Evidence Summary

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Internet based programs reduce waist circumference.

Seo, DC and Niu, J. Evaluation of internet-based interventions on waist circumference reduction: A meta-analysis J Med Internet Res. 2015;17:e181.

Review question

Do internet lifestyle programs help adults reduce waist circumference?


The internet provides easy access to health information and resources and has the potential to help people change lifestyle behaviours like diet and physical activity to improve health. Internet programs promote physical activity, nutrition or both using theory, counseling, goal setting or social support to strengthen effectiveness of interventions focused on waist circumference reduction. Waist circumference is a strong predictor of increased risk for many diseases like hypertension and diabetes.

How the review was done

The researchers did a meta-analysis of 31 randomized controlled trials published between 1980 and 2014.

The studies included 8442 people that were assigned to a participant or control group with an average age ranging from 19 to 65 years.


Key features of the studies were:

  • The programs were delivered via the internet lasting from 4 weeks to 2 years
  • Components of the programs include behavior theories, self-monitoring behavior, feedback on performance, individual counseling, goal setting, social support, motivational interviewing and incentives to encourage weight loss.
  • The internet programs involved one or more of: online logs, email counseling, forums, online sessions and Facebook support groups.
  • Control groups received usual care or information only, through brochures and the internet or received nothing.

What the researchers found

Internet programs to change lifestyle behaviours significantly reduce waist circumference. Average change in waist circumference was 2.99 cm with internet programs and 0.81 cm with the control groups. The researchers found programs that included a social support component were most effective in reducing waist circumference with an average change of 1.16 cm. Internet programs had similar effects to more resource intense approaches such as paper, phone or person-based lifestyle behavior change. 


Internet programs for obesity or lifestyle changes may be an efficient and effective method to reduce waist circumference. Online social support should be included as part of an internet program to reduce waist circumference.



Control group
A group that receives either no treatment or a standard treatment.
Advanced statistical methods contrasting and combining results from different studies.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.

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