Online Dietary Weight Loss Program for Arab Adults: A Randomized Controlled Trial

Obesity is a growing public health concern in Saudi Arabia and is associated with increased risk of chronic conditions such as type 2 diabetes, hypertension, and cardiovascular disease. Although hospital-based weight management services are available, access to structured, culturally relevant, and sustainable dietary support remains limited for many adults. Online interventions may offer a practical and scalable alternative, particularly when they are tailored to local language, culture, and eating habits.

This study will evaluate a culturally adapted online dietary and lifestyle intervention designed for Arab adults in Saudi Arabia. The intervention was developed based on the EMPOWER weight loss program and revised using participant feedback from a prior Saudi pilot study. The current version includes Arabic-language educational content, Saudi food examples, visual tools to support food choices, and ongoing support for behavior change and weight management.

Participants will be randomly assigned to either the online lifestyle and dietary intervention group or the usual care group. The online intervention will be delivered over 6 months and will include 12 educational sessions, practical dietary guidance, and individualized support from dietitians when needed. Participants in the usual care group will receive the standard dietary care available through the hospital.

Study outcomes will include changes in body weight, waist and hip circumference, dietary intake, and health-related quality of life over time. The findings from this trial may help identify an effective, accessible, and culturally appropriate model for obesity treatment in Arab populations.

• Online Lifestyle and Dietary Program (Behavioral): A culturally adapted, 6-month online program designed for Arab adults that includes 12 educational sessions, practical dietary guidance, and tools to support sustainable lifestyle changes and weight management. Participants may also receive support from dietitians and feedback on dietary and weight progress.
• Usual Dietary Care (Behavioral): Standard dietary care provided in the hospital setting, including individualized dietary recommendations based on clinical assessment and routine follow-up.

Primary outcomes

• Change in Body Weight [Baseline, 3 Months, and 6 Months]: Change in body weight in kilograms measured from baseline to follow-up visits.

Secondary outcomes

• Change in Waist and Hip Circumference [Baseline, 3 Months, and 6 Months]: Change in waist and hip circumference measured in centimeters from baseline to follow-up visits.
• Change in Dietary Intake [Baseline, Monthly Dietary Records, and 6 Months]: Changes in dietary intake, including calorie intake and protein and fiber density, assessed using dietary records and food frequency questionnaire.
• Change in Health-Related Quality of Life [Baseline and 6 Months]: Changes in health-related quality of life measured using the RAND 36-Item Health Survey (RAND-36).

Sex: All, ages: 18 Years to 75 Years, accepts healthy volunteers

Inclusion Criteria:

Adults aged 18 to 75 years Arabic-speaking Body mass index (BMI) ≥25 kg/m² Have at least one obesity-related comorbidity, such as hypertension, type 2 diabetes, hyperlipidemia, or joint-related problems Own a smartphone Have Wi-Fi/internet access at home Willing to participate in a 6-month study Willing to attend 12 educational sessions if assigned to the intervention group Able to provide informed consent

Exclusion Criteria:

Currently pregnant or breastfeeding Planning pregnancy during the study period Currently using weight loss medications (including GLP-1 medications) History of bariatric surgery Planning bariatric surgery during the study period Currently participating in another structured weight loss program Severe medical conditions that may make participation unsafe, such as serious renal disease or other unstable health conditions Limited ability to use online materials or complete digital assessments independently

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• Manabu Nakamura, PhD, DVM, Principal investigator, University of Illinois Urbana-Champaign
• Asma Yahya, MS, Study director, University of Illinois at Urbana-Champaign