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Integrating Technology Into Standard Weight Loss Treatment: A Randomized Controlled Trial
Study Questions:
Is the outcome of a physician-directed weight loss treatment improved by adding mobile technology?
Methods:
A two-arm, 12-month (October 2007-September 2010) weight loss study was conducted in 70 adults (body mass index [BMI] ≥25 and ≤40 kg/m2) who were randomly assigned to either standard-of-care (standard group) or to the standard and connective mobile technology system (+mobile group). Participants attended biweekly weight loss groups held by the Veterans Affairs outpatient clinic. The +mobile group was provided personal digital assistants to self-monitor diet and physical activity; they also received biweekly coaching calls for 6 months. Weight was measured at baseline and at 3-, 6-, 9-, and 12-month follow-up.
Results:
Sixty-nine adults received intervention (mean age, 57.7 years; 85.5% were men, mean weight 111.1 kg, and mean BMI 36.3 kg/m2). A longitudinal intent-to-treat analysis indicated that the +mobile group lost a mean of 3.9 kg more (representing 3.1% more weight loss relative to the control group; 95% confidence interval [CI], 2.2-5.5 kg) than the standard group at each post-baseline time point. Compared with the standard group, the +mobile group had significantly greater odds of having lost 5% or more of their baseline weight at each post-baseline time point (odds ratio, 6.5; 95% CI, 2.5-18.6).
Conclusions:
The addition of a personal digital assistant and telephone coaching can enhance short-term weight loss in combination with an existing system of care. Mobile connective technology holds promise as a scalable mechanism for augmenting the effect of physician-directed weight loss treatment.
Perspective:
While there was a value of the mobile device in the study, the actual weight loss as a percent of baseline weight was low for both groups, despite an excellent protocol and education effort. Only 41% of the +mobile device group and 10.7% in the standard group lost at least 5% of their weight at 6 months. Further, when comparing baseline to 12 months, there was no change in mean weight in the standard group, and only 2.5 kg (approximately 2%) in the +mobile group.
Keywords: Food Habits, Seasons, Weight Loss, Telephone, Body Weight, Diet, Reducing, Weight Gain, Computers, Handheld, Body Mass Index, Leucomycins, Motor Activity, Cardiovascular Diseases, Obesity
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