An Internet-delivered program helps people with HIV lose weight
Although there’s no reason to suspect that losing weight may be more or less difficult for people living with HIV, there haven’t been any randomized controlled trials testing behavioral weight loss programs specifically for people living with HIV. This is an important line of inquiry, however, said Katie Becofsky, PhD, from the University of Massachusetts Amherst, since being overweight or obese in combination with HIV infection may be more damaging than either condition on its own.
“When people are overweight or obese, there’s an increased risk of cardiovascular, metabolic and musculoskeletal conditions. That includes heart disease, diabetes, osteoarthritis and sleep apnea. And HIV is a pro-inflammatory condition that often occurs with a lot of comorbidities—so we’re really worried that there could be synergistic effects when the two conditions are combined.”
At the Conference on Retroviruses and Opportunistic Infections this year, Becofsky presented results from a small pilot study conducted with overweight and obese people living with HIV. Promising results from the study showed that an Internet-delivered program delivered over 12 weeks helped people lose, on average, about ten pounds. The weight loss program was developed by Rena Wing, PhD, from the Warren Alpert Medical School of Brown University, the director of the Weight Control and Diabetes Research Center at The Miriam Hospital.
During the study, 40 people living with HIV were randomly assigned to receive either the Internet-delivered intervention or a control condition. The weight loss intervention included:
- Watching a series of 15-minute videos online with tips healthy eating, physical activity and weight control strategies (and advice on how to integrate them into daily life); and,
- Tracking physical activity, weight, and foods eaten and reporting it through an online portal.
The weight loss program also provided automated feedback when people logged their self-reported data online, said Becofsky. “For instance, people would get a message saying, ‘great job! You hit your goals this week.’ Or, ‘Here’s a tip on how to get more physical activity next week.’”
People in the program had a goal to lose about one to two pounds per week. On average, people who received the weight loss intervention lost significantly more weight than people in the control group. On average, people in the weight loss program group lost about 10 pounds over 12 weeks.
There were large differences between people in the weight loss group in terms of the amount of weight lost, said Becofsky. “Some people were huge responders, and lost almost 40 pounds. Then we had other people who ended up gaining weight. This is pretty typical for a weight loss program—you always get a range of responses.”
92% of people included in the study completed the study. People who logged into the online portal and submitted their data more consistently were more likely to lose weight than people who were less adherent.
Because this was a pilot study, the researchers don’t know if people in the study kept the weight off over time. But the hope, said Becofsky, is that people continue to use the behavioral strategies they learned during the 12 weeks of the weight loss program to monitor their food intake, enlist social support, and incorporate more physical activity into daily life.
Tips for weight loss
Track your calories.
Becofsky said that many of the people she’s worked with use the MyFitnessPal app. Logging your food and drink intake keeps you accountable and helps you figure out why you are—or aren’t—seeing results.
Track your activity and/or steps.
The number of steps taken per day is a great indication, said Becofsky, of overall physical activity. Pedometers are inexpensive, and many people can use an app on their phone to track their steps. Fitbits can also help people track the number of steps taken in a day.
Weigh yourself daily.
If your primary goal is to lose weight, weighing yourself can be helpful, said Becofsky. This helps you keep track of how you’re doing, and adjust your behaviors (like how much you eat and exercise) if you’re not getting the results you want.
Becofsky, K. Randomized Trial of Behavioral Weight Loss For HIV-Infected Patients. CROI, 2017. Abstract 694.