Objective

Weight control programs that incorporate group sessions produce greater weight losses, but this has not been explored in the context of online programs. Further, counselor-crafted self-monitoring feedback is a core element of lifestyle interventions, although pre-scripted, modular feedback which does not require detailed counselor review may adequately promote weight loss. The current study explored the weight losses achieved in an online program that included facilitated group sessions, as well as outcomes when counselor-crafted self-monitoring feedback was provided.

Methods

A 2x2 pilot factorial randomized participants (90% women) with overweight/obesity (N=73) to facilitated group sessions (yes/no) and type of feedback (counselor-crafted/ pre-scripted, modular) within a 16-week online behavioral weight control program. Weight change outcomes were collected digitally. Treatment engagement and intervention delivery time were also tracked.

Results

Individuals offered weekly facilitated online group sessions lost more weight (-5.3+4.9%) than those receiving the same digital program without group sessions (-3.1+4.0%; p=.04). Those receiving group sessions also demonstrated significantly greater treatment engagement. Individuals receiving pre-scripted, modular feedback lost significantly more weight (-5.3+4.8%) than those receiving the more traditional counselor-crafted feedback (-3.1+4.1%; p=.04), but treatment engagement did not differ between conditions. However, interventionist time required to provide feedback was markedly lower for pre-scripted than counselor-crafted feedback (1.4 hours versus 3.5 hours per participant over 16 weeks, respectively, p=.01).

Conclusions

Incorporating weekly facilitated online group sessions significantly increased weight losses achieved in a digital lifestyle program. Further, pre-scripted, modular feedback required significantly less staff time than counselor-crafted feedback without diminishing weight losses. Thus, group sessions and pre-scripted feedback warrant consideration when designing digital lifestyle programs.

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