Internet-based program may help low-income women lose weight gained during pregnancy, study finds
The intervention included a website with weekly lessons, a web diary, instructional videos, computerized feedback, text messages, and monthly in-person meetings at the clinics.
An internet-based weight loss program may help low-income women shed weight gained during pregnancy and return to their preconception weight, according to a recent cluster randomized trial.
The study included 371 postpartum women (mean age, 28.1 years; 81.6% Hispanic) participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) at 12 clinics in California. Researchers randomized six clinics to provide WIC as usual and six clinics to add an internet-based weight loss curriculum to the program.
The intervention included a website with weekly lessons, a web diary, instructional videos, computerized feedback, text messages, and monthly in-person meetings at the clinics. The primary outcome was weight change over 12 months. Secondary outcomes were the proportion of women returning to preconception weight, as well as changes in physical activity and diet. Results were published online on June 20 by JAMA.
Overall, 89.2% of participants completed the study. At 12 months, women in the intervention group achieved greater mean weight loss compared to those receiving WIC alone (3.2 kg vs. 0.9 kg; difference, 2.3 kg [95% CI, 1.1 to 3.5]; P<0.001). They also had greater mean decreases in waist circumference (4 cm vs. 1.2 cm; difference, 2.8 cm [95% CI, 1.3 to 4.3]; P<0.001).
By the end of the study, 32.8% of women receiving the intervention returned to their preconception weight, compared to 18.6% of those receiving usual care. The number needed to treat to return one woman to her preconception weight was about seven. Changes in physical activity and calorie intake were not significant between groups.
The study authors noted limitations, including that internet access could be cost-prohibitive in this population, as they provided it to about 36% of study participants. In addition, they noted that the groups were not matched on contact, “so it remains unknown if the weight differences were attributable to actual intervention components.”
These results suggest that a postpartum population may benefit from remote methods of behavioral modification interventions, in sharp contrast to the high-intensity, in-person interventions currently recommended for people with obesity, an accompanying editorial noted. “Internet-based interventions may be more useful to new mothers providing an opportunity to receive on-going counseling and support that is adaptable to their demanding schedules,” the editorialists wrote.