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T he Internet has powerfully changed the world of health and nutrition so much so that the term "e-dieting" has come quickly into fashion in the beginning of the twenty-first century. By joining online communities, individuals can seek information, treatment programs, or help from experts within seconds. The World Wide Web has become a particularly popular way for people to access dieting information because of its convenience and simplicity. Whether people around the world are tracking their calories online or sharing dieting techniques, virtual communities are unique in the anonymity they prove for participants. Individuals can sit in the comfort of their homes and read about dieting plans online, tell personal stories, and even join groups focused on weight loss. As such, the powerful technology of the Internet has impacted dieting culture by making access to information fast and faceless.

The categories of health topics found on the Internet include: (i) academic resources, (2) obesity related-organizations, (3) chat groups and social support resources, and (4) commercial services and products. In each of these four areas, the Internet has become a "therapeutic tool" (Fontaine and Allison 2002). People can access innovative organizational websites that explain ways to prevent obesity and other medical problems resulting from a poor diet. Consumers can even educate themselves using these diverse resources, which may provide them a greater level of control over their weight and health in general.

The wide variety of websites and virtual tools available to the online community allow users to choose sites based on their personal preference. The Internet's 24/7 available access provides many tools including customized eating advice, plans, and information. Individuals can become members of websites, such as e-diets.com and caloriescount.com, where they can track their calories and access a diet plan with the click of a button. Some websites offer plans with specific recipes and make it convenient for dieters to keep food diaries and track their progress online (Graham 2006). Other sites have instructions for following specific popular diets, such as the Atkins diet or the South Beach diet. Cyber diet plans, however, involve a lot of time, effort, and accuracy. Users must fill out diet and activity questionnaires carefully (and truthfully) in order to effectively track their weight. In addition to these, blogs and personal websites connect dieters across the globe and create a large following of cyber social groups. These sites can play a big role in shaping people's dieting behaviors in positive and negative ways (Graham 2006). For example, while virtual weight-watchers meetings encourage people to stick to their diets, pro-anorexia websites provide those with an eating disorder dangerous weight-loss tips.

Numerous government websites also provide information on obesity, eating disorders, and nutrition. Federally funded web-based programs that promote interactive experiences for users may be some of the most helpful and safe tools available online. These sites provide education on healthy eating and exercise by outlining specific instructions that one can follow, as well as weight-management and self-monitoring systems where members can follow strict regimens to attain the optimal body weight (Fontaine and Allison 2002). For example, the Shape Up America! program, founded by U.S. Surgeon General C. Everett Koop is an important online tool in the national battle against obesity. This federally funded program is a result of collaboration between numerous health experts all focused on promoting healthy eating and physical exercise and making Americans realize that preventing obesity should be a public health priority (Fontaine and Allison 2002). The findings from Shape Up America! show the promise web-based programs have for improving the health of Americans. In addition, other sites, like the Government's mypyramidtracker.org, allow people to find out if what they are eating has the suggested amount of nutrition (Fontaine and Allison 2002). Today, federally funded health-related websites provide one way for the government to educate its citizens about how to lose weight and stay healthy; however, in order for them to work, consumers have to be invested in weight loss and healthier eating.

People's investments in dieting vary almost as much as their reasons for choosing online dieting help. While it is impossible to know exactly why consumers choose internet dieting, some may be too embarrassed to seek professional help, while others many want to feel a part of an online community where they can be held accountable for their dieting progress. Moreover, consumers may prefer the convenient and inexpensive tools on the web. Whatever a person's reason for choosing online dieting, there are several potential advantages to using cyber tools (Fontaine and Allison 2002). Primarily, the unlimited use of the Internet allows one to access thousands of individuals at an extremely low cost. In addition, the Internet can be used at any hour of the day and from any city; thus, the number of people who can access online dieting sites is nearly limitless. Further, experts can monitor users and give quick and direct feedback on their progress. Lastly, the ability for people to participate in a treatment program tailored to their needs and yet remain anonymous is a positive aspect of Internet use.

Like any powerful technology that is convenient and for the information-savvy, there are potential drawbacks (Fontaine and Allison 2002). Many websites focusing on weight loss and health, for example, lack accurate information. Because the Internet does not require face-to-face interaction, it is also tough to know whether people are really keeping the weight off or fibbing about their smaller pant-sizes to their internet peers. In addition, though the Internet eliminates personal interactions, it allows a person to expose themselves and even sometimes overexpose themselves. Through Internet chatrooms and blogs, dieters can tell their personal stories and connect with other patrons who are experiencing similar situations; however, uncertainties about safety and truth remain a potential downside. It is ultimately the responsibility of the Internet user to ensure the accuracy of the advice that they are obtaining.

Studies have also found evidence that when compared to other treatments such as in-person therapy, internet dieting is less successful. A study conducted at the University of Vermont, for example, looked at the difference in weight maintenance programs conducted over the Internet versus in-person treatments. A record of the body weight, dietary intake, energy expended in physical activity, attendance, self-monitoring, and comfort with technology of 122 healthy, overweight adults was kept over twelve months. Results showed that the Internet group gained significantly more weight than the in-person group during the first six months of weight maintenance. These findings suggest that internet support is not as effective at facilitating the long-term maintenance of weight loss compared to in-person therapy (Harvey-Berino et al. 2002). Other studies have found that internet sites such as e-diets.com are not as effective at helping users lose weight as compared to manual inperson weight-loss programs (Womble et al. 2004).

Despite their questionable efficacy, dieting websites are becoming more and more common in the internet universe. The semi-public yet still private environment of the Internet allows dieters to feel in control of their dieting habits. In addition, if one's diet falters, it remains a behind-doors matter. While safety and oversight are problematic in cyberspace, research on the benefits of

Popular health-related websites

Site

What it offers

Cost

Goal

Caloriescount.com

You can pick a recipe-based plan or a convenience-based plan, or a combination of both.

$10 for the first two months; discounted rates for longer terms

Healthy weight loss (one to two pounds a week)

Ediets.com

Flexibility in choosing a plan; can add restaurant meals, etc.

$16 for one month; extra features are additional costs

Has plans that follow many popular plans (Mayo Clinic, Atkins, Slim Fast, etc.)

Weightwatchers.com

Well-balanced diet plan with support and behavior training.

$46.90 for the first month, then $16.95 a month.

Easy weighing, measuring, and counting

Eatright.org

Provides information on American Dietetic Association

Free

N/A

Something-fishy.org

Largest website for eating disorders. Includes information, conference updates, chatrooms, "treatment finder service," and help for family and friends.

Free

N/A

Mypyramidtracker.gov

You can fill out food-intake questionnaire and find if you're getting enough recommended nutrients.

Free

Ability to see if you follow food pyramid suggestions

internet dieting suggests that this dieting method will continue to grow in popularity.

SLG/Jessica Sawhney See also Anorexia; Atkins; Food Pyramid; Nidetch

References and Further Reading

Fontaine, Kevin R. and Allison, David B. (2002) "Obesity and the Internet," in Christopher G. Fairburn and Kelly D. Brownell (eds), Eating Disorders and Obesity: A Comprehensive Handbook, 2nd edn, New York: Guilford Press, pp. 609-12. Graham, Janis (2006) "Best Sites for Staying Well and Shaping Up," Good Housekeeping 243 (5): 73-82.

Harvey-Berino J., Pintauro, S., Buzzell, P., DiGiulio, M., Casey Gold, B., Moldovan, C., and Ramirez, E. (2002) "Does Using the Internet Facilitate the Maintenance of Weight Loss?" International Journal of Obesity and Related Metabolic Disorders 26 (9): 1254-60.

Shape Up America! Healthy weight for life (2006) available online at <http://www.shapeup.org/ shape/index_shape.php> (accessed December 15, 2006).

Womble, L.G., Wadden, T.A., McGuckin, B.G., Sargent, S.L., Rothman, R.A., and Krauthamer-Ewing, E.S. (2004) "A Randomized Controlled Trial of a Commercial Internet Weight Loss Program," Obesity Research 12 (6): 1011-18.

144 ISRAELI, ISAAC BEN SALOMON

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