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Obesity: Technology-Supported Multicomponent Coaching or Counseling Interventions – To Reduce Weight


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 14 studies (search period 1966-June 2008).

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to obesity prevention and control.

Summary of Results

Fourteen studies were included in the systematic review.

Weight loss

  • All of the studies reported weight loss with a median decrease of 8.1 lbs (3.7 kgs) over a median follow-up time of 6 months (13 studies).

Physical activity

  • Most of the studies reported an increase in physical activity (5 of 7 studies).


  • All of the studies showed small decreases in caloric and fat intake (7 studies).

Summary of Economic Evidence

Two studies were included in the economic review. Monetary values are presented in 2009 U.S. dollars.

  • One study evaluated a 6-month, Internet-based program that used case management to assist patients with cardiac rehabilitation and risk factor reduction.
    • The estimated cost for the program was $528 per participant.
    • Net savings from the intervention were $1125/person, for an estimated return of $2.13 for every $1.00 spent.
  • Another study evaluated an Internet-based weight loss program in Sweden.
    • The cost-effectiveness for participants who stayed in the program for 6 months was $0.49/pound lost.
    • A large number of participants dropped out of the study or had incomplete data. When these participants were included in the analysis, the cost-effectiveness of the program increased to $2.45/pound lost.


Findings of the review should be applicable to the following:

  • Adults
  • Home and community settings
  • U.S.
  • Interventions delivered by counselors and other types of healthcare providers
  • Assorted technologies (e.g., websites, email, interactive TV modalities)

Evidence Gaps

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • Does the type of technology and whether it is mobile make a difference?
  • Are technology-based interventions as effective across subpopulations? Does effectiveness vary by age, cultural, SES, gender, race, or ethnicity?
  • Does effectiveness vary based on an interaction between subpopulations (e.g., cultural, age) and type of technology (e.g. computer, mobile device)?
  • How does provider training or credentialing affect services to clients?
  • Are clients and providers more likely to engage if technical support or training on computer applications are provided?

Study Characteristics

  • Studies included randomized controlled trials (13 studies), and one before-and-after study design. Comparison groups, however, were exposed to a variety of treatment conditions.
  • Studies were conducted in the U.S. (12 studies), U.S. and Canada (1 study), and Taiwan (1 study).
  • The primary purpose for interventions included weight loss (10 studies) and diabetes management (4 studies).
  • Studies targeted adults (13 studies) and children and adolescents (1 study).