Health coaches could play an important role in the battle of the bulge

LifespanJul 31 2012

Coaches can help athletes score touchdowns and perfect their golf swing, but can they also influence weight loss? Researchers from The Miriam Hospital's Weight Control and Diabetes Research Center say health coaches could play an important role in the battle of the bulge, according to the findings of a pilot study published online in the journal Obesity.

In the first study of its kind, obese individuals participating in a low-intensity behavioral weight loss program who were supported by either a professional health coach or a peer coach lost clinically significant amounts of weight (at least 5 percent of their initial body weight). These weight losses are comparable to the amount of weight lost by patients participating in a more intensive behavioral intervention with twice as many treatment sessions.

"Our study suggests health coaches may not only yield impressive weight loss outcomes, but that lay - or peer - health coaching may be particularly promising as a cost-effective obesity treatment strategy," said lead author Tricia M. Leahey, Ph.D., of The Miriam Hospital's Weight Control and Diabetes Research Center. "Although these findings are only preliminary, it's encouraging that lay health coaches successfully supplemented a less intensive, lower cost behavioral intervention and that their weight losses were actually comparable to those produced by professional coaches - something that could be critical in this changing health care landscape."

Obesity remains a common, serious and costly disease in the United States. About one-third of American adults are obese, according to the Centers for Disease Control and Prevention, and no state has met the nation's Healthy People 2010 goal to lower obesity prevalence to 15 percent. Obesity and its associated health problems, including heart disease and diabetes, continue to have a significant economic impact on the U.S. health care system, costing the nation hundreds of billions of dollars each year.

Health coaches have grown in popularity, yet empirical support is limited. In the health coach treatment model, health coaches supplement treatment by providing ongoing support, accountability and information to promote behavior change between treatment visits. Health coaches can be professional health care providers, such as nurses or social workers; peers, or individuals currently facing the same health problem who coach one another to support behavior change; and mentors, or master coaches, who have previously and successfully faced the same health situation.

In this randomized controlled pilot study, 44 participants took part in a group behavioral weight loss program that met for 12 times over the course of 24 weeks - half the amount of sessions of a traditional treatment plan. Groups met weekly for the first six weeks, biweekly for the following six weeks and monthly thereafter.

Miriam researchers randomly assigned individuals to work with one of three different types of health coaches: a professional (behavioral weight loss interventionist), peer (a fellow group member) or mentor (a successful weight loser). During the weeks where there were no group meetings, participants emailed their weekly weight, calorie and physical activity information to their coach and received feedback. All coaches were trained on appropriate coaching strategies and feedback delivery.

While all three groups yielded clinically significant weight losses, participants guided by professional and peer coaches had the most success, losing more than 9 percent of their body weight on average, compared to just under 6 percent in the mentor group. At least half of the participants in the professional and peer coaching groups achieved a 10 percent weight loss, which research has shown can reduce the risk of a wide range of illnesses linked to obesity, including heart disease and diabetes. Only 17 percent of those in the mentor group accomplished this goal.

Because it is a pilot study, Leahey notes larger trials are needed to confirm whether incorporating health coaching into less intensive behavioral weight loss treatment programs improves outcomes and to examine which type of coach is most effective. She recently received a 5-year, $2 million grant from the National Institutes of Health to continue to explore the impact and influence of lay health coaches for obesity treatment.