The internet is a novel medium for delivering behavioural modification weight loss programs and owing to its widespread accessibility it has the potential to treat at the population level. This thesis aimed to evaluate the effects of a unique web-based behaviour change program (WBP) called 'Imperative Health' on weight loss in an overweight/ obese population at high risk of cardiovascular disease (CVO) using a randomised controlled trial. In total, 65 participants were randomly assigned to one of two groups for 12 months: the control group (usual care) or the intervention group (WBP). Assessments were conducted at baseline, 3-, 6- and 12-months. The primary outcome of this study was between-group change in weight loss at 3 months. Secondary outcomes included between-group change in the following health outcomes: CVD risk factors, health-related quality of life, emotional states and self efficacy. The intervention group achieved a mean weight loss of -4.4 ± 3.5 kg at 3 months; the control group lost -0.54 ± 3.0 kg, overall this accounted for a Significant mean weight difference of -3.66 kg after adjusting for baseline weight between the groups (P <0.001). No treatment effect was observed between the groups in the longer term (12 months). A substantial impact on the majority of the above health outcomes irrespective of weight loss was not observed. Web-based programs for weight loss have the potential to reach large proportions of the population and the ability to promote modest weight loss in the short term. It is difficult, however, to ascertain their long term effectiveness as a result of their associated high attrition and non-usage attrition rates. Solutions are required to enhance engagement levels in the longer term in order to maximise the potential of WBPs for weight management to treat obesity at the population level.

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Media promotion of the ideal body as slimness for women and muscularity for men, has led to increasing numbers of both genders reporting dissatisfaction with their bodies and trying to change using weight control products. It has been suggested that pharmacists can play a key role in promoting healthy lifestyles and weight management. The main aim of the research study was to examine the impact of media on body image perception and to investigate the role of pharmacists in weight management. This thesis consists of three studies: an evaluation of weight control websites, a body image survey of young adults and interviews with pharmacists. The results from the evaluation study showed that the quality of most weight loss (64%) and weight gain product advertisements (80%) was generally poor, principally due to the use of misleading claims and a lack of useful information. These data complement the survey that university students reported rarely being influenced by weight control product adverts and hardly considered using these products as a method for changing weight. The survey also showed that most participants of both genders (71%) felt satisfied with their body image. However, the findings in this study indicated that there was a relationship between a high level of body image concern and self-perception of being overweight and the attempt to lose weight. Interviews with pharmacists showed that they were unlikely to be actively involved in reducing obesity problems and promoting healthy lifestyles in the community. Although the prevalence of body dissatisfaction and the use of weight control products among these young adults may not be as high as has been reported elsewhere, healthcare professionals, including pharmacists, need to be aware of this problem when providing advice or consultations for young adults. Healthcare professionals should promote the benefits of healthy lifestyles as well as providing information about potential problems of harmful weight control strategies. The effect of ethnicity and culture on body image concern warrants further. The availability of weight control products and quality of information provided should also be further examined.