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Testing an Internet-Based Turkish Obesity Behavioral Therapy Program: A Randomized Study

Cenan HEPDURGUN, Özgün ÖZALAY, Şebnem PIRILDAR, Gülbin RUDARLI NALÇAKAN, Lütfiye Füsun SAYGILI, Selda SEÇKİNER, Murat Osman ÜNALIR, Hayriye ELBİ
2020 31(1): 41-47
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Objective: Behavioral treatment is recommended as the first line
intervention for the prevention of health problems pertaining to obesity.
Internet-based programs are used to provide cognitive behavioral
therapy for psychiatric disorders and systemic diseases to a large number
of patients at low cost. The aim of this study is to develop the first
internet based Turkish obesity behavioral therapy program and test its
short-term effectiveness.
Method: A Turkish web-based behavioral therapy program based on
the behavioral strategies employed in the Diabetes Prevention Program
was generated. In order to test the effectiveness of this internet-based
program an eight week randomized study was conducted. A total of 101
overweight participants with body mass index in the 25-40 range were
randomly assigned to an eight-week weight loss program using either
the Internet Behavior Therapy (IBT, n=51) or e-mail education (EE,
n=50). The participants in the IBT group were provided access to an
Internet program that provided videos teaching behavioral weight-loss
skills as well as a self-monitoring platform to calculate the daily calorie
balance. The participants in the EE group received weekly e-mails with
information on healthy eating, physical exercises and weight loss for
eight weeks. The primary outcome measure was the observed weight
change at the end of the 8 weeks.
Results: In the analyses wherein baseline weight was carried forward
for missing data, the IBT produced significantly larger mean weight
loss in comparison to the EE at the end of the 8 weeks [2.28 kg (2.11)
vs. 0.74 kg (1.57), p=0.001]. The participants in the IBT group, when
compared to the EE group, were also more likely to achieve a clinically
significant weight loss of 5% of their initial body weight at the end of
the 8-week study period (17.6% vs. 2%, p=0.016).
Conclusion: The participants who received a structured IBT
intervention lost significantly more weight after two months, compared
to those who received weekly informational emails regarding weight
loss. Internet-based behavioral therapy programs may have the potential
to serve as a low-cost alternative for obese patients.