Telemedical Coaching Improves Long-Term Weight Loss in Overweight Persons: A Randomized Controlled Trial

Abstract

Background: Lifestyle interventions have shown to be effective when continuous personal support was provided. However, there is lack of knowledge whether a telemedical-approach with personal coaching contributes to long-term weight losses in overweight employees. We, therefore, tested the hypothesis that telemedical-based lifestyle interventions accompanied with telemedical coaching lead to larger weight losses in overweight persons in an occupational health care setting.

Methods: Overweight employees (n=180) with a body mass index (BMI) of >27 kg/m² were randomized into either a telemedical (TM) group (n=61), a telemedical coaching (TMC) group (n=58), or a control group (n=61). Both intervention groups were equipped with scales and pedometers automatically transferring the data into a personalized online portal, which could be monitored from participants and coaches. Participants of the TMC group received additionally one motivational care call per week by mental coaches to discuss the current data (current weight and steps) and achieving goals such as a healthy lifestyle or weight reduction. The control group remained in routine care. Clinical and anthropometric data were determined after the 12-week intervention. Additionally, weight change was followed up after 12 months.

Results: Participants of TMC (-3.1 ± 4.8 kg, p<0.0001) and TM group (-1.9 ± 4.0 kg; p=0.0012) significantly reduced weight and sustained it during the 1-year follow-up, while the control group showed no change. Compared to the control group only weight loss in the TMC group was significantly different (p<0.001) after 12 months. TMC and TM group also reduced BMI, waist circumference, and LDL cholesterol. Moreover, TMC group improved additionally systolic and diastolic blood pressure, total cholesterol, HDL cholesterol, and HbA1c.

Conclusions: Telemedical devices in combination with telemedical coaching lead to significant long-term weight reductions in overweight persons in an occupational health care setting. This study is registered with NCT01868763, ClinicalTrials.gov.

Figure 1

Flow diagram.

Figure 2

Weight changes and differences after 12 weeks of intervention. Participants of the telemedical coaching (TMC; n=58) group, the telemedical (TM; n=61) group, and the control group (n=61) were classified according to their weight change after 12 weeks of intervention into one of four categories: (1) ≥1 kg weight gain (black), (2) stable weight with <1 kg weight change (dark grey), (3) weight loss of 1-5 kg (light grey), or (4) weight loss of 5-20 kg (white). Shown are percentages. Differences in frequency distribution of weight change between the three groups were analyzed by using the Chi square test (∗, p<0.05; ∗∗∗, p<0.001).

Figure 3

Weight change and long-term effect. Weight was determined at baseline, after 12 weeks of intervention and at the 52-week follow-up. Shown are means ± standard error of means. The Friedman test with Dunn's multiple comparisons test was used to test the within group differences between time points (∗, p<0.05; ∗∗, p<0.01; ∗∗∗, p<0.001; ∗∗∗∗; p<0.0001).