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However, lost weight is usually regained, returning to the initial or even higher levels in the long term. New counselling methods for maintaining lifestyle changes are urgently needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>An information and communication technology\u2010based health behaviour change support system (<jats:styled-content style=\"fixed-case\">HBCSS<\/jats:styled-content>) that utilizes persuasive design and methods of cognitive behavioural therapy (<jats:styled-content style=\"fixed-case\">CBT<\/jats:styled-content>) was developed with the aim of helping individuals to maintain body weight. The purpose of this study was to assess whether <jats:styled-content style=\"fixed-case\">CBT<\/jats:styled-content>\u2010based group counselling combined with <jats:styled-content style=\"fixed-case\">HBCSS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">HBCSS<\/jats:styled-content> alone helps to maintain improved lifestyle changes needed for weight loss compared to self\u2010help guidance or usual care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized lifestyle intervention for overweight or obese persons (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> 27\u201335\u00a0kg\u00a0m<jats:sup>\u22122<\/jats:sup> and age 20\u201360\u00a0years), recruited from the population registry in the city of Oulu, Finland, was conducted. This study comprised six randomly assigned study arms: <jats:styled-content style=\"fixed-case\">CBT<\/jats:styled-content>\u2010based group counselling (eight sessions led by a nutritionist), self\u2010help guidance\u2010based group counselling (<jats:styled-content style=\"fixed-case\">SHG<\/jats:styled-content>; two sessions led by a nurse) and control, each with or without <jats:styled-content style=\"fixed-case\">HCBSS<\/jats:styled-content>, for 52\u00a0weeks. Subjects visited the study centre for anthropometric measurements, blood sample collection and to complete questionnaires at baseline, 12 and 24\u00a0months. The main outcome was weight change from baseline to 12\u00a0months and from baseline to 24\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1065 volunteers screened for the study, 532 subjects (51% men) met the inclusion criteria and were enrolled. The retention rate was 80% at 12\u00a0months and 70% at 24\u00a0months. <jats:styled-content style=\"fixed-case\">CBT<\/jats:styled-content>\u2010based counselling with <jats:styled-content style=\"fixed-case\">HBCSS<\/jats:styled-content> produced the largest weight reduction without any significant weight gain during follow\u2010up. The mean weight change in this arm was 4.1% [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), \u22125.4 to \u22122.8, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) at 12\u00a0months and 3.4% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, \u22124.8 to \u22122.0, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) at 24\u00a0months. <jats:styled-content style=\"fixed-case\">HBCSS<\/jats:styled-content> even without any group counselling reduced the mean weight by 1.6% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, \u22122.9 to \u22120.3, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.015) at 24\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of <jats:styled-content style=\"fixed-case\">CBT<\/jats:styled-content>\u2010based group counselling and <jats:styled-content style=\"fixed-case\">HBCSS<\/jats:styled-content>\u2010based weight management is feasible for overweight or obese individuals. Moreover, <jats:styled-content style=\"fixed-case\">HBCSS<\/jats:styled-content> alone could be disseminated to the population at large as an effective means of treating obesity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.12802","type":"journal-article","created":{"date-parts":[[2018,7,5]],"date-time":"2018-07-05T05:01:21Z","timestamp":1530766881000},"page":"534-545","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["A randomized clinical trial of the effectiveness of a Web\u2010based health behaviour change support system and group lifestyle counselling on body weight loss in overweight and obese subjects: 2\u2010year outcomes"],"prefix":"10.1111","volume":"284","author":[{"given":"A.\u2010M.","family":"Teeriniemi","sequence":"first","affiliation":[{"name":"Biocenter Oulu Research Center for Internal Medicine University of Oulu Oulu Finland"},{"name":"Department of Internal Medicine Oulu University Hospital Oulu Finland"},{"name":"Medical Research Center Oulu Oulu University Hospital University of Oulu Oulu Finland"},{"name":"Department of Medicine, Endocrinology and Clinical Nutrition Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5104-5792","authenticated-orcid":false,"given":"T.","family":"Salonurmi","sequence":"additional","affiliation":[{"name":"Biocenter Oulu Research Center for Internal Medicine University of Oulu Oulu Finland"},{"name":"Department of Internal Medicine Oulu University Hospital Oulu Finland"},{"name":"Medical Research Center Oulu Oulu University Hospital University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Jokelainen","sequence":"additional","affiliation":[{"name":"Unit of Medicine Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"V\u00e4h\u00e4nikkil\u00e4","sequence":"additional","affiliation":[{"name":"Research Unit of Oral Health Sciences University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Alah\u00e4iv\u00e4l\u00e4","sequence":"additional","affiliation":[{"name":"Oulu Advanced Research on Service and Information Systems (OASIS) Faculty of Information Technology and Electrical Engineering University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Karppinen","sequence":"additional","affiliation":[{"name":"Oulu Advanced Research on Service and Information Systems (OASIS) Faculty of Information Technology and Electrical Engineering University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Enwald","sequence":"additional","affiliation":[{"name":"Medical Research Center Oulu Oulu University Hospital University of Oulu Oulu Finland"},{"name":"Department of Information Studies Faculty of Humanities University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.\u2010L.","family":"Huotari","sequence":"additional","affiliation":[{"name":"Medical Research Center Oulu Oulu University Hospital University of Oulu Oulu Finland"},{"name":"Department of Information Studies Faculty of Humanities University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Laitinen","sequence":"additional","affiliation":[{"name":"Finnish Institute of Occupational Health Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Oinas\u2010Kukkonen","sequence":"additional","affiliation":[{"name":"Oulu Advanced Research on Service and Information Systems (OASIS) Faculty of Information Technology and Electrical Engineering University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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