Long term Weight Loss in a Primary Care-Anchored eHealth Lifestyle Coaching Program in Denmark: Randomized Controlled Trial (Preprint)

BACKGROUND Long-term weight loss among subjects with obesity can reduce the risk and progression of noncommunicable diseases (NCDs). Observational studies suggest that digital coaching can lead to long-term weight loss. OBJECTIVE We investigated whether an eHealth lifestyle coaching program (LIVA) for subjects with obesity with or without type 2 diabetes (T2D) leads to significant long-term (more than 6 months) weight loss compared to usual care. METHODS In a randomized controlled trial that took place in 50 municipalities in Denmark, 340 subjects with obesity with or without T2D were enrolled from April 16, 2018, to April 1, 2019, and randomized via an automated computer algorithm to an intervention (200) or a control (140) group. Patients were recruited via their general practitioners, the Danish diabetes organization, and social media. The digital coaching intervention comprised of an initial one-hour face-to-face motivational interview followed by digital coaching using behavioral change techniques enabled by individual live monitoring. Primary outcome was change in body weight from baseline to 6 and 12 months. RESULTS Data were assessed for 235 participants, 149 from the intervention group and 86 from the control group who completed 6 and/or 12 months follow-up. After 12 months mean body weight and body mass index were reduced significantly in both groups but significantly more in the intervention group (–4.6 (-5.7; -3.4) kg vs. -1.4 (-2.6; -0.1) kg, P<.001 and -1.5 (-1.9; -1.2) kg/m2 vs. -0.5 (-0.9; -0.1) kg/m2, P<.001). Hemoglobin A1c (HbA1c) was significantly reduced in both the intervention (-6.0 (-7.7; -4.3) mmol/mol) and the control group (-4.9 (-7.4; -2.4) mmol/mol) without significant group difference. CONCLUSIONS Compared to usual care, digital lifestyle coaching can induce significant weight loss in obese subjects both with and without T2D after 12 months. CLINICALTRIAL ClinicalTrials.gov NCT03788915; https://clinicaltrials.gov/ct2/show/NCT03788915