Small effects seen for tech-based pediatric obesity interventions
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Digital interventions, such as websites, text messages and exercise-based video games, offered as part of pediatric obesity treatment added to small weight losses, but had no effect on obesity prevention, according to a meta-analysis.
“As the COVID-19 pandemic catalyzes health care systems and ongoing intervention to rapidly shift from in-person appointments to telemedicine and use of digital tools, the evaluation of the noninferiority of digital solutions may be a particularly important inquiry right now,” Lauren A. Fowler, PhD, a postdoctoral research fellow at Washington University in St. Louis, said during a presentation at ObesityWeek Interactive. “The ubiquity of technology provides unique access to care in ways that may be less invasive, burdensome and costly. Results should be interpreted with a lens toward scalability, cost benefits and consideration of population impact when interpreting small effects.”
Fowler and colleagues conducted a meta-analysis of randomized controlled trials that analyzed the use of technology interventions for either the prevention or treatment of overweight and obesity in children aged 1 to 18 years. Researchers searched seven databases for trials from 2014 to 2020. All studies had weight status as either a primary or secondary outcome. Researchers evaluated obesity prevention and obesity treatment trials separately.
There were 55 trials included in the study, with 22 focused on obesity prevention and 33 examining obesity treatment. A community sample population was used in 25 studies, a clinical sample population was included in 15 studies, and a school-based population was used in 12 studies. Twenty-five of the studies took place in the U.S., with 13 others located in western or central Europe.
Most of the studies assessed one type of technology, but 11 examined the use of more than one type of technology. A web-based platform was the most common technology type, featured in 15 studies. There were 14 studies that featured phone calls, 12 used text messaging, eight examined mobile app use, and seven featured exergames.
Meta-analysis of 31 technology-based obesity treatment trials showed youths who participated had a small decrease in weight (mean decrease = –0.13; 95% CI, –0.2 to –0.06; P = .001). Trials that feature child-delivered interventions and interventions delivered to both the parent and child yielded a greater weight loss than parent-only interventions.
“There were significantly greater treatment effects on outcomes for pilot interventions, interventions delivered to the child compared to parent-delivered interventions, and as child age increased and intervention duration decreased,” Fowler told Healio.
The 20 technology-based obesity prevention trials had no significant effect on weight outcomes. There were also no differences found in comparator types, technology role, technology use or intervention type.
Fowler noted that although only small effects were found in technology-based treatment, these may be enough to offer lifetime medical cost savings and temper the possible impact of COVID-19 on weight gain in children.
“Research is needed to determine the comparative effectiveness of technology-based interventions to gold-standard interventions and elucidate the potential for eHealth to increase scalability and reduce costs while maximizing impact,” Fowler told Healio.
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Fowler LA. A Meta-analysis of technology-based approaches for pediatric obesity prevention and treatment. Presented at: ObesityWeek Interactive; Nov. 2, 2020 (virtual meeting).
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