Twitter use can help achieve a healthy weight

A study by researchers at the University of South Carolina's Arnold School of Public Health has found that using Twitter, the popular information network joining people throughout the world, is a valuable support system for helping people lose weight.

Led by Arnold School researcher Brie Turner-McGrievy, the study found that Twitter use among participants in a weight loss program enhanced the likelihood of their success at shedding pounds. Published in Translational Behavioral Medicine this week, the study also revealed that participants mainly used Twitter to provide information support to one another through status updates.

Although researchers have used Twitter and other social networking sites to study health trends and explore how people use these sites to discuss health-related questions and topics, the USC study is one of the first to examine the use of Twitter as part of a behavioral weight loss intervention, she said.

"The results show that those who regularly utilized Twitter as part of a mobile weight loss program lost more weight," said Turner-McGrievy of the Arnold School's Department of Health Promotion, Education and Behavior.

The study followed 96 overweight and obese men and women living in a metropolitan area over a six-month period. All participants were required to own one of four types of internet-capable mobile devices: iPhone, iPod Touch, BlackBerry or an Android-based phone. Participants were randomly assigned to either the podcast-only (Podcast) or podcast, plus enhanced mobile media intervention (Podcast + mobile), groups.

Both groups received two podcasts per week for three months (15 minutes each) and two mini-podcasts per week during the third to sixth months (five minutes each). The podcasts included information about nutrition and exercise, goal setting and even an audio soap opera. In addition to the podcasts, the Podcast + mobile group downloaded a diet and physical activity monitoring application (app) and a Twitter app to their mobile device. The main trial found both the Podcast only and Podcast + mobile delivery methods to be effective in producing a 2.7 percent decrease in body weight at 6 months, with no difference between the groups.

The current analysis sought to explore the interactions and weight loss outcomes as related to Twitter use among the Podcast + mobile group only.

Participants in the Podcast + mobile group followed each other on Twitter with the goal of providing social support to one another as they participated in a weight loss program. They were asked to log on daily to read and post messages so they would receive the content delivered by a weight loss counselor and fellow participants. Two daily messages, posted to Twitter by the weight loss counselor, reinforced content from the podcasts and encouraged discussion among participants.

Among the study's findings:

•Over the six-month period, there were 2,630 Twitter posts.
•Seventy-five percent of the posts were informational, with most characterized as teaching (providing new facts or skills). One of the most frequent types of teaching posts was a status update from a participant (81 percent of all teaching posts), such as "I avoided eating a pastry this morning at a breakfast meeting! I did have a skim Mocha without whipped cream… not too bad".
•Other types of support present were emotional support, through demonstrating listening (6.6 percent), and esteem support, through providing compliments (4.6 percent).
•Both Podcast only and Podcast + mobile participants achieved a 2.7 percent weight loss at six months. However, those who engaged with Twitter were more successful with losing weight, such that every 10 posts to Twitter corresponded with approximately −0.5 percent weight loss.

A strength of the study, Turner-McGrievy said, was the researchers' ability to have an in-depth examination of the interactions that took place among a group of people who were actively receiving a behavioral weight loss program.

"Traditional behavioral weight loss interventions generally provide social support through weekly, face-to-face group meetings. While we know this is effective, it is costly and can create a high degree of burden on participants," she said. "Providing group support through online social networks can be a low cost way to reach a large number of people who are interested in achieving a healthy weight."

Additional studies should be conducted to find ways to provide social support for participants in remotely delivered weight loss programs in ways that are engaging, rewarding and useful for a wide variety of participants, she said.

Turner-McGrievy is currently using Facebook to provide social support as part of a remotely-delivered weight loss intervention for women with Polycystic Ovary Syndrome and is collaborating with colleagues in USC's computer science department to find ways to enhance engagement within social networks.