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 18 February 2018

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Effect of an internet-based program on weight loss for low-income postpartum women

The latest issue of the Journal of the American Medical Association examines whether an internet-based weight loss program promotes long-term weight loss in low-income postpartum women in the Special Supplemental Nutrition Program for Women, Infants, and Children.

News image

Postpartum weight retention increases lifetime risk of obesity and related morbidity.

Few effective interventions exist for multicultural, low-income women.

Dr Suzanne Phelan and colleagues tested whether an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) for low-income postpartum women could produce greater weight loss than the WIC program alone over 12 months.

The research team performed a 12-month, cluster randomized, assessor-blind, clinical trial enrolling 371 adult postpartum women at 12 clinics in WIC programs from the California central coast between 2011 and 2015 with data collection completed in 2016.

Clinics were randomized to the WIC program (standard care group) or the WIC program plus a 12-month primarily internet-based weight loss program (intervention group), including a website with weekly lessons, web diary, instructional videos, computerized feedback, text messages, and monthly face-to-face groups at the WIC clinics.

The team's primary outcome was weight change over 12 months, based on measurements at baseline, 6 months, and 12 months.

89% of participants completed the study
Journal of the American Medical Association

Secondary outcomes included proportion returning to preconception weight and changes in physical activity and diet.

Participants included 371 women randomized to the intervention group or standard care group.

The researchers found that 89% of participants completed the study.

The intervention group produced greater mean 12-month weight loss compared with the standard care group.

The research team found that more participants in the intervention group than the standard care group returned to preconception weight by 12 months.

The team noted that the intervention group and standard care group did not significantly differ in 12-month changes in physical activity, calorie intake, or incidences of injury or low breastmilk supply from baseline to month 6, and from month 6 to 12.

Dr Phelan's team comments, "Among low-income postpartum women, an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) compared with the WIC program alone resulted in a statistically significant greater weight loss over 12 months."

"Further research is needed to determine program and cost-effectiveness as part of the WIC program."

JAMA 2017;317(23):2381-2391
26 June 2017

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