This purpose of this trial is to determine whether a 12-month eHealth behavioral intervention that includes interactive self-monitoring and feedback, tailored skills training materials, telephone counseling calls, and primary care physician (PCP) counseling will produce greater weight change at 12 months than a standard primary care control.

This is a patient randomized trial in which patients will be randomized into one of two treatment arms: 1) standard primary care; or 2) primary care plus a 12-month eHealth behavioral intervention (iOTA), which includes interactive self-monitoring and feedback, tailored skills training materials, 18 telephone counseling calls, and primary care provider counseling. The primary outcome is weight change at 12 months. Participants will be 351 adult male and female patients from local community health centers with obesity and a related comorbidity.

Inclusion Criteria:

• At least 1 visit in the previous 12 months to an adult medicine, internal medicine, or family practice provider at a participating community health center
• BMI between 30.0-45.0 kg/m2 and weight ≤ 320 pounds
• Diagnosis of hypertension or diabetes

Exclusion Criteria:

• Current pregnancy
• Pregnancy in previous 12 months
• Heart attack/stroke in previous 2 years
• Active cancer diagnosis
• Current participation in another weight loss study