A study by Johns Hopkins researchers found that a weight loss program conducted solely by telephone and the Internet was as effective in helping people lose weight and keep it off as a program attended in person, with face-to-face counseling. The findings were published in November 2011 by the New England Journal of Medicine.

Led by Dr. Lawrence J. Appel, the study recruited 415 obese people with an average body mass index (BMI) of 36.6 and an average weight of 229 pounds. Three-quarters of them had hypertension. Study participants were randomly split into three groups.

One was a control group that received information about weight loss but didn't receive any counseling. Another had its program delivered remotely, with phone counseling, an interactive website and physician support. The third group was provided with in-person support along with the interactive website and physician support.

Each program focused on weight-management behaviors such as eating fewer calories and exercising more. The researchers found that obese patients achieved and sustained clinically significant weight loss over a period of 24 months from the remote and in-person support programs. Almost 19 percent of patients in the self-directed weight loss program lost 5 percent or more of their initial weight, an amount associated with numerous health benefits, including improved control of diabetes and hypertension and lower levels of risk factors for cardiovascular disease.

In comparison, 38.2 percent in the group receiving remote support only, and 41.4 percent in the group receiving in-person support, lost 5 percent or more of their initial weight. In-person programs are the standard, and such programs do lead to weight loss. But it was surprising to see that those who had only telephone contact with coaches did just as well as those who had in-person sessions. As the study progressed, the in-person group opted to trade in the face-to-face sessions for the convenience of using the phone.

Publication Review By: Lawrence Appel, M.D., and Rafael H. Llinas, M.D.

Published: 14 Jul 2013

Last Modified: 22 Sep 2015