Internet Treatment for Patients With Obesity

Avoidant social behavior due to obesity-related psychosocial disorders which is measured with the Obesity-related Problems scale "(OP)". The OP scale is validated to measure obesity-specific quality of life. OP measures the negative effects of obesity on psychosocial functioning and is useful for evaluating the effects of obesity interventions on quality of life. Scores range from 0 to 100, and higher scores indicate dysfunction.

Each participant's weight reduction in kilograms reported as a percentage of body weight before starting treatment

Proportion of participants with ≥ 5% weight reduction in kilograms

General quality of life is measured with RAND-36 which consists of 36 questions and measures 8 health domains: physical function, role function-physical, pain, general health, energy / fatigue, social function, role function-emotional and emotional well-being. Using the standard scoring algorithm from RAND Corporation, eight conceptual attributes (subscales) are calculated by averaging values of 35 of the 36 ordinal scale items. The remaining item (general health change), assesses change in perceived health during the last year. Subscale scores range from 0 to 100, where higher scores represent better health status.The Swedish version is validated

Psychosocial distress due to obesity-related problems is measured with the Obesity-related Problems scale "(OP)". The OP scale is validated to measure obesity-specific quality of life. OP measures the negative effects of obesity on psychosocial functioning and is useful for evaluating the effects of obesity interventions on quality of life. Scores range from 0 to 100, and higher scores indicate dysfunction.

Dietary habits are measured by the National Board of Health and Welfare's five dietary index questions. The questions measure how often the person eats 1) vegetables, 2) fruit, 3) fish, 4) coffee bread / chocolate / sweets / soft drinks, and 5) how often the person eats breakfast.

Measured with the National Board of Health and Welfare three indicator questions about exercise, exercise and sitting still. The questions measure how much time per week the person performs 1) strenuous activities, e.g. running, playing ball, and 2) moderately strenuous activities, e.g. walking, cycling and 3) how many hours during the day the person is sedentary.

Measured with an accelerometer for 7 days before treatment and at follow-up at 6 and 12 months after the start of treatment. The measurement is made with the Actigraph GTX3 + monitor which is distributed or sent home to participants at the above times. Data on physical activity are combined with body weight to calculate energy consumption. During the 7 days that the survey takes place, the participants document various activities in a diary.

Eating behavior is measured with the Three-Factor Eating Questionnaire-Revised 18 items (TFEQ-R18v2) which is a validated questionnaire consisting of 18 questions that measure three aspects of eating behavior: uncontrolled eating (tendency to lose control over intake when you feel hungry or when you exposed to external stimuli), cognitive restraint (conscious restriction of food intake to control body weight or body shape) and emotional eating (overeating in connection with negative emotional states).Responses are scored on a 4-point scale, and anchors can vary across items (e.g., definitely true to definitely false, or never to at least once a week). Means are computed for each subscale (as long as at least half of the items have been answered) and are transformed to correspond to a 0-100 scale score. A higher score indicates more restraint, uncontrolled, and emotional eating.

Measured with the Insomnia Severity Index (ISI) which consists of 7 questions that evaluate sleep, sleep during the night, waking up early, the feeling of being rested, how the sleep problems affect daily life, and whether the sleep pattern worries the individual. The scale score ranges between 0-28 and a higher score indicates more sleep problems.

Percentage who complete the treatment program

The patient's experience of the treatment program is measured with questions after each treatment module and at the end of treatment after 6 months. The questionnaire questions are answered in the treatment platform and contain questions about:

• how easy or difficult it is to follow the treatment program

• to understand the language
• to absorb the content
• to access and use the program
• to understand the homework and whether these were relevant / helpful
• how helpful the feedback from the therapist is
• what can be improved