. G., Raynor, H. A., Bond, D. S., Luke, A. K., Cardoso, C. C., Foster, G. D., & Wing, R. R. (2017). Weight loss in Weight Watchers Online with and without an activity tracking device compared to control: A randomized trial. Obesity, 25(6), 1014–1021. https://doi.org/10.1002/oby.21846
Turner-McGrievy, G., & Tate, D. (2011). Tweets, Apps, and Pods: Results of the 6-month Mobile Pounds Off Digitally (Mobile POD) randomized weight-loss intervention among adults. Journal of Medical Internet Research, 13(4), e120. https://doi.org/10.2196/jmir.1841
Weinstein, P. K. (2006). A review of weight loss programs delivered via the Internet. Journal of Cardiovascular Nursing, 21(4), 251–258. https://doi.org/10.1097/00005082-200607000-00003
West, D. S., Harvey, J. R., Krukowski, R. A., Prewitt, T. E., Priest, J., & Ashikaga, T. (2016). Do individual, online motivational interviewing chat sessions enhance weight loss in a group-based, online weight control program. Obesity, 24(11), 2334–2340. https://doi.org/10.1002/oby.21645
Winett, R. A., Anderson, E. S., Wojcik, J. R., Winett, S. G., & Bowden, T. (2007). Guide to health: Nutrition and physical activity outcomes of a group-randomized trial of an Internet-based intervention in churches. Annals of Behavioral Medicine, 33(3), 251–261. https://doi.org/10.1007/BF02879907
Wing, R. R., Tate, D. F., Gorin, A. A., Raynor, H. A., & Fava, J. L. (2006). A self-regulation program for maintenance of weight loss. New England Journal of Medicine, 355(15), 1563–1571. https://doi.org/10.1056/NEJMoa061883
Zeiler, M., Kuso, S., Nacke, B., Klesges, L. M., & Waldherr, K. (2021). Evaluating reach, adoption, implementation and maintenance of Internet-based interventions to prevent eating disorders in adolescents: A systematic review. European Journal of Public Health, 31(Supplement_1), 38–47.
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Han, K.J., Yu, M. & Kehinde, O. Effectiveness of Different Online Intervention Modalities for Middle-Aged Adults with Overweight and Obesity: A 20-Year Systematic Review and Meta-analysis. J of Prevention 45, 123–157 (2024). https://doi.org/10.1007/s10935-023-00761-z
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DOI: https://doi.org/10.1007/s10935-023-00761-z