• An Internet based weight loss program for postpartum women worked. Color me surprised.

    From JAMA, “Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women“:

    Importance  Postpartum weight retention increases lifetime risk of obesity and related morbidity. Few effective interventions exist for multicultural, low-income women.

    Objective  To test whether an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) for low-income postpartum women could produce greater weight loss than the WIC program alone over 12 months.

    Design, Setting, and Participants  A 12-month, cluster randomized, assessor-blind, clinical trial enrolling 371 adult postpartum women at 12 clinics in WIC programs from the California central coast between July 2011 and May 2015 with data collection completed in May 2016.

    Interventions  Clinics were randomized to the WIC program (standard care group) or the WIC program plus a 12-month primarily internet-based weight loss program (intervention group), including a website with weekly lessons, web diary, instructional videos, computerized feedback, text messages, and monthly face-to-face groups at the WIC clinics.

    Main Outcomes and Measures  The primary outcome was weight change over 12 months, based on measurements at baseline, 6 months, and 12 months. Secondary outcomes included proportion returning to preconception weight and changes in physical activity and diet.

    Pretty much all mothers gain weight during pregnancy. Keeping that extra weight after pregnancy, however, carries with it risks and issues. This study wanted to test an Internet-based program coupled with WIC for lower-income women. It was a year-long randomized controlled trial of 371 postpartum women at 12 clinics in California. Control clinics got standard WIC. Intervention clinics also got a website with weekly lessons, a diary, videos, automatic feedback, text messages, and monthly face-to-face meetings. The main outcome of interest was how much weight changed over a year.

    I’d have bet money this wouldn’t work. It’s just some web based stuff and the usual outreach. Nothing significant. But the intervention group lost 3.2 kg over the year versus 0.9 kg in the control group. Almost a third of women in the intervention group returned to the preconception weight by a year versus less than 19% in the control group. There were no differences in their physical activity, calorie intake, incidence of injury, or low-milk supply.

    So this pretty simple intervention worked, and it worked at a year. That’s better than a lot of diets, and this focused on women at the low end of the socio-economic spectrum. Seems like it’s at least worth more study and some consideration.

    @aaronecarroll

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