Comment on "Health Coaching: 100 Strategies for Weight Loss: A Systematic Review and Meta-Analysis"

Identifying Factors Contributing to Dropouts in a Pilot Telenutrition Weight-Loss Program: A Qualitative Study

Background

Telehealth programs exhibit strong potential to improve health measures and quality of life among obese and overweight individuals for whom medical nutritional therapy remains a challenge due to poor adherence and dietary compliance. Supporting weight-management programs with dietary interventions or "telenutrition" and integrating telemonitoring and/or telehealth coaching have had a significant positive impact on weight-loss patients achieving their goals in long-term interventions.

Methods

The aim of the current study was to identify the factors leading patients to drop out of a telenutrition weight-loss program, including weekly telemonitoring (total of 36 weeks) and monthly telehealth coaching (total of 6 months). Descriptive qualitative semistructured interviews were held with 10 obese and overweight participants. The data gathered through these interviews were then thematically analyzed through a content analysis.

Results

The findings showed that 50% of participants who dropped out of the study felt pressured at work and/or university. Specifically, 60% reported being influenced by marital responsibilities, and 50% indicated that they did not achieve their goals. Nevertheless, participants who dropped out of the study reported that they were not negatively influenced by family factors and/or financial status. Participants also indicated feeling happy to take part in the program and noted that the diet positively influenced their psychological status. Participants also noted the clarity of instructions and that they were fully motivated during the trial.

Conclusions

The factors associated with dropouts in this study were different from those identified in the literature, given that our weight-loss program was delivered remotely and supported with weekly telemonitoring and monthly telehealth coaching. Despite the dropouts, the interview data highlighted positive factors that could enhance adherence to the dietary program and reduce dropout rates in larger and longer interventions. Future research should highlight the need to develop clear guidelines related to telenutrition programs or other digital health interventions to ensure successful long-term positive outcomes.

Occupational Health of Health-Care Workers with Overnutrition: Scoping Review with Meta-Analysis

(1) Objective: To review the scientific literature on the impact of interventions to enhance the occupational health of health-care workers with overnutrition. (2) Methods: Scoping review with meta-analysis. Data were obtained by consulting the following bibliographic databases: MEDLINE (via PubMed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Literature on Health Sciences (LILACS), and Medicina en Español (MEDES). The terms used as descriptors and as text in the title and abstract fields of the records were "health workers", "overnutrition", and "occupational health", using the filters "human", "adult": 19+ years", and "clinical trial". The search update date was January 2023. The documentary quality of the articles was evaluated using the CONSORT questionnaire and the presence of bias was assessed using the Rob 2.0 tool. (3) Results: From the 611 digitally retrieved references, 17 clinical trials were selected after applying the inclusion and exclusion criteria. CONSORT scores ranged from a minimum of 14.6% to a maximum of 91.7%, with a median of 68.8%. According to the SIGN criteria, this review provided "1" evidence with a grade B recommendation. Six different types of intervention were tested, grouped into strategies ranging from a single intervention to a combination of four interventions. The summary effect of the meta-analysis showed significant weight loss, but no association with reduced body mass index. (4) Conclusions: While workplace interventions have been shown to be potentially effective, and strategies using different types of interventions have been proven to be useful in tackling overnutrition, an effective and sustainable solution for changing the behavior of health professionals to tackle overweight and obesity has yet to be identified.

Effectiveness of combined health coaching and self-monitoring apps on weight-related outcomes in people with overweight and obesity: A systematic review and meta-analysis (Preprint)

BACKGROUND

Self-monitoring smartphone apps and health coaching have both individually been shown to improve weight-related outcomes, but their combined effects remain unclear.

OBJECTIVE

This study aims to examine the effectiveness of combining self-monitoring apps with health coaching on anthropometric, cardiometabolic, and lifestyle outcomes in people with overweight and obesity.

METHODS

Relevant articles published from inception till June 9, 2022, were searched through 8 databases (Embase, CINAHL, PubMed, PsycINFO, Scopus, The Cochrane Library, and Web of Science). Effect sizes were pooled using random-effects models. Behavioral strategies used were coded using the behavior change techniques taxonomy V1.

RESULTS

A total of 14 articles were included, representing 2478 participants with a mean age of 39.1 years and a BMI of 31.8 kg/m2. Using combined intervention significantly improved weight loss by 2.15 kg (95% CI -3.17 kg to -1.12 kg; P<.001; I2=60.3%), waist circumference by 2.48 cm (95% CI -3.51 cm to -1.44 cm; P<.001; I2=29%), triglyceride by 0.22 mg/dL (95% CI -0.33 mg/dL to 0.11 mg/dL; P=.008; I2=0%), glycated hemoglobin by 0.12% (95% CI -0.21 to -0.02; P=.03; I2=0%), and total calorie consumption per day by 128.30 kcal (95% CI -182.67 kcal to -73.94 kcal; P=.003; I2=0%) kcal, but not BMI, blood pressure, body fat percentage, cholesterol, and physical activity. Combined interventional effectiveness was superior to receiving usual care and apps for waist circumference but only superior to usual care for weight loss.

CONCLUSIONS

Combined intervention could improve weight-related outcomes, but more research is needed to examine its added benefits to using an app.

TRIAL REGISTRATION

PROSPERO CRD42022345133; https://tinyurl.com/2zxfdpay.