Telehealth in Rural Populations Could Aid Sustained Weight Loss

one young overweight man, outdoors nature, running on asphalt road

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Key Takeaways

  • A new study suggests using telemedicine could help those in rural areas maintain their weight loss.
  • This is important because rural residents are more at risk for obesity than their urban counterparts.
  • Teleheath, in general, has been seeing a boom lately that experts hope will continue into the future.

In rural areas, distance can be an obstacle to health care, particularly when it comes to more specialized services like counseling that are less readily available than in denser cities. But telehealth is having a meaningful impact when it comes to addressing those access issues—and rural America might get lighter and leaner as a result.

A recent study in Nutrition, Obesity, and Exercise suggests telemedicine may be effective in reaching rural communities and engaging them in weight loss and maintenance efforts.

In a randomized clinical trial, researchers looked at different potential strategies for weight-loss maintenance. After all participants participated in 16 weekly in-person group counseling sessions, they were split into one of three groups: individual telephone counseling, group telephone counseling, or an educational program with the same content used in the counseling calls.

They found that those participating in one-on-one calls had significantly better results than those in the other two groups, including:

  • Greater adherence to caloric intake goals
  • Maintained weight loss of at least 5% nearly two years after the study's start
  • One-third had a weight loss of at least 10%
  • Higher participation rate

Although the calls didn't include a video component, researchers suggested the group counseling participants may have had similar results if that had been added, since rapport could be playing such a big role here.

Rural Residents and Obesity

Considered a public health crisis affecting more than 40 percent of the U.S. population, obesity can be particularly troublesome for rural populations. A 2016 behavioral risk factor survey found:

  • Obesity prevalence was about 34 percent in rural counties versus 29 percent in metropolitan counties.
  • The findings held true for adults in most sociodemographic categories, including age, sex, and household income.
  • This increases the risk factors among rural populations for many chronic diseases, including type 2 diabetes, coronary heart disease, and some cancers.

That report noted that various strategies have been undertaken to try and address the problem, including increasing community access to public buildings—letting local residents swim in the high school pool on nights and weekends, for example—and looking at land use for more outdoor public recreation.

But just having resources hasn't seemed to boost overall activity or motivated people to improve their nutrition. One study suggested that factors like higher smoking rates, a culture of inactivity, and generally poorer health was proving tough to overcome. As obesity takes hold, it can be difficult to reverse, according to Erica Kenney, ScD, MPH, an assistant professor in the Department of Nutrition at the Harvard T.H. Chan School of Public Health.

Erica Kenney, ScD, MPH

Obesity is a chronic disease, and much like other conditions, prevention is much easier than treatment. It needs to be addressed on a community-wide level, and that's difficult to do, particularly in an environment where it's more prevalent.

— Erica Kenney, ScD, MPH

Having strategies that work for individuals can ripple out into the community, she adds. That means as more people lose weight and maintain that weight loss using an affordable, easily accessed resource like telemedicine or telehealth, it could have a greater impact.

Rise of Telehealth

In addition to having a potentially significant effect on weight loss and management for rural populations, telehealth is certainly having a moment (one that's likely to last, advocates say) for bringing all types of care into homes.

For example, a recent meta-analysis in EClinicalMedicine reported that electronically delivered cognitive behavioral therapy was more effective than face-to-face therapy at reducing depression symptom severity and found that it was less costly to patients as well.

In addition to health care professionals who use telehealth for appointments, people in rural settings can also access other types of experts who can guide them when it comes to nutrition, exercise, stress relief, and other strategies for weight issues.

For example, they could use telehealth to talk to a registered dietitian about a weight-maintenance plan, or a physical therapist about overcoming limitations for exercise, without having to drive long distances to do so. Because these professionals can be referred by a physician, these telemedicine sessions have a higher likelihood of getting covered by insurance as well.

"Being able to access these resources from your home can really reduce the stigma for people who have difficulty reaching out for help," says Jennifer Gentile, PsyD, who treats some patients virtually using a telehealth app. "You also take away barriers that might seem minor but are actually very important, like scheduling flexibility and transportation issues."

Barriers to Telehealth

While rural populations have much to gain from increased access to medical care through telehealth, the solution is not without complications. While efforts to remedy the problem are in progress, rural areas are significantly more likely to have limited access to high speed internet—an unfortunate hurdle for those seeking care through video counseling, for example.

What This Means For You

Telehealth is a big step toward closing the health care gaps in many parts of the country, but there is still work to be done to ensure that all potential barriers to accessible and quality care or prevention are removed. As the research shows, early education and maintenance of lifelong healthy behaviors are the clearest paths toward improved long-term health outcomes.

8 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hu L, Popp C, Sevick MA. Weight Loss Maintenance in Rural Populations in the United States: Can Telemedicine Help? JAMA Netw Open. 2020;3(6):e207134. doi:10.1001/jamanetworkopen.2020.7134

  2. Centers for Disease Control and Prevention. Adult Obesity Facts.

  3. Lundeen EA, Park S, Pan L, O’Toole T, Matthews K, Blanck HM. Obesity Prevalence Among Adults Living in Metropolitan and Nonmetropolitan Counties — United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67:653–658. doi:10.15585/mmwr.mm6723a1

  4. Murimi MW, Harpel T. Practicing preventive health: the underlying culture among low-income rural populations. J Rural Health. 2010;26(3):273-282. doi:10.1111/j.1748-0361.2010.00289.x

  5. Harpaz J. Forbes. 5 Reasons Why Telehealth Is Here To Stay (COVID-19 And Beyond).

  6. Luo C, et al. A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysisEClinicalMedicine. 2020. doi:10.1016/j.eclinm.2020.100442

  7. Federal Communications Commission. Eighth Broadband Progress Report.

  8. Reynolds MA, Jackson cotwright C, Polhamus B, Gertel-rosenberg A, Chang D. Obesity prevention in the early care and education setting: successful initiatives across a spectrum of opportunities. J Law Med Ethics. 2013;41 Suppl 2:8-18. doi:10.1111/jlme.12104

By Elizabeth Millard, CPT, RYT
Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition.