Raising the issue

Internet-based Programmes

The internet is a popular medium of communication and source of information on all aspects of health, including obesity. Access to the worldwide web has increased and as such has created new potential in terms of delivering patient healthcare.10 Several research centres have evaluated the potential of using an internet-based weight management programme 11-13 with mixed findings in relation to the use of the internet as a medium for facilitating long-term weight maintenance.14, 15 Research in this area is relatively limited at present, but the possibilities for healthcare professionals to use this as a medium for delivering structured programmes and supporting patients has enormous future potential.

There is of course no shortage of internet sites that make fantastic claims about so called 'slimming aids' and patients would be well advised not to invest in such products. However there are a number of other sites which offer the opportunity for patients to follow a programme online.

As with commercial slimming groups, patients may need to consider the qualifications of the programme directors, the costs involved as well as how comprehensive and realistic the offered programme is. The efficacy of websites is difficult to evaluate as none have published results, however they may offer an alternative to having to physically attend a group meeting and they are an instant means of support and information.

An example of a site which is supported by medical, nutritional and fitness professionals is http://www.realslimmers.com/. This site offers support, advice and information in the form of articles, and 5 and 7-day trial menus are offered as products to purchase on the site.

Another site, http://www.weightlossresources.co.uk/, focuses on keeping food records which are assessed, as well as providing information on a wide range of topics. Information about the qualifications of the people who run the programme is not immediately obvious and there is a monthly fee (£7 - £9 at time of writing) for members who sign up to the site.

A site maintained by state registered dietitians is http://www.eating4health.co.uk/ which offers assessment and advice based on individual needs. They have developed structured programmes, which promise choice, and advice which is evidence based, with fees per individual consultation ranging from £19 - £21.

A FREE website aimed exclusively at overweight men is http://www.fatmanslim.com/.

As yet it is difficult to make firm recommendations about the role of internet-based sites. It is useful to ask for feedback from patients who have experienced using an internetbased weight management site and also to visit sites in order to make a judgement about the philosophy of the programmes offered.