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Overweight and ObesityPhase 2/3NCT04520256

Rapid Evaluation of Innovative Intervention Components to Maximize the Health Benefits of Behavioral Obesity Treatment Delivered Online: An Application of Multiphase Optimization Strategy

A Phase 2/3 study testing Online Behavioral Weight Loss Program, Virtual Reality for Behavioral Weight Loss Skills Training and Tailored Interactive Video Feedback in people with Overweight and Obesity, run by The Miriam Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

When delivered online, behavioral obesity treatments have the potential to reach large numbers of individuals with overweight/obesity and produce significant improvements in health and wellbeing. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Overweight and Obesity
What is being tested?
Online Behavioral Weight Loss Program, Virtual Reality for Behavioral Weight Loss Skills Training and Tailored Interactive Video Feedback
Could I receive a placebo?
No, everyone receives an active treatment
How many people
384 participants
Where
1 siteUnited States
Study dates
22 Sep 2020to 18 May 2023
Phase
Phase 2/3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult
  • English language fluent and literate at the 6th grade level
  • Body mass index (BMI) between 25 and 50 kg/m-squared
  • Able to walk 2 city blocks without stopping
  • Not currently participating in another weight loss program
  • Not currently taking weight loss medication
  • Has not lost ≥5% of body weight in the 6 months prior to enrolling
  • Has not been pregnant within the 6 months prior to enrolling
  • Does not plan to become pregnant within 12 months of enrolling
  • Denies having a heart condition, chest pain during periods of activity or rest, or loss of consciousness in the 12 months prior to enrolling
  • Denies any medical condition that would affect the safety of participating in unsupervised physical activity
  • Denies any condition that would result in inability to follow the study protocol, including terminal illness, substance abuse, eating disorder (not including Binge Eating Disorder) and untreated major psychiatric illness

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Miriam Hospital Weight Control and Diabetes Resarch Center

    Providence, Rhode Island, 02903

Other trials in United States

About this study

When delivered online, behavioral obesity treatments have the potential to reach large numbers of individuals with overweight/obesity and produce significant improvements in health and wellbeing. In order to maximize the public health benefit of disseminating these treatments online, this study will use the Multiphase Optimization Strategy (MOST) framework to most quickly and efficiently determine which, if any, of 5 innovative intervention components, alone or in combination, increases the proportion of patients achieving a ≥5% weight loss, and mean weight loss, after a 12-month online behavioral obesity treatment.

Read the detailed description

Decades of research have demonstrated that behavioral obesity treatments can produce clinically significant weight losses that improve health and disease risk/severity. However, these treatments have not been disseminated widely due to high costs and lack of qualified providers. The investigators therefore aim to develop and test a fully automated online obesity treatment that would produce clinically significant weight losses (i.e., ≥ 5 % of initial body weight) when delivered online. In order to maximize the public health impact of online obesity treatment, and advance the science of online behavioral intervention in general, it is imperative to evaluate innovative behavioral intervention components with the potential to optimize weight loss outcomes. Because digital health technology evolves rapidly, this research will use the Multiphase Optimization Strategy (MOST) framework to most quickly and efficiently determine which, if any, of 5 innovative intervention components, alone or in combination, increases the proportion of patients achieving a ≥5% weight loss, and mean weight loss, of the online Rx Weight loss (RxWL) program at 12- months. The 5 intervention components to be tested are: (a) Web-based virtual reality intervention for training in basic behavioral weight loss skills; tailored interactive intervention targeting (b) structured physical activity and (c) dysregulated eating; (d) a platform for social interaction including opportunities for friendly competition, and (e) interactive video feedback with content tailored to the unique needs of each participant and a focus on dietary skills. A sample of 384 individuals with BMI ≥ 25 will be randomized to receive RxWL and 0-5 of the experimental intervention components in a full factorial experiment. This design will allow the investigators to determine which intervention components maximize weight loss and whether there are favorable combinations of components. In addition, by evaluating the effects of each component on proximal outcomes (i.e., mediators) it will be possible learn not only which components are (or are not) effective but also why or how they exert their effects. This project advances the science of behavioral obesity treatment, and will directly impact the care of patients receiving RxWL.

Being tested
Online Behavioral Weight Loss Program, Virtual Reality for Behavioral Weight Loss Skills Training, Tailored Interactive Video Feedback, Tailored Intervention for Structured Physical Activity, Skills Training for Dysregulated Eating
Keywords
Diet, Physical activity, Online
Medical subject headings
Overweight, Obesity, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Online Behavioral Weight Loss ProgramBehavioural

    A self-guided, online program that helps participants reduce energy intake and gradually increase physical activity.

  • Virtual Reality for Behavioral Weight Loss Skills TrainingBehavioural

    This program allows participants to practice behavioral weight loss skills using an online virtual reality system accessed via a Web browser.

  • Tailored Interactive Video FeedbackBehavioural

    Video-recorded messages are used to provide periodic feedback on progress with weight loss, dietary change, and physical activity. Additional videos provide dietary skills training.

  • Tailored Intervention for Structured Physical ActivityBehavioural

    Periodic self-assessment is used to guide selection of a physical activity goal. Home-based instructional videos are provided to help meet the selected goal.

  • Skills Training for Dysregulated EatingBehavioural

    Periodic self-assessment is used to guide selection of skills training modules designed to counter common causes of dysregulated eating (e.g., boredom, stress).

  • Platform for Social Support & Friendly CompetitionBehavioural

    An online platform is provided for participants to connect with each other, support each other, and compete on achievement of behavioral and weight loss milestones.

Study groups in NCT04520256
Study groupRoleWhat they receive
Core Program OnlyExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program
Social SupportExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Platform for Social Support & Friendly Competition
Dysregulated EatingExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Skills Training for Dysregulated Eating
Social Support, Dysregulated EatingExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Skills Training for Dysregulated Eating; Behavioral: Platform for Social Support & Friendly Competition
ExerciseExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Intervention for Structured Physical Activity
Social Support, ExerciseExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Platform for Social Support & Friendly Competition
Dysregulated Eating, ExerciseExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Skills Training for Dysregulated Eating
Social Support, Dysregulated Eating, ExerciseExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Skills Training for Dysregulated Eating; Behavioral: Platform for Social Support & Friendly Competition
FeedbackExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Interactive Video Feedback
Social Support, FeedbackExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Interactive Video Feedback; Behavioral: Platform for Social Support & Friendly Competition
Dysregulated Eating, FeedbackExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Interactive Video Feedback; Behavioral: Skills Training for Dysregulated Eating
Social Support, Dysregulated Eating, FeedbackExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Interactive Video Feedback; Behavioral: Skills Training for Dysregulated Eating; Behavioral: Platform for Social Support & Friendly Competition
Exercise, FeedbackExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Interactive Video Feedback
Social Support, Exercise, FeedbackExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Interactive Video Feedback; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Platform for Social Support & Friendly Competition
Dysregulated Eating, Exercise, FeedbackExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Interactive Video Feedback; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Skills Training for Dysregulated Eating
Social Support, Dysregulated Eating, Exercise, FeedbackExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Tailored Interactive Video Feedback; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Skills Training for Dysregulated Eating; Behavioral: Platform for Social Support & Friendly Competition
VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training
Social Support, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Platform for Social Support & Friendly Competition
Dysregulated Eating, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Skills Training for Dysregulated Eating
Social Support, Dysregulated Eating, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Skills Training for Dysregulated Eating; Behavioral: Platform for Social Support & Friendly Competition
Exercise, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Intervention for Structured Physical Activity
Social Support, Exercise, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Platform for Social Support & Friendly Competition
Dysregulated Eating, Exercise, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Skills Training for Dysregulated Eating
Social Support, Dysregulated Eating, Exercise, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Skills Training for Dysregulated Eating; Behavioral: Platform for Social Support & Friendly Competition
Feedback, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Interactive Video Feedback
Social Support, Feedback, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Interactive Video Feedback; Behavioral: Platform for Social Support & Friendly Competition
Dysregulated Eating, Feedback, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Interactive Video Feedback; Behavioral: Skills Training for Dysregulated Eating
Social Support, Dysregulated Eating, Feedback, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Interactive Video Feedback; Behavioral: Skills Training for Dysregulated Eating; Behavioral: Platform for Social Support & Friendly Competition
Exercise, Feedback, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Interactive Video Feedback; Behavioral: Tailored Intervention for Structured Physical Activity
Social Support, Exercise, Feedback, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Interactive Video Feedback; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Platform for Social Support & Friendly Competition
Dysregulated Eating, Exercise, Feedback, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Interactive Video Feedback; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Skills Training for Dysregulated Eating
Social Support, Dysregulated Eating, Exercise, Feedback, VRExperimentalNot described
Receives: Behavioral: Online Behavioral Weight Loss Program; Behavioral: Virtual Reality for Behavioral Weight Loss Skills Training; Behavioral: Tailored Interactive Video Feedback; Behavioral: Tailored Intervention for Structured Physical Activity; Behavioral: Skills Training for Dysregulated Eating; Behavioral: Platform for Social Support & Friendly Competition

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Weight Change (Percent of Initial Body Weight) From Baseline to Month 12, Main Effect of Time

    Weight was measured at the research center by the research team, or measured by the participant at home and sent to the research team with with documentation of the value reported (e.g., a photograph from a home scale showing the weight).

    A change between two time points is reported. The value of this outcome was calculated using: [(baseline weight - month 12 weight) ÷ baseline weight] × 100. Estimated mean change was obtained from a linear mixed models analysis of variance. Data from all randomized participants were included in the model (ITT analysis).

    Measured: From Baseline to Month 12

  2. Weight Change (Percent of Initial Body Weight) From Baseline to Month 12, Time by Intervention Component Interaction

    Weight was measured at the research center by the research team, or measured by the participant at home and sent to the research team with with documentation of the value reported (e.g., a photograph from a home scale showing the weight).

    A change between two time points is reported. The value of this outcome was calculated using: [(baseline weight - month 12 weight) ÷ baseline weight] × 100. Estimated mean change was obtained from a linear mixed models analysis of variance. Data from all randomized participants were included in the model (ITT analysis).

    This outcome measure is reported as an additional effect beyond that of Outcome Measure 1 (each intervention component has it's own weight loss effect that is above and beyond the weight change calculated in the Outcome Measure 1 analyses).

    Measured: From Baseline to Month 12

  3. Proportion of Participants With Weight Loss ≥ 5% at Month 12, Main Effect of Time

    Weight was measured at the research center by the research team, or measured by the participant at home and sent to the research team with with documentation of the value reported (e.g., a photograph from a home scale showing the weight).

    Weight loss was calculated using: [(baseline weight - month 12 weight) ÷ baseline weight] × 100.

    The estimated proportion of participants achieving a weight loss of ≥ 5% of their Baseline body weight was obtained from a generalized linear mixed models analysis of variance to account for missing data. All randomized participants were utilized in the model (ITT analysis).

    Measured: Month 12

  4. Proportion of Participants With Weight Loss ≥ 5% at Month 12, Time by Intervention Component Interaction

    Weight was measured at the research center by the research team, or measured by the participant at home and sent to the research team with with documentation of the value reported (e.g., a photograph from a home scale showing the weight).

    Weight loss was calculated using: [(baseline weight - month 12 weight) ÷ baseline weight] × 100.

    Estimated proportions of participants with weight loss of ≥ 5% of initial body weight at Month 12 were obtained from a generalized linear mixed models analysis of variance to account for missing data. All randomized participants were utilized in the model (ITT analysis).

    Measured: Month 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Aug 2020
  2. Study start22 Sep 2020
  3. Primary completion18 May 2023
  4. Study completion18 May 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
384 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04520256
Sponsor's protocol ID
R01DK117857
Other IDs
R01DK117857
Status last verified
Mar 2024
First submitted
12 Aug 2020
Last updated
15 Jan 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Thomas JG, Goldstein CM, Bond DS, Lillis J, Hekler E, Goldstein SP, Butryn ML, Cao Z, Wing RR. Evaluation of Five Novel Intervention Components in Online Obesity Treatment: Outcomes of a Randomized Factorial Experiment. Obesity (Silver Spring). 2025 Nov;33(11):2128-2138. doi: 10.1002/oby.70039. Epub 2025 Sep 18.

    PubMed 40968617

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Online Behavioral Weight Loss Program, Virtual Reality for Behavioral Weight Loss Skills Training and Tailored Interactive Video Feedback in people with Overweight and Obesity, run by The Miriam Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Jan 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Weight Change (Percent of Initial Body Weight) From Baseline to Month 12, Main Effect of Time (time frame: From Baseline to Month 12). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04520256, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jan 2025.

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