Evaluation of Behavioral Theory and Integrated Internet/Telephone Technologies to Support Military Obesity and Weight Management Programs

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The primary objective of the study was to evaluate the interaction of two different weight management interventions and two methods of follow up counseling on weight loss in overweight active duty military service members after 3 months. Participants (n=172) were randomized to one of four groups using a 2 x 2 factorial treatment structure: (1) Standard 'Class' + 'In-person' follow up counseling every 3 months, (2) 'Class' + weekly 'Internet' weight management follow up, (3) 'Tailored' behaviorally based counseling session + 'In-person' follow up every 3 months, or 4) 'Tailored' + 'Internet'. The secondary objective was to determine the relationship between stages of change for five different weight control behaviors (dietary fat, fruits and vegetables, portion control, beverage choices, exercise) and weight loss after 3 months. Measurements were taken at 0 (baseline) and 3 months and included body weight, body composition, waist circumference, blood pressure, fasting blood glucose, lipid levels, stages of change and dietary assessment. Analysis of covariance with repeated measures was used to compare outcome differences among groups over time.

There was no significant difference in weight loss or other outcomes among treatment groups at 3 months. However, the 'Tailored + Internet' (-1.33 +/- 0.66 kg, p<0.05) and 'Class + In-person' (-1.4 +/- 0.63 kg, p<0.05) groups lost significant weight compared to baseline after 3 months. The 'Tailored + Internet' group also lost significant total fat, trunk fat and percent body fat and had reduced waist circumference after 3 months while the 'Class + In-person' group significantly lost lean body mass but not fat when compared to baseline. Furthermore, being in the action stage for each weight control behavior did not result in significantly more weight loss than being in the pre-action stages.

These results suggest that although the 'Tailored + Internet' group lost significant weight and body fat after 3 months when compared to baseline, no treatment was superior. Future research should explore other approaches, such as those found in an ecological model of health behavior, because of the influence of other environmental factors on weight management in the military.