A Randomized Trial Comparing Human e-Mail Counseling, Computer-Automated Tailored Counseling, and No Counseling in an Internet Weight Loss Program

Abstract

The Internet has increasingly been used to provide behavioral change interventions, and several studies^1-3 have demonstrated its potential for delivering weight control therapy. In 2 of these studies,^1,2 better weight losses were produced by programs in which a human counselor provided weekly e-mail behavioral weight loss counseling compared with Internet programs that were self-directed and involved no weekly guidance. Although providing Internet weight loss programs with e-mail counseling may offer an alternative to in-person programs, if effective counseling were provided by a computer preprogrammed with messages based on performance criteria, Internet weight management interventions could be a more widely disseminable treatment approach. The goal of this study was to determine the short-term efficacy of a self-directed Internet weight loss program compared with the same program supplemented with behavioral counseling from either a computer-automated tailored system or from a human counselor.