- Primary care physicians encouraged the patients’ weight loss at routinely scheduled visits.
- It’s likely that programs delivered by telephone with website support and physician encouragement could address a variety of heart disease risk factors and chronic medical conditions.
ORLANDO, FLA., Nov. 15, 2011 ― A weight loss program delivered by health coaches over the phone with website and email support but no in-person contact was as effective as one delivered in person, according to late-breaking research presented at the American Heart Association’s Scientific Sessions 2011.
The study is simultaneously published in the New England Journal of Medicine.
In both weight loss programs, primary care physicians had a supportive role and were presented as part of a team with the health coaches.
“Programs delivered by telephone with website back-up could be the wave of the future in addressing a variety of heart disease risk factors or managing chronic conditions,” said Lawrence J. Appel, M.D., M.P.H., lead researcher and professor of medicine, epidemiology and international health at the Johns Hopkins Medical Institutions in Baltimore, Md.
The Practice-based Opportunities for Weight Reduction (POWER) trial included 415 patients from six primary care practices in Baltimore who were obese and had high blood pressure, high cholesterol or diabetes.
Their goal was to lose at least 5 percent of initial weight within six months and keep it off during the 24-month study. Weight reduction can be associated with many health benefits, including lower levels of heart disease risk factors and preventing or improving diabetes and high blood pressure.
At six months, success in achieving 5 percent or greater weight loss was:
- 14 percent in a self-directed group that received information and a list of weight-loss websites, but no counseling;
- 53 percent in a call-center-directed group that spoke on the phone with health coaches and that used an interactive website;
- 46 percent in an in-person-directed group that received in-person counseling along with some phone support and an interactive study website.
“I expected the biggest change in the in-person program and was surprised that the results were generally the same in the program delivered over the phone,” Appel said.
After 24 months, the percentage of participants weighing at least 5 percent less than they did at baseline was:
- 19 percent in the self-directed group;
- 38 percent in the call-center-directed group; and
- 41 percent in the in-person-directed group.
“The success in keeping off weight could be due to the active involvement of primary care physicians who encouraged their patients at routinely scheduled visits to stick with their weight loss program even when it was difficult,” Appel said.
The study participants were 64 percent women, 41 percent African-American. Their average age was 54 years. At baseline, average body mass index, or BMI, was 36.6 kg/m2 and average weight was 229 pounds.
Johns Hopkins coaches conducted the in-person program. Coaches from Healthways, Inc., a disease-management company, implemented the call-center-directed program and developed the study website.
Co-authors are Jeanne M. Clark, M.D., M.H.S.; Hsin-Chieh Yeh, Ph.D.; Nae-Yuh Wang, Ph.D.; Janelle W. Coughlin, Ph.D.; Gail Daumit, M.D., M.P.H.; Edgar Miller, M.D., Ph.D.; Arlene Dalcin, R.D.; Gerald J. Jerome, Ph.D.; Steven Geller, M.D.; Gary Noronha, M.D.; Thomas Pozefsky, M.D.; Jeanne Charleston, R.N.; Jeffrey B. Reynolds; Nowella Durkin; Richard Rubin, Ph.D.; Thomas A. Louis, Ph.D.; and Frederick L. Brancati, M.D., M.H.S.
Disclosures are here: http://newsroom.heart.org/pr/aha/document/Disclosures_for_LBCT.xlsx.
The study was funded primarily by the National Heart, Lung, and Blood Institute.
Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding .
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