Telemedicine-Based Health Coaching Is Effective for Inducing Weight Loss and Improving Metabolic Markers

Abstract

Background: To assess the efficacy of health coaching (HC) delivered through videoconferencing (VC) to favorably change physical activity (PA), weight, and metabolic markers in adults with high body mass index (BMI).

Materials and methods: Thirty adults (BMI ≥30 kg/m2) were randomly assigned to one of three groups: VC, in-person (IP), or control group (CG). Participants received wireless watches and weight scales to sync with their personal smartphones; recorded data were wirelessly uploaded to a secure database. Participants assigned to VC and IP received individualized HC by a multidisciplinary team (registered dietitian, exercise physiologist, and medical doctor) based on data uploaded over the 12-week intervention. Steps/day and weight loss were analyzed through analyses of covariance.

Results: Within- and between-group changes in weight (kg), glucose, insulin, hemoglobin A1c (HbA1c), and Homeostasis Model Assessment estimate of insulin resistance (HOMA-IR) were analyzed through analyses of variance. Weight loss was greater (p < 0.05) for VC (8.23 ± 4.5 kg; 7.7%) than IP (3.2 ± 2.6 kg; 3.4%) and CG (2.9 ± 3.9 kg; 3.3%), respectively. Steps/day were significantly higher in VC than IP at week 4 and VC was significantly higher than the CG at weeks 6, 8, 9, and 11 (p ≤ 0.05). No within- or between-group differences were found for glucose, insulin, or HbA1C. HOMA-IR decreased for VC only (p ≤ 0.05).

Conclusions: Our innovative, multidisciplinary, telemedicine HC delivered through VC led to more favorable changes in weight loss, PA (steps/day), and HOMA-IR than IP or no HC. VC may be an economical approach to improve health and promote behavior change in obese adults.

Clinical trial registration number: ClinicalTrials.gov identifier NCT03278951.

Conflict of interest statement

Dr. Michelle Alencar owns stock inHealth Medical Services, Inc. inHealth Medical Services, Inc., provided project-related content, including subject education content, modules, and technology support only. All other authors declare no conflict of interests.

Figures

Fig. 1.

Mobile health device and telemedicine database framework. VC, videoconferencing; IP, in-person.

Fig. 2.

Comparison of daily step average per day by group (n = 10 for each group). *Significant difference between VC and IP groups; +significant difference between VC and control group; p < 0.05. Each time point (weeks) is presented as adjusted LMS and SE. LMS, least mean square; SE, standard error.

Fig. 3.

Comparison of weekly body weight in kg by group (n = 10 for each group). *Significant difference between VC and IP group; +significant difference between VC and control group; p < 0.05. Each time point (weeks) is presented as adjusted LMS and SE.