Patient-provided e-support in reduced intensity obesity treatment: The INSPIRE randomized controlled trial.

Tricia M. Leahey, Tania B. Huedo-Medina, Andrea Grenga, Linda Gay, Denise Fernandes, Zeely Denmat, Caroline Doyle, Remei Areny-Joval, Rena R. Wing

Research output: Indexed journal article Articlepeer-review

7 Citations (Scopus)


Objective: There are two types of patient supporters, peers (two individuals initiating health behavior change who support one another) and mentors (a previously successful patient who supports incoming patients). Social comparison theory suggests that peers and mentors may elicit social comparison processes (patients may compare their progress to that of their peer/mentor), and these social comparisons could impact treatment outcomes. This randomized controlled trial is the first to examine the differential impact of peers and mentors on obesity treatment outcomes and social comparison processes when added to reduced intensity treatment. Method: Participants (N = 278) were randomly assigned to reduced intensity behavioral weight loss treatment alone (rBWL), rBWL plus peer e-support (rBWL + Peer), or rBWL plus mentor e-support (rBWL + Mentor). rBWL involved periodic group sessions that decreased over time; when group sessions decreased, intensity of peer/mentor e-support increased. Weight and social comparison processes were assessed throughout the 12-month intervention. Results: There was a significant treatment effect; when group sessions became less frequent and peer/mentor e-support became more frequent, rBWL + Peer had significantly greater weight loss than rBWL alone, and rBWL + Mentor was not significantly different from the other two. Social comparison processes differed by treatment arm; rBWL + Peer participants tended to report more lateral social comparisons (“my weight loss progress is ‘similar’ to my peer’s”), whereas rBWL + Mentor participants reported more upward comparisons (“my weight loss progress is ‘worse than’ my mentor’s”). Upward comparisons were associated with poorer weight loss outcomes. Conclusions: Peer e-support may be an effective, low-cost, sustainable method for improving longer-term weight loss outcomes in reduced intensity obesity treatment.

Original languageEnglish
Pages (from-to)1037-1047
Number of pages11
JournalHealth Psychology
Issue number12
Publication statusPublished - 2020
Externally publishedYes


  • lay support
  • obesity treatment
  • peer support
  • social comparison
  • weight loss

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