Up-close and personal, as well as online, can help counter obesity

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Two studies on obesity just published in the New England Journal of Medicine both found that primary care physicians (PCPs) can deliver safe and effective weight-loss interventions.

The first trial, from Johns Hopkins University, randomly assigned 415 obese patients with at least one cardiovascular risk factor to one of three primary care weight-loss interventions: A weight-loss support group that remotely encouraged participants via emails, websites, and telephone calls; an in-person intervention that consisted of group and individual sessions in addition to three remote means of support; and, finally, a control group in which weight-loss was self-managed. After two years, researchers found that participants in either intervention group were twice as likely to lose 5 percent or more of their initial body weight compared to the control group. People in the in-person group, however, only attended two out of 24 sessions seven months into the study, while those in the remote support group participated in a median of 16 of 18 telephone contacts during the same time period, thus demonstrating that such remote interventions present fewer adherence barriers.

In the second study, researchers from the University of Pennsylvania randomly assigned 390 obese adults to receive either usual primary care consisting of quarterly doctor visits and education about weight management; brief lifestyle counseling that included monthly sessions with lifestyle coaches; or enhanced lifestyle counseling that, in addition to monthly sessions, also provided participants with meal replacements or weight-loss medications. After two years of follow-up, participants in the enhanced lifestyle counseling group lost significantly more weight than those in either of the other two groups.

What s the take-home message? Well, other than observing how difficult obesity is to treat, ACSH's Dr. Gilbert Ross notes that even remote counseling managed by a PCP can make a definite impact on weight loss, and in-person contact is not required to achieve such results.

ACSH s Dr. Ruth Kava adds, While these data are encouraging, it s important to note that a two-year follow-up hardly suffices to show that these techniques will result in subjects maintaining the weight loss later in life.