By Charles Platkin, PhD
The Ins and Outs of Internet Dieting and How to Find Your Online Dieting Groove
Does online dieting work?
There have been several studies by the University of Vermont and Brown University that show some interesting progress with online dieting. The most recent (http://www.obesityresearch.org/cgi/content/abstract/15/1/155) compared an “online, therapist-led structured behavioral weight-loss Web site” with eDiets.com. In this case the therapist-led group lost significantly more weight and kept it off. In another study, researchers at University of Pennsylvania School of Medicine (http://www.obesityresearch.org/cgi/content/full/12/6/1011##F2) compared eDiets.com with a simple “weight-loss manual.” Here again researchers reported that “participants who received the weight-loss manual lost significantly more weight at weeks 16 and 52 than those assigned to eDiets.com.” Another recent study published in the Archives of Internal Medicine (http://archinte.ama-assn.org/cgi/content/abstract/167/9/944) suggests that the Internet is no better than print marketing campaigns to motivate exercise (which could be considered a good thing, but the Internet is not necessarily a less expensive alternative).
According to Dawn Jackson Blatner, R.D., a spokesperson for the American Dietetic Association, the bottom line is that “research shows that #weight loss and maintenance are improved when participants have personalized feedback from the program, log in regularly, complete food and activity diaries and use peer/social support tools.”
What are the different types of online diets?
There are many types of programs online, including:
- E-mail counseling with nutritionists and/or dietitians (e.g., PersonalDiets.com)
- Web tools, including food and activity diaries (FitDay.com, MyFoodDiary.com)
- Web tools, meal planners, social support (eDiets.com, WeightWatchers.com, Southbeachdiet.com)
What are the advantages?
- Privacy and Anonymity: “Many dieters are very self-conscious about their bodies and are sensitive to being judged. The Internet is a great way for someone who struggles with those issues, or someone who’s isolated, to get some support without the scarier commitment of seeing a coach or group face-to-face. If you know you need someone to really collar you to get you to a group or exercise class, and if you just can’t get yourself motivated, the Internet may not be your best option,” says Annie B. Kay M.S., R.D., author of Every Bite Is Divine (Life Arts Press, 2007).
- 24/7 Access: You can get to your #online diet from anywhere at any time.
- Time Saver: “It reduces the barrier of traveling to a clinic. It also allows people to have access to a regular source of check-in, even when they are traveling. So if someone is in Chicago on Thursday and next Tuesday in New York, they still have the same check-in time. In theory, people can do it on their own schedule,” says Gary D. Foster, Ph.D., director of the Center for Obesity Research and Education at Temple University.
- Support: Internet diets also offer wonderful opportunities for individuals who are going through similar experiences to support each other. Research supports the concept of peer-to-peer support for many #health matters, including weight control. This also includes the concept of success stories. “Hearing and seeing someone who has ‘done the impossible — lost weight and kept it off’ is highly motivating for many individuals. Internet weight-loss ‘buddies’ are also very helpful for many people for that reason. One of the reasons that a commercial diet program like Weight Watchers is so successful is the weekly group meeting,” says Janet Bond Brill, Ph.D., R.D., LDN, author of Cholesterol Down (Crown, 2006).
- Cost: “They’re usually much cheaper than face-to-face consultations with a nutritionist or personal trainer, and there is a ton of high-quality information available for those who know how to find it,” says Kay. The typical charge is about $5 per week with a three-month commitment. Personal dietitian counseling is about $7–$10 per week.
What are the negatives?
- No accountability: “Many of the sites are fancy tools that offer no accountability. Individuals are often more successful at weight loss when they are monitored by another party (such as weekly weigh-ins at Weight Watchers). Internet diet programs often lack the interpersonal communication of one-on-one contact and support,” says Brill.
- Time Consuming: Keeping track and entering your food and activities, updating your meal plan, shopping using the shopping lists online — it’s more work then having a nutritionist assist you.
- Computer Skills Required: You need to really know how to use the Internet and computers to make most of these programs work.
- Interference: “There’s more product marketing on the sites than in the usual personal session. Ads and inducements to buy products that may or may not help the dieter are everywhere, and beg the question of what type of relationship is being established,” says Kay.
- Lack of Feeling: According to Kay, “The biggest drawback is that there’s no real substitute for quality personal contact. As a dietitian, when I see someone face to face, I see my client’s emotions more clearly, and the nuances of a face-to-face conversation just can’t be replicated over the Internet.
- No Activity: “Sitting at the computer is a completely sedentary activity that contributes to the couch-potato lifestyle that must be reversed to promote a lifetime of weight control,” says Brill.
- Maintenance is Difficult: Prescriptive meal plans are difficult to stick to, even if you personalize them, and what happens when you go off the meal plan? Are you supposed to follow it forever?
- Getting Involved: If you want to avoid dieting online — you simply don’t log on. It’s easier than skipping an appointment with a nutritionist or personal trainer. Blatner suggests making the online diet program your home page. However, it’s easy to avoid your online diet. “I think you need to have online support groups, live chats and other events that get you excited about checking in. The e-mail communications must be individualized and consistent. And, the more that checking your e-mail is like checking in with your friends, the more fun and successful it will be for everyone,” says Kay.
- Pricing: Many of the dieting sites don’t tell you the price of the program until you’ve filled out the uninformative “diet profile.” This is an annoying and time-consuming practice.
What are the characteristics of a good Internet dieting program?
According to Blatner all online programs should include:
- Diet recommendations, recipes and menus
- Exercise recommendations, suggested exercises
- Log/tracking system
- Social component, chat rooms, bulletin boards
- Individualized feedback, counseling and accountability
Additionally, Foster recommends that some sort of weekly check-in is critical. “With the check-in, there should be feedback (a system of accountability) — tailored sites work better than non-tailored sites. Meaning, if you don’t check in, you will be prompted with an e-mail. That is, the program should ask you what day and time is good for check-in (i.e., Mondays at 6 p.m.). If you don’t check in within 24 hours of your scheduled time you would get an e-mail reminder.”
Blatner also warns against “scam” sites. They usually:
- Promise a quick fix
- Make claims that sound too good to be true
- Give recommendations based on a single research study (or none at all)
- List good and bad foods
- Make dramatic statements that are refuted by reputable scientific organizations
- Push products such as supplements/have weight-loss supplement advertisements on the site
How much does it cost?
- WeightWatchers.com: $65 for your first three months, $16.95 a month thereafter
- eDiets.com: $17.96 per month, three-month minimum ($25 cancellation fee)
- South Beach Diet Online: $65 per three months
- FitDay.com and SparkPeople.com, DietDetective.com (with code “newspaper”): Free
- PersonalDiets.com: $90 for three months
Questions you need to ask yourself before you join.
- Are you at your computer often? Will you remember to log on to the diet site?
- Are you self-motivated?
- What diets have worked for you in the past?
- Do you get a good feel from the site? Is it easy to navigate?
- You like the tools, but will you really use them?
- Is the information on the site engaging?
- Will this site work with your lifestyle?
- Does the program include accountability?
- Can you afford it?
- Is there a free option that does the same thing?
- Do you need face-to-face interaction, or will virtual interactions be enough?
What are the right questions to ask about any online weight-loss program?
- What kind of specific support do you offer your members?
- Are there message boards? Are they monitored by a professional, a member of the group, or are they completely unmonitored?
- How many active members do you have?
- Do you sell supplements?
- Is the pricing policy clearly stated on the Web site?
- Is there a base fee?
- Are there any additional charges aside from the base fee?
- Do you require food purchases, or are they simply an add-on to the program?
- Who developed the program? Was it designed by qualified health professionals who have previous experience in weight-loss counseling? Did at least one registered dietitian (R.D.) assist with the development?
- Is your site medically supervised? Psychologically supervised? Registered dietitian supervised?
- When you say “personalized” or “tailored,” what does that mean?
- Is the support simply customer-service messages? Or are there real, live people responding?
- What is your cancellation policy?
- Do you have a guarantee? What is it? Is it listed on the site?
- Do you have a phone number with an address? Do you answer the phone? How long is the wait?
- What kinds of physical activity or exercise programs do you offer? Who developed them? Were the programs developed by certified exercise professionals? (American College of Sports Medicine or the National Strength and Conditioning Association)
- Is there advertising on the site? Do you have an advertising policy?
- Is the site easy to navigate and use?
- Does the site look professional?
- Are there articles on the site? Who wrote them? Are they experts?
- Is the site promoting or advertising quick weight loss?
- Is the diet very restrictive? Will it work for you? Is it healthy?
- Is it a one-size-fits-all diet, or is it tailored or designed specifically for your height, weight, gender, age, personality, eating preferences and activity level? What if you’re a vegetarian or have other food restrictions — will the diet accommodate them?
- Does the site belong to HON — Health on the Net Foundation — and follow the HON Code of Conduct (HONcode) for medical and health Web sites?