Seeking weight-loss counseling? Pick up the phone

Obesity is a growing problem in the U.S. Just this week, researchers at the American Heart Association projected that by 2020, the vast majority of Americans will be overweight or obese, with more than half of the country either diabetic or pre-diabetic.

Amidst all the bad news, however, researchers at Johns Hopkins University are offering a small ray of light. Their recent study on telephone counseling by health coaches finds it to be just as effective a means of losing weight as more traditional in-person programs.

That's particularly important because in-person programs are, by nature, more time-consuming and thus harder for many to stick to when the initial thrill of attendance and weight loss wears off.

"In most weight loss studies, there is a lot of emphasis on frequent in-person counseling sessions, but from a logistical perspective, it's a disaster," says study leader Lawrence J. Appel, a professor of medicine at Johns Hopkins University, in a news release.

"Patients start off strong, but then stop attending in-person sessions. That's why I like the telephone program. It is convenient to individuals and can be done anywhere. You could be living in rural South Dakota, and we could deliver this intervention. It removes some of the major logistical barriers."

For this study, published in November in the New England Journal of Medicine, 415 obese people with an average weight of 229 pounds and an average body mass index of 36.6 (above 30 is considered obese) were randomly split into three groups: the control group, which received information but not counseling; the telephone group, which received counseling over the phone, and the in-person group, which received counseling in person and by phone.

Over the course of two years, the participants receiving counseling went from weekly meetings or phone calls to bi-monthly meetings or monthly phone calls. After two years, those in the control group--who had no counseling--lost an average of 2 pounds, while those in the other two groups lost an average of 10 pounds.

Ten pounds may not sound like much, but those 10 pounds usually accounted for at least 5 percent of the person's body weight--a reduction associated with several health benefits, including blood pressure, lower cholesterol, and better diabetes control.

Appel says he was at first surprised that the telephone group was performing as well as the group that also received in-person counseling. Then, as the study progressed, the in-person group began to trade in those in-person sessions for phone sessions.

Convenience--or, seen another way, inconvenience--is a powerful force.