Five-year follow-up of a randomized weight loss trial on a digital health behaviour change support system
Turkkila, Eero; Pekkala, Taru; Merikallio, Heta; Merikukka, Marko; Heikkilä, Laura; Hukkanen, Janne; Oinas-Kukkonen, Harri; Salonurmi, Tuire; Teeriniemi, Anna-Maria; Jokelainen, Terhi; Savolainen, Markku J (2025-03-15)
Springer
15.03.2025
Turkkila, E., Pekkala, T., Merikallio, H. et al. Five-year follow-up of a randomized weight loss trial on a digital health behaviour change support system. Int J Obes 49, 949–953 (2025). https://doi.org/10.1038/s41366-025-01742-4
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© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
https://creativecommons.org/licenses/by/4.0/
© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202503172059
https://urn.fi/URN:NBN:fi:oulu-202503172059
Tiivistelmä
Abstract
Background:
The weight regain after successful weight loss is a common challenge. This study aimed to assess the long-term effectiveness of a web-based health behaviour change support system (HBCSS) utilizing persuasive systems design (PSD) and methods of cognitive behavioural therapy (CBT). We have previously demonstrated the two-year effectiveness of the HBCSS.
Methods:
In total, 532 participants with overweight or obesity (BMI 27–35 kg m−2) were split into three groups with different intensities of intervention: CBT-based group counselling, self-help guidance (SHG), and usual care. These groups were further divided into HBCSS and non-HBCSS groups. The HBCSS was a 52-week programme. The follow-up took five years in total.
Results:
Mean weight change (%) (95% CI) from baseline among HBCSS and non-HBCSS users was 1.5 (−0.02 to 2.9), p = 0.056 and 1.9 (0.3–3.3), p = 0.005, respectively, at five years. Of the six groups, the SHG group without HBCSS had a statistically significant increase in weight (%) from baseline at five years (3.1, 95% CI 0.6 to 5.6, p = 0.010). The other groups did not have a significant increase in weight. There was no significant difference between groups at five years in weight. Fewer blood pressure medications were started over the five-year period in HBCSS group (p = 0.046).
Conclusion:
The 12-month HBCSS intervention was not able to maintain reduced weight better than non-HBCSS at 5 years. However, there were significant weight difference favouring HBCSS over the whole 5-year period. The decrease in the need for antihypertensives suggests that the significant weight loss by HBCSS at early years has a health-promoting legacy effect.
Background:
The weight regain after successful weight loss is a common challenge. This study aimed to assess the long-term effectiveness of a web-based health behaviour change support system (HBCSS) utilizing persuasive systems design (PSD) and methods of cognitive behavioural therapy (CBT). We have previously demonstrated the two-year effectiveness of the HBCSS.
Methods:
In total, 532 participants with overweight or obesity (BMI 27–35 kg m−2) were split into three groups with different intensities of intervention: CBT-based group counselling, self-help guidance (SHG), and usual care. These groups were further divided into HBCSS and non-HBCSS groups. The HBCSS was a 52-week programme. The follow-up took five years in total.
Results:
Mean weight change (%) (95% CI) from baseline among HBCSS and non-HBCSS users was 1.5 (−0.02 to 2.9), p = 0.056 and 1.9 (0.3–3.3), p = 0.005, respectively, at five years. Of the six groups, the SHG group without HBCSS had a statistically significant increase in weight (%) from baseline at five years (3.1, 95% CI 0.6 to 5.6, p = 0.010). The other groups did not have a significant increase in weight. There was no significant difference between groups at five years in weight. Fewer blood pressure medications were started over the five-year period in HBCSS group (p = 0.046).
Conclusion:
The 12-month HBCSS intervention was not able to maintain reduced weight better than non-HBCSS at 5 years. However, there were significant weight difference favouring HBCSS over the whole 5-year period. The decrease in the need for antihypertensives suggests that the significant weight loss by HBCSS at early years has a health-promoting legacy effect.
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