Due to wide accessibility, utilising electronic communication is a potentially effective counselling solution for the increasingly obese Australian population. This study aimed to investigate the effect of utilising esupport in delivering weight management strategies compared with face-to-face counselling among hospital outpatient referrals on change in weight and waist circumference. Participants self-selected their preferred mean of support. This is the first known hospital pilot study using self-selection and open-label trial of these two interventions. Both groups received weekly advice either face-to-face or via e-mail for 8 weeks. Motivational strategies related to weight management were reviewed from the literature. Satisfaction was assessed using a validated tool. There was no difference in age (p = 0.811) and gender (p = 0.528) between the study participants (n = 8, 51.4 ᠱ3.5 yrs, 62.5% female) and general dietetic outpatients (n = 182, 55.6 ᠱ4.3 yrs, 51.1% female). No clinically significantly changes in weight or waist circumference occurred after 8 weeks in either the face-to-face or e-mail group. Between week 1-8, self-rated motivation of the face-to-face group remained stable (3 of a 5 point scale), but varied (ranged 1 to 5) among participants utilising e-support (p = NS). High satisfaction with both delivery methods was obtained (>77%, good/very good). The literature review demonstrated enhanced motivation through implementing social support (eg. electronic message boards, online-chat sessions), weekly creation of self-motivational statements and points systems for rewards/lottery. Weight management group delivery by electronic means is considered worthy of further investigation to enable increased service delivery capacity while managing workload, dietetic time and the costs of scheduling in-person appointments.