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Smartphone-based weight loss program comparable to gold standard

A mobile smartphone-based behavioral obesity intervention achieved weight loss outcomes similar to that of a more intensive gold standard group-based approach, according to findings published in Obesity.

“Behavioral obesity treatments focused on improving eating, physical activity and related behaviors reliably produce mean weight losses of 5% to 10% of initial body weight,” J. Graham Thomas, PhD, associate professor in the department of psychiatry and human behavior at the Warren Alpert Medical School of Brown University, and colleagues wrote. “These weight losses reduce the risk and severity of multiple diseases, including cardiovascular disease, type 2 diabetes, and cancer. However, these treatments are not widely available because they are highly intensive.”

More accessible and less costly approaches to behavioral obesity treatments are necessary, and a mobile health approach may fill that need, according to the researchers.

Thomas and colleagues performed a randomized clinical trial to compare the effectiveness of a primarily smartphone-based behavioral obesity treatment (SMART), a more intensive group-based behavioral obesity treatment and a control condition for weight loss. They recruited 276 adults with overweight or obesity (17% men; 7.2% minority; mean age, 55.1 years; mean BMI, 35.2 kg/m²).

Participants were randomly assigned to one of three treatment groups at a ratio of 2:2:1.

The SMART intervention (n = 114) consisted of three 5-minute dietary education and skills training videos weekly via a smartphone for 6 months, followed by twice weekly for the next 6 months and once a week for the last 6 months. Participants in this group reported their own dietary intake, daily weight and physical activity using the MyFitnessPal app. Interventionists weighed these participants monthly and provided feedback.

Participants in the group intervention (n = 106) attended dietary education and skills training sessions led by group interventionists weekly for the first 6 months, biweekly for the next 6 months and monthly for the last 6 months. Participants self-reported their diet, weight status and physical activity in paper diaries. The group interventionists weighed each participant at each group session and provided feedback.

The control intervention (n = 56) included monthly weigh-ins and feedback from interventionists. Participants in the control group self-reported their daily weight, dietary intake and physical activity using paper diaries.

After 18 months, estimated mean weight loss did not significantly differ between participants in the SMART group (5.5 kg; 5.7%; 95% CI, 4.1-7.4), those in the group intervention (5.9 kg; 6.2%; 95% CI, 4.7-7.7) and those in the control group (6.4 kg; 6.7%; 95% CI, 3.8-9.6).

Significantly more participants in the SMART group (83%) and group intervention (81%) completed the 18-month program compared with those in the control group (66%).

“This trial demonstrates the potential of a primarily smartphone-based behavioral obesity treatment with occasional remote and in-person human contact to produce weight loss not different from that of the more intensive gold standard in-person treatment with regular group treatment sessions,” Thomas and colleagues concluded.

“Additionally, focusing the smartphone-based intervention on self-monitoring led to greater adherence to this key behavior than in in-person treatment,” they added. “The combination of mobile technology with occasional low-intensity clinical contact could serve as one effective approach for addressing the problem of obesity in routine and representative clinical contexts.” – by Alaina Tedesco

Disclosures: The authors report no relevant financial disclosures.