Journal Articles

Randomized trial comparing group size of periodic in-person sessions in a remotely delivered weight loss intervention

November 01, 2017

Deborah F. Tate, Carmina G. Valle, Melissa M. Crane, Brooke T. Nezami, Carmen D. Samuel-Hodge, Karen E. Hatley, Molly Diamond and Kristen Polzien (2017). Randomized trial comparing group size of periodic in-person sessions in a remotely delivered weight loss intervention. International Journal of Behavioral Nutrition, 14:144.

Author Affiliations

Department of Health Behavior, Department of Nutrition, The University of North Carolina at Chapel Hill
Department of Preventive Medicine, Rush University Medical Center
Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill

*This study was conducted at the UNC Nutrition Research Institute at the North Carolina Research Campus in Kannapolis, North Carolina with participants recruited from Kannapolis and the surrounding area.


Few randomized studies have examined differential effects of group size in behavioral weight control, especially in hybrid programs that include Internet treatment approaches.

Randomized controlled trial (n = 195) comparing a 4 month hybrid internet weight loss program coupled with monthly face to face groups of 100 persons (Large Group, LG; 1 group) or to the same approach with monthly groups of 20 persons (Small Group, SG; 4 groups). Repeated-measures mixed-model analysis with age and race as covariates were used to estimate primary (weight) and secondary outcomes, and to test group differences in change over time.

The sample was 46.3 years old ±10.4, 90.3% female, and 51.9% non-white, with BMI 37.9 ± 8.4 kg/m2. Participants in the LG were more likely to return for the 4-month assessment visit than those in the SG (p = 0.04). Participants randomized to both the LG and SG conditions experienced significant WL over time (no between group difference: −4.1 kg and −3.7 kg, respectively) and weight loss was positively associated with attendance at monthly meetings and logins to the website. Satisfaction with the program was high and similar in both groups (94.4% reported that they were “satisfied” or “very satisfied”).

Using a hybrid approach of in-person and online weight loss interventions may be an effective way to reach larger and more diverse populations. Delivering the face to face component of the intervention in groups larger than those traditionally delivered (20–25 people) could increase the cost-effectiveness of group-based behavioral weight loss interventions.

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