Help for the overweight could be at the end of a phone

Counselling via the phone and internet can help weight management in overweight individuals, according to a Dutch study published in the open access journal, BMC Public Health.

The project compared counselling via phone and e-mail with the standard practice of issuing self-help literature in approximately 1400 workers as an aid to weight management. The study was undertaken by a group led by Willem Van Mechelen of the Department of Public and Occupational Health/EMGO Institute of VU University Medical Center in Amsterdam, the Netherlands. This study was funded by The Netherlands Organization for Health Research and Development, The Netherlands Heart Foundation and Body@Work TNO-VUmc.

Globally, obesity rates are increasing. However, few people receive professional help in weight management programmes; the reasons for this are unknown. The face-to-face counselling of these programmes requires frequent visits to a treatment facility, making it less appealing for those with busy lifestyles. In cases like this, counselling by phone or via the internet may be of greater use. Trials evaluating phone counselling for weight loss programmes have shown mixed results, and few trials have evaluated e-mail based counselling, but those that have found the results encouraging. The impacts of the two have not, however, been compared.

The study set out to assess the effects of fortnightly counselling sessions by phone or internet on weight loss and diet in overweight workers after six months.

The participants in this study, each with a BMI greater than 25 (the level considered overweight), were employees recruited from seven companies. They were randomly split into three groups: a control group, one which received written programme-materials and counselling via phone and another which had access to an interactive programme-website and received counselling via e-mail. All of the participants, including the control group, received self-help brochures that emphasised the importance of physical exercise and diet. The counselling received by the internet and phone groups included encouragement to fit physical activity into their normal routine, such as taking a walk at lunch, and stressed eating a healthy diet. These interventions were continued for up to 6 months.

The researchers assessed the body weight of each participant and each was given a questionnaire by which their food intake, physical activity and waist measurements were assessed. These measurements were taken again six months later.

Overall, all the groups had significant weight loss and reduced their fat intake, but those in the phone group lost the most weight and had the greatest improvement in diet. There were no overall significant differences between the phone and internet groups and both groups that received counselling lost more weight than participants who did not. Those in the phone group also increased their physical activity to a greater extent.

The authors concluded that lifestyle counselling by phone and e-mail is effective for weight management. According to Van Mechelen, "this could form the basis of improvements in weight management programmes for those unwilling to seek face-to-face counselling. Future studies should evaluate the cost effectiveness of such schemes."

1. Phone and e-mail counselling are effective for weight management in an overweight working population: a randomized controlled trial
Marieke F Van Wier, Geertje AM Ariëns, J Caroline Dekkers, Ingrid JM Hendriksen, Tjabe Smid and Willem Van Mechelen
BMC Public Health (in press)

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