A Facebook-based Weight Loss Programme for Obese Adults in Hong Kong

The purpose of this study is to determine the feasibility and efficacy of a 6-month weight loss intervention program for obese working adults through a popular social networking site - Facebook.

Obese individuals often are at higher risk for developing non-communicable diseases such as diabetes and cardiovascular disease. The regular physical activity, healthy diet and social support have been shown to be beneficial for weight loss. This is a two-arm parallel design randomized controlled trial for 6 months. Participants who completed the baseline assessment will be randomly allocated, after stratified by gender, to either a control group or Facebook-based intervention group. The control group will receive information on healthy eating, physical activity, obesity and cancer via three government printed health pamphlets. In addition to the government health pamphlets, the intervention group will receive a programme delivered through Facebook. The interventions include participation in a private research group on Facebook for health education, self monitoring and social support. Participants will receive 12 weekly lessons related to nutrition, physical activity, Chinese food therapy, acupressure, weight loss. A registered nutritionist and a registered Chinese medicine practitioner will join the Facebook group as health partners. Both of them are also registered nurses. Data collection will be carried out at baseline, 3 months and 6 months. Each time, both groups will complete online questionnaires and attend in-person anthropometric measurements

Lifestyle Intervention: The interventions include participation in a private research group on Facebook for health education, self monitoring and social support. Participants will receive 12 weekly lessons related to nutrition, physical activity, Chinese food therapy, acupressure, weight loss. A registered nutritionist and a registered Chinese medicine practitioner will join the Facebook group as health partners. Both of them are also registered nurses. Besides the Facebook contents, the participants will also receive government printed health information on healthy eating, physical activity, obesity and cancers.

The participants randomized into the Control Group will only receive government printed health information on healthy eating, physical activity, obesity and cancers.

East-meets-West Lifestyle Intervention elements include nutrition and exercise from the Western perspective, food therapy and acupressure from the Traditional Chinese Medicine perspective, self-monitoring, and motivational videos of successful stories from working colleagues. The group participants in the Facebook are encouraged to post their health behaviors and questions, self-monitor, pledge for weight loss, seek social support and interact with health partners and other participants.

Height will be taken at baseline using a wall-mounted stadiometer. BMI will be calculated as weight (kg)/height (m2)

A 5-item questionnaire will be used to categorize participants into stages of change (pre-contemplation, contemplation, preparation, action, maintenance)

Self-efficacy for weight loss will be assessed by using a 20-item Weight Efficacy Lifestyle Questionnaire (WEL).

A questionnaire of perceived confidence to engage in physical activity under a variety of circumstances on a 5-point Likert scale will be used.

A 20-item questionnaire of perceived pros and cons of weight loss on a 5-point Likert scale. The balance of the two scores >0 indicate more advantages than disadvantages to weight loss

A questionnaire will be used to measure the perceived support and sabotage from friends and family for healthy eating and physical activity

A questionnaire will be used to assess self-reported intake of fruits and vegetables in terms of portion size and frequency

The International Physical Activity Questionnaire will be used to assess the changes in physical activity

Inclusion Criteria: university full-time employees; age 18 to 60 years, BMI of 25 to 40 kg/m2, have access to Internet and Facebook; able to communicate in both English and Chinese at F.5 secondary school level or above. agree to communicate with Internet, email, Facebook group and respect privacy. Exclusion Criteria: Smoker; an unstable medical or mental status; history of myocardial infarction or stroke, or cancer in the past 5 years; orthopedic or joint problems that would prohibit exercise; in treatment for alcohol or drug dependency; an eating disorder; pregnant, breastfeeding, or planning on becoming pregnant within the next 6 months; use of medication that might affect body weight; a recent weight loss of more than 4.5 kg in the previous 6 months; currently participating in a weight loss program; organic obesity; unable to attend assessments or increase physical activity.