A review of weight loss programs delivered via the Internet.

The escalating obesity epidemic has prompted healthcare professionals to seek interventions that can reach large numbers of individuals in a timely and cost-effective manner. The Internet, with its growing audience, seems an obvious solution. Commercial weight loss programs already abound on the Internet. The purpose of this review is to describe the efficacy of weight loss programs delivered via the Internet in the United States. A search for clinical trials evaluating weight loss via Internet programs was conducted using PubMed, CINAHL, Cochrane Library, Academic Search Premier, the National Institutes of Health Clinical Trials Database, and the Internet as well as a cross-check of reference lists. Eight published studies that met the inclusion criteria were reviewed. Data were extracted on study design, sample characteristics, attrition, weight loss, duration of treatment, and maintenance of weight loss. Of the 8 studies, 3 evaluated the Internet as a means to maintain long-term weight loss. All studies examining weight loss via Internet programs reported positive results, except for one investigating a commercial program. Results from the 3 weight loss maintenance programs conducted on the Internet were equivocal. Because the subjects of all these studies were predominately white, educated women, generalization of findings is limited. Data from the reviewed studies suggest that the Internet may be an alternative to traditional face-to-face weight loss programs. Questions still remain as to the efficacy of using the Internet for long-term weight loss maintenance. Findings from these studies provide beginning guidelines for healthcare providers who may choose to use Internet-based weight loss interventions. Future research is still needed to determine the applicability of such interventions in diverse age, ethnic, and socioeconomic groups.