People living in rural areas are at greater risk for obesity than the general population, and they often have limited access to healthy, affordable food, physical activity facilities, public transportation, and health care institutions. Weight loss interventions are more successful with support from a dietitian, but many rural residents do not have preventive care providers nearby.

A research team at the University of Illinois Urbana-Champaign developed an online weight management program that provides personalized assistance from a registered dietitian. In a new study, they collaborated with Illinois Extension to test the program’s efficacy among residents of rural Illinois.

“EMPOWER is a new iteration of the Individualized Dietary Improvement Program (iDip), an in-person platform that includes nutrition education and lifestyle coaching. We developed a web application that allows people to experience the whole program online, enabling us to better reach underserved populations,” said lead author Ashleigh Oliveira, a doctoral student in the Division of Nutritional Sciences, part of the College of Agricultural, Consumer and Environmental Sciences at Illinois.

The program’s main feature is the MealPlot web application, which provides tools for participants to monitor their weight and food intake. While other weight loss apps typically measure caloric content, MealPlot focuses on fiber and protein density. This helps people consume meals that provide a greater sense of satiation with lower caloric intake, ensuring nutrient needs for safe weight loss are met.

“The MealPlot app does not tell people what to eat; it helps them design their own food intake based on their fiber and protein goals. Similarly, we do not recommend specific physical activities but encourage participants to explore what fits into their lifestyle. Exercise can include things like going for a walk, doing house chores, or gardening,” said co-author Manabu Nakamura, associate professor in the Department of Food Science and Human Nutrition at U. of I.

“People can experiment and learn on their own and get immediate feedback to encourage behavioral changes in diet and lifestyle. They’ll get into a habit of daily weighing and tracking. And instead of just going to the store and buying things haphazardly, they have a tool to direct their food choices. Then, over time, hopefully they will not need to rely on this feature but intuitively understand what foods to eat,” Oliveira added.

The study included a sample of rural residents from seven Illinois counties with a population of less than 50,000 people, recruited with the help of Illinois Extension Nutrition and Wellness educators. The researchers followed participants for 12 months, recording their weight, body composition, and diet intake.

Participants were asked to weigh daily, using a Wi-Fi scale that was connected to the MealPlot app and automatically recorded their weight.

The program included 17 interactive lessons covering topics on weight loss principles, essential nutrients, physical activity, and lifestyle tips. Participants also received personalized nutrition coaching by email, text, and phone or video calls.

“We employed a dietitian who had experience with the local environment and how to get food and navigate other challenges in rural areas. The app can point people towards foods that are high in protein and fiber, but it’s not going to tell them what grocery store to go to, so the dietitian could provide that kind of expertise,” Oliveira said.

The researchers found that participants on average lost about 5 kilograms, or 6% of their body weight, mostly attributed to the loss of fat mass. In surveys, respondents indicated they liked the nutrition and lifestyle coaching components of the program, and believed they would sustain the changes they made to their diet.

The study suggests EMPOWER may be an effective weight loss program for rural residents, and the online platform improved accessibility and was well-liked, the researchers concluded.

Feedback from the study participants informed upgrades and revisions to the MealPlot app, and the team plans to launch a final version by spring 2026.

The paper, “Feasibility and acceptability pilot study of an online weight loss program in rural, underserved communities,” is published in PeerJ [DOI:10.7717/peerj.18268]. Funding was provided by the USDA Hatch ILLU-698-908.