A Review of Telemedicine Interventions for Weight Loss

Purpose of Review Telemedicine has become popular as an alternative for in-person weight loss treatment during the COVID-19 pandemic. This review focuses on weight loss interventions utilizing real-time telemedicine. Recent Findings Telemedicine interventions are usually run as a weekly counseling and educational session or as a complement to a primarily Web-based intervention. A wide variety of healthcare professionals may provide the intervention. Common content includes portion control, increased physical activity, and relapse prevention. Self-monitoring is associated with intervention success. Modalities considered include online chats, text messages, phone calls, and videoconferences. Videoconferencing may be especially useful in capturing the interpersonal connection associated with in-person care but is understudied compared to other modalities. While many interventions show improvements in weight and weight-related outcomes, small sample sizes limit generalizability. Technology access and digital literacy are both necessary. Summary Telemedicine interventions can successfully help patients with obesity lose weight. Telemedicine interventions provide a safe, remote alternative and may expand treatment access to hard-to-reach populations. Further research is needed on telemedicine weight loss treatments for seniors, men, and ethnic minorities, as well as on the impact of long-term interventions.

Impact of Portion Control Tools on Portion Size Awareness, Choice and Intake: Systematic Review and Meta-Analysis

Portion control utensils and reduced size tableware amongst other tools, have the potential to guide portion size intake but their effectiveness remains controversial. This review evaluated the breadth and effectiveness of existing portion control tools on learning/awareness of appropriate portion sizes (PS), PS choice, and PS consumption. Additional outcomes were energy intake and weight loss. Published records between 2006–2020 (n = 1241) were identified from PubMed and WoS, and 36 publications comparing the impact of portion control tools on awareness (n = 7 studies), selection/choice (n = 14), intake plus related measures (n = 21) and weight status (n = 9) were analyzed. Non-tableware tools included cooking utensils, educational aids and computerized applications. Tableware included mostly reduced-size and portion control/calibrated crockery/cutlery. Overall, 55% of studies reported a significant impact of using a tool (typically smaller bowl, fork or glass; or calibrated plate). A meta-analysis of 28 articles confirmed an overall effect of tool on food intake (d = –0.22; 95%CI: –0.38, –0.06; 21 comparisons), mostly driven by combinations of reduced-size bowls and spoons decreasing serving sizes (d = –0.48; 95%CI: –0.72, –0.24; 8 comparisons) and consumed amounts/energy (d = –0.22; 95%CI: –0.39, –0.05, 9 comparisons), but not by reduced-size plates (d = –0.03; 95%CI: –0.12, 0.06, 7 comparisons). Portion control tools marginally induced weight loss (d = –0.20; 95%CI: –0.37, –0.03; 9 comparisons), especially driven by calibrated tableware. No impact was detected on PS awareness; however, few studies quantified this outcome. Specific portion control tools may be helpful as potentially effective instruments for inclusion as part of weight loss interventions. Reduced size plates per se may not be as effective as previously suggested.

The effects of dietary restraint and portion-control packaging on snack consumption behaviour

The present study investigated the effects of package size on consumption behaviour when either body image or dietary concerns are activated, in restrained and unrestrained eaters. Portion-control packaging has recently emerged under the assumption that carefully-controlled portion sizes help limit consumption of palatable snacks. While there is reasonably good support for this in most populations, recent findings suggest that portion-control packaging may paradoxically increase consumption for restrained eaters (Coelho Do Vale, Pieters, & Zeelenberg, 2008; Scott et al., 2008). Consistent with prior research, we hypothesized that restrained eaters activated for dieting or body image concerns are more likely to deem larger packaged-sized treats as “unacceptable” and decrease intake. Similarly, activated restrained eaters are more likely to deem smaller packaged-sized treats as “acceptable” and thus paradoxically increase intake. However, the present study did not find support for hypotheses. Theoretical reasons as to why results were not what researchers anticipated are proposed.

The effects of dietary restraint and portion-control packaging on snack consumption behaviour

The present study investigated the effects of package size on consumption behaviour when either body image or dietary concerns are activated, in restrained and unrestrained eaters. Portion-control packaging has recently emerged under the assumption that carefully-controlled portion sizes help limit consumption of palatable snacks. While there is reasonably good support for this in most populations, recent findings suggest that portion-control packaging may paradoxically increase consumption for restrained eaters (Coelho Do Vale, Pieters, & Zeelenberg, 2008; Scott et al., 2008). Consistent with prior research, we hypothesized that restrained eaters activated for dieting or body image concerns are more likely to deem larger packaged-sized treats as “unacceptable” and decrease intake. Similarly, activated restrained eaters are more likely to deem smaller packaged-sized treats as “acceptable” and thus paradoxically increase intake. However, the present study did not find support for hypotheses. Theoretical reasons as to why results were not what researchers anticipated are proposed.