Wearable Technology Combined With Lifestyle Intervention for Long-Term Weight Loss

Study Questions:

Does wearable technology to monitor diet and physical activity in combination with a standard behavioral weight loss intervention improve long-term weight loss?

Methods:

The IDEA (Innovative Approaches to Diet, Exercise and Activity) trial was a randomized clinical trial conducted at the University of Pittsburgh between October 2010 and October 2012. A total of 471 men and women ages 18-35 years of age, with a body mass index (BMI) between 25 and 40 kg/m2 were enrolled. Data collection was completed in December 2014. Participants were placed on a low-calorie diet, prescribed increases in physical activity, and had group counseling sessions. At 6 months, the interventions added were telephone counseling sessions, text message prompts, and access to study materials on a website. Also at 6 months, participants randomized to the standard intervention group initiated self-monitoring of diet and physical activity using a website, and those randomized to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity. The primary outcome of interest was change in weight from baseline to 24 months. Weight was measured at 6-month intervals from baseline to 24 months. Secondary outcomes included body composition, fitness, physical activity, and dietary intake.

Results:

A total of 471 participants were randomized, of which 28.9% were nonwhite and 77.2% were women. A total of 470 initiated the intervention and 74.5% completed the 24-month study. Estimated weight loss was 5.9 kg (95% confidence interval [CI], 5.0-6.8) in the standard group and 3.5 kg (95% CI, 2.6-4.5) in the enhanced intervention group. Weight change at 24 months differed significantly by intervention group (difference, 2.4 kg; 95% CI, 1.0-3.7; p = 0.002). Both groups had significant improvements in body composition, fitness, physical activity, and diet, with no significant difference between groups.

Conclusions:

The investigators concluded that among young adults with a BMI between 25 and <40 kg/m2, the addition of a wearable technology device to a standard behavioral intervention resulted in less weight loss over 24 months. Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches.

Perspective:

These data highlight the fact that wearable technologies may not work well for lifestyle modification for all groups. Understanding the most effective tailoring strategies, timing of the interventions, and selecting the right groups who can benefit from the use of wearables is warranted.

Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Diet, Exercise

Keywords: Body Composition, Body Mass Index, Body Weight, Caloric Restriction, Counseling, Diet, Exercise, Life Style, Motor Activity, Obesity, Overweight, Primary Prevention, Text Messaging, Weight Loss


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