Developing and testing an internet based Turkish obesity behavioral therapy program: A randomized controlled study

INTRODUCTION: Obesity is a public health problem that is increasingly common in our country as it is in the whole world. It increases the health expenditures by leading to diseases such as diabetes, hypertension and heart diseases. Therefore effective and inexpensive tools which can be widely used in community for obesity treatment are needed to be developed. AIM: The aim of this study is to develop a Turkish internet obesity behavioral therapy program which can be used in wider community and test its short-term effectiveness. HYPOTHESES: The internet education program to be prepared on the basis of cognitive behavioral therapy of obesity will be completed by at least half of the participants. This program will be more effective in weight loss than sending weekly informative e-mails to patients. There will be a correlation between the frequency of using the internet based program and the weight loss. METHOD: 101 participants who applied to participate in the study and met the participation criteria were allocated to the program group and the e-mail group with computer-generated randomization. Participants in the program group were asked to use the internet behavioral treatment program for 8 weeks while e-mail group participants received informative e-mail about healthy life and weight loss for 8 weeks. The primary outcome of this study was weight change over 8 weeks. For intent-to-treat analysis, baseline observations of participants who did not complete the study were carried forward. Statistical analyzes were performed using the chi square test, independent samples t test, ANCOVA and Spearman correlation tests. RESULTS: 51 pariticipants were assigned to the program group and 50 participants were assigned to the e-mail group with randomization. 78,4% of the participants in the program group completed the study but only 25,4% of them watched all of the videos in 8-week education program. As a result of intent-to-treat analysis The change in body weight of the participants in the program group was -2.28 (± 2.11) on average after 8 weeks, while it was -0.74 (± 1.578) for the participants in e-mail group. (p = 0.001). In the program group, there was a significant correlation between weight loss and the number of videos watched (p=0.001). The number submissions to the eating diary also showed a significant correlation with the weight loss (p=0.001). CONCLUSION: Participants who used the internet program in our study lost statistically significant more weight than the participants in e-mail group over 8 weeks. Although this result reflects the minimal effectiveness of the program in the very short term, it is encouraging for new studies to develop a low-cost alternative for obesity treatment.