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Obesity is the main focus of preventive medicine studies in many countries. In Japan, nationwide health guidance activities have started from April 2008, aiming at the improvement of body mass index (BMI) and waist circumference. Although an email correspondence is a standard method of the health counseling, its ’individual’ counseling style preclude an effective use of group dynamics individuals may experience through group sessions. We developed a web-based peer-conscious system to utilize the group dynamics and investigated whether the web-based system has a superior effect to the email on the weight reduction.
Subjects aged 35 years or older, with BMI 25 or higher in the latest health checkup, were enrolled. They were randomized to the web-based support group or email-based support group after the initial introductory meeting, and received the health guidance for three months. At baseline, height, weight, and waist circumference (standing and lying positions) were measured, as well as dietary habits (FFQg), daily activities, activity levels, and QOL(SF-36). During the 3-month counseling period, the participants reported weight changes and progress of health conditions at least once a week. A managing nutritionist’s advice was given in response to each participant’s report. After the 3-month period, final measurements of height, weight, and waist circumferences were performed. The primary endpoint was the changes of body weight; secondary endpoints were the changes of waist circumferences, dietary habits (FFQg), activity levels, and QOL.
From July 2008 through February 2009, 193 subjects were enrolled and randomized to the web group (97 subjects) or email group (96 subjects). Each one of 13 managing nutritionists was placed in charge of 13 to 17 participants. Managing nutritionists, participants’ sex, age, and initial weight were evenly distributed, and the background factor of each group was taken into consideration and balanced. Although this research project is still in progress, as of January 30, 2009, 147 participants have completed the project and evaluation. Out of these 147 participants, preliminary results showed a weight reduction of 1.3 – 2.5 kg and a waist circumference reduction of 3.1 – 3.7 cm in standing position and of 3.1 – 3.4 cm in lying position.
Conclusion: Although this study directly examines the effectiveness of newly developed health counseling system compared with the standard methodology, our results will also provide an important implication for an effective use of group dynamics in the health guidance.


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