Weight Loss in Chronic Disease Patient Population

Inclusion Criteria: * Age ≥ 18 yrs old * BMI ≥ 25 kg/m2 and waist circumference \> 40 inches (men)/ 35 inches (women) * Weight ≤ 500lbs * At least one of the following: * Fasting blood sugar \> 100 mg/dL at any point and/or taking medications for diabetes And/Or * Resting blood pressure \> 130/90 mm Hg at any point and/or taking medications for hypertension * Not involved in regular physical activity or weight loss management programs * Capable of being physically active * Physically able to use in-home equipment (or presence of a household member who can assist the subject in equipment use) * Currently-working conventional telephone line at primary residence * Grounded electrical power supply at primary residence * Have been in LSU HCSD system for 6 months and anticipate remaining in the LSU HCSD patient population for the next 6 months Exclusion Criteria: * A history of drug abuse in the last year, or excess alcohol consumption (40g/day)6 * Currently dieting or engaging in any activity with the goal of losing weight * Significant weight loss or weight gain in the past year (\> 50 lbs) or current use of weight loss medications * History of gastrointestinal bypass or other bariatric surgery in the last 3 years * Diagnosis of congestive heart failure * Under treatment for end-stage renal disease or end-stage liver disease * History of major organ transplant * History of cancers requiring treatment in the past 5 years with anything but excellent prognosis * Current diagnosis of schizophrenia, bipolar disorder, or other psychotic disorders * Pregnant or plan on becoming pregnant in the next 12 months. * Lack support from health care provider or family members. * Current member of household participating in study * Factors that may limit adherence to intervention or affect conduct of the trial. * Unable or unwilling to communicate with staff, to provide written informed consent, or accept the randomized assignment. * Any other condition, which, in the opinion of the investigators would impede competence or compliance or possibly hinder completion of the study.