Web-based Interventions to Curb Obesity: A Systematic Review and Meta-Analysis

Introduction: Web-based health management programs are a feasible way to treat large numbers of individuals dealing with weight management.  The aim of this systematic review and meta-analysis is to examine how the quality and features of web-based intervention studies for weight loss and weight loss maintenance are related to their effectiveness .

Methods: Using six databases: PubMed, Medline, Cochrane, CENTRAL, CINAHL, and PsycINFO, we selected 12 articles (published in 2003 ~ 2013). Preferred Reporting Items for Systematic Reviews and Meta-Analyses was employed as standards for reporting our SR and MA (Moher et al., 2009).  Additionally, we assessed studies based on 11 criteria for methodological quality including quality control, follow-up rate, etc. (Miller et al., 2003); and 11 features including interactions with professionals, buddy program, etc. (Neve et al., 2010).

Results: The results showed that studies with higher scores of quality and feature were significantly more effective in weight loss than those studies with lower scores. Regarding comparisons with other types of interventions, 1) web-based interventions were more effective than self-directed methods or usual care; 2) face-to-face interventions were more effective than web-based interventions; 3) there were no significant differences in the effectiveness between web-based interventions and combined methods of web-based interventions and in-person interventions. Largely, the results are consistent with the assumption of cognitive behavior theory.

Discussion: These results may contribute to improve the effectiveness of the existing web-based interventions for weight loss. The multiple aspects of quality and feature should be incorporated into designing a web-based intervention to improve effectiveness.