Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Internet-Based Weight Loss Program for Postpartum Women
JAMA; ePub 2017 Jun 20; Phelan, Hagobian, et al
Low-income postpartum women experienced statistically significant greater weight loss over 12 months through an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women (WIC) compared with the WIC program alone, according to a recent study. The 12-month, randomized clinical trial included 371 postpartum women (mean age, 28.1 years; 81.6% Hispanic) at 12 clinics in WIC programs between July 2011 and May 2015. 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). Primary outcome was weight change over 12 months; secondary outcomes included proportion returning to preconception weight and changes in physical activity and diet. Researchers found:
- Greater mean 12-month weight loss was observed in the intervention group vs the standard group (7 pounds vs 2 pounds).
- More participants in the intervention group returned to preconception weight by 12 months vs the standard group (33% vs 19%).
- The change in calorie intake (-298 intervention group vs -144 in the control group) just missed statistical significance with a p-value of 0.06.
Phelan S, Hagobian T, Brannen A, et al. Effect of an internet-based program on weight loss for low-income postpartum women. A randomized clinical trial. JAMA. 2017;317(23):2381-2391. doi:10.1001/jama.2017.7119.
Approximately 25% of women in the US have postpartum weights that are more than 10 pounds greater than their pre-pregnancy weight. That number is higher for Hispanic women and women with food insecurity, with up to 60% of those groups gaining over 10 pounds. That weight gain can have serious consequences, including an increased risk of lifetime obesity, cardiovascular disease, and type 2 diabetes.1 With such a large proportion of women affected, it is important that we develop easy-to-use, easy-to-deliver,and cost-effective interventions. Internet delivered interventions clearly meet that bill. This study shows that one such internet-based intervention, tested in a high-risk group receiving WIC, worked well. Hopefully, this program will be picked up by WIC and used to help those women for whom such weight loss could be both healthy and gratifying. —Neil Skolnik, MD