@Article{info:doi/10.2196/39741, author="Hesseldal, Laura and Christensen, Jeanette Reffstrup and Olesen, Thomas Bastholm and Olsen, Michael Hecht and Jakobsen, Pernille Ravn and Laursen, Ditte Hjorth and Lauridsen, J{\o}rgen Trankj{\ae}r and Nielsen, Jesper Bo and S{\o}ndergaard, Jens and Brandt, Carl Joakim", title="Long-term Weight Loss in a Primary Care--Anchored eHealth Lifestyle Coaching Program: Randomized Controlled Trial", journal="J Med Internet Res", year="2022", month="Sep", day="23", volume="24", number="9", pages="e39741", keywords="obesity; digital behavioral coaching; health behavior change; interactive advice; lifestyle change; mobile intervention; patient engagement; telemedicine; eHealth; digital health; digital coach; weight loss; coaching; training; engagement; behavior changes; diabetes; type 2 diabetes; T2D", abstract="Background: Long-term weight loss in people living with obesity can reduce the risk and progression of noncommunicable diseases. Observational studies suggest that digital coaching can lead to long-term weight loss. Objective: We investigated whether an eHealth lifestyle coaching program for people living with obesity with or without type 2 diabetes led to significant, long-term (12-month) weight loss compared to usual care. Methods: In a randomized controlled trial that took place in 50 municipalities in Denmark, 340 people living with obesity with or without type 2 diabetes were enrolled from April 16, 2018, to April 1, 2019, and randomized via an automated computer algorithm to an intervention (n=200) or a control (n=140) group. Patients were recruited via their general practitioners, the Danish diabetes organization, and social media. The digital coaching intervention consisted of an initial 1-hour face-to-face motivational interview followed by digital coaching using behavioral change techniques enabled by individual live monitoring. The primary outcome was change in body weight from baseline to 12 months. Results: Data were assessed for 200 participants, including 127 from the intervention group and 73 from the control group, who completed 12 months of follow-up. After 12 months, mean body weight and BMI were significantly reduced in both groups but significantly more so in the intervention group than the control group (--4.5 kg, 95{\%} CI --5.6 to --3.4 vs --1.5 kg, 95{\%} CI --2.7 to --0.2, respectively; P<.001; and --1.5 kg/m2, 95{\%} CI --1.9 to --1.2 vs --0.5 kg/m2, 95{\%} CI --0.9 to --0.1, respectively; P<.001). Hemoglobin A1c was significantly reduced in both the intervention (--6.0 mmol/mol, 95{\%} CI --7.7 to --4.3) and control (--4.9 mmol/mol, 95{\%} CI --7.4 to --2.4) groups, without a significant group difference (all P>.46). Conclusions: Compared to usual care, digital lifestyle coaching can induce significant weight loss for people living with obesity, both with and without type 2 diabetes, after 12 months. Trial Registration: ClinicalTrials.gov NCT03788915; https://clinicaltrials.gov/ct2/show/NCT03788915 ", issn="1438-8871", doi="10.2196/39741", url="https://www.jmir.org/2022/9/e39741", url="https://doi.org/10.2196/39741", url="http://www.ncbi.nlm.nih.gov/pubmed/36149735" }