Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity

Sang Ouk Chin, Changwon Keum, Junghoon Woo, Jehwan Park, Hyung Jin Choi, Jeong-Taek Woo, Sang Youl Rhee, Sang Ouk Chin, Changwon Keum, Junghoon Woo, Jehwan Park, Hyung Jin Choi, Jeong-Taek Woo, Sang Youl Rhee

Abstract

A discrepancy exists with regard to the effect of smartphone applications (apps) on weight reduction due to the several limitations of previous studies. This is a retrospective cohort study, aimed to investigate the effectiveness of a smartphone app on weight reduction in obese or overweight individuals, based on the complete enumeration study that utilized the clinical and logging data entered by Noom Coach app users between October 2012 and April 2014. A total of 35,921 participants were included in the analysis, of whom 77.9% reported a decrease in body weight while they were using the app (median 267 days; interquartile range = 182). Dinner input frequency was the most important factor for successful weight loss (OR = 10.69; 95% CI = 6.20-19.53; p < 0.001), and more frequent input of weight significantly decreased the possibility of experiencing the yo-yo effect (OR = 0.59, 95% CI = 0.39-0.89; p < 0.001). This study demonstrated the clinical utility of an app for successful weight reduction in the majority of the app users; the effects were more significant for individuals who monitored their weight and diet more frequently.

Figures

Figure 1. Distribution of weight loss among…
Figure 1. Distribution of weight loss among app users.
Percentages (and 95% CIs) of participants achieving 20% weight loss relative to baseline at the end of the 6-month trial period. Data are reported as the mean ± SD.

References

    1. Park H. S., Park C. Y., Oh S. W. & Yoo H. J. Prevalence of obesity and metabolic syndrome in Korean adults. Obes Rev. 9, 104–107, doi: 10.1111/j.1467-789X.2007.00421.x (2008).
    1. Zheng W. et al.. Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med. 364, 719–729, doi: 10.1056/NEJMoa1010679 (2011).
    1. Kopelman P. G. Obesity as a medical problem. Nature 404, 635–643, doi: 10.1038/35007508 (2000).
    1. Haslam D. W. & James W. P. Obesity. Lancet 366, 1197–1209, doi: 10.1016/s0140-6736(05)67483-1 (2005).
    1. Wang Y. C., McPherson K., Marsh T., Gortmaker S. L. & Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet 378, 815–825, doi: 10.1016/s0140-6736(11)60814-3 (2011).
    1. Appel L. J. et al.. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. Jama 289, 2083–2093, doi: 10.1001/jama.289.16.2083 (2003).
    1. Wadden T. A. et al.. A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med. 365, 1969–1979, doi: 10.1056/NEJMoa1109220 (2011).
    1. Knowler W. C. et al.. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 346, 393–403, doi: 10.1056/NEJMoa012512 (2002).
    1. Stewart K. J. et al.. Effect of exercise on blood pressure in older persons: a randomized controlled trial. Arch Intern Med. 165, 756–762, doi: 10.1001/archinte.165.7.756 (2005).
    1. Goodpaster B. H. et al.. Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial. Jama 304, 1795–1802, doi: 10.1001/jama.2010.1505 (2010).
    1. Smith S. R. et al.. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 363, 245–256, doi: 10.1056/NEJMoa0909809 (2010).
    1. Allison D. B. et al.. Controlled-release phentermine/topiramate in severely obese adults: a randomized controlled trial (EQUIP). Obesity (Silver Spring) 20, 330–342, doi: 10.1038/oby.2011.330 (2012).
    1. Fidler M. C. et al.. A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: the BLOSSOM trial. J Clin Endocrinol Metab. 96, 3067–3077, doi: 10.1210/jc.2011-1256 (2011).
    1. Eddy D. M., Schlessinger L. & Kahn R. Clinical outcomes and cost-effectiveness of strategies for managing people at high risk for diabetes. Ann Intern Med. 143, 251–264 (2005).
    1. Knowler W. C. et al.. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 374, 1677–1686, doi: doi: 10.1016/s0140-6736(09)61457-4 (2009).
    1. de Jongh T., Gurol-Urganci I., Vodopivec-Jamsek V., Car J. & Atun R. Mobile phone messaging for facilitating self-management of long-term illnesses. Cochrane Database Syst Rev. 12, Cd007459, doi: 10.1002/14651858.CD007459.pub2 (2012).
    1. Beratarrechea A. et al.. The impact of mobile health interventions on chronic disease outcomes in developing countries: a systematic review. Telemed J E Health 20, 75–82, doi: 10.1089/tmj.2012.0328 (2014).
    1. Kim Y. J. et al.. A Smartphone Application Significantly Improved Diabetes Self-Care Activities with High User Satisfaction. Diabetes Metab J 39, 207–217, doi: 10.4093/dmj.2015.39.3.207 (2015).
    1. Klasnja P. & Pratt W. Healthcare in the pocket: mapping the space of mobile-phone health interventions. J Biomed Inform. 45, 184–198, doi: 10.1016/j.jbi.2011.08.017 (2012).
    1. Carter M. C., Burley V. J., Nykjaer C. & Cade J. E. Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial. J Med Internet Res. 15, e32, doi: 10.2196/jmir.2283 (2013).
    1. Allen J. K., Stephens J., Dennison Himmelfarb C. R., Stewart K. J. & Hauck S. Randomized controlled pilot study testing use of smartphone technology for obesity treatment. J Obes. 2013, 151597, doi: 10.1155/2013/151597 (2013).
    1. Spring B. et al.. Integrating technology into standard weight loss treatment: a randomized controlled trial. JAMA Intern Med. 173, 105–111, doi: 10.1001/jamainternmed.2013.1221 (2013).
    1. Laing B. Y. et al.. Effectiveness of a smartphone application for weight loss compared with usual care in overweight primary care patients: a randomized, controlled trial. Ann Intern Med. 161, S5–12, doi: 10.7326/m13-3005 (2014).
    1. Hebden L. et al.. A mobile health intervention for weight management among young adults: a pilot randomised controlled trial. J Hum Nutr Diet. 27, 322–332, doi: 10.1111/jhn.12155 (2014).
    1. Flores Mateo G., Granado-Font E., Ferre-Grau C. & Montana-Carreras X. Mobile Phone Apps to Promote Weight Loss and Increase Physical Activity: A Systematic Review and Meta-Analysis. J Med Internet Res. 17, e253, doi: 10.2196/jmir.4836 (2015).
    1. Semper H. M., Povey R. & Clark-Carter D. A systematic review of the effectiveness of smartphone applications that encourage dietary self-regulatory strategies for weight loss in overweight and obese adults. Obes Rev, doi: 10.1111/obr.12428 (2016).
    1. Pagoto S., Schneider K., Jojic M., DeBiasse M. & Mann D. Evidence-based strategies in weight-loss mobile apps. Am J Prev Med. 45, 576–582, doi: 10.1016/j.amepre.2013.04.025 (2013).
    1. Patel R. et al.. Smartphone apps for weight loss and smoking cessation: Quality ranking of 120 apps. N Z Med J 128, 73–76 (2015).
    1. R. Core Team R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. (2013).
    1. Executive summary: Guidelines (2013) for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society published by the Obesity Society and American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Based on a systematic review from the The Obesity Expert Panel, 2013. Obesity (Silver Spring) 22 Suppl 2, S5–39, doi: 10.1002/oby.20821 (2014).
    1. Sperduto W. A., Thompson H. S. & O’Brien R. M. The effect of target behavior monitoring on weight loss and completion rate in a behavior modification program for weight reduction. Addict Behav. 11, 337–340 (1986).
    1. Burke L. E., Wang J. & Sevick M. A. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 111, 92–102, doi: 10.1016/j.jada.2010.10.008 (2011).
    1. Burke L. E. et al.. Using mHealth technology to enhance self-monitoring for weight loss: a randomized trial. Am J Prev Med. 43, 20–26, doi: 10.1016/j.amepre.2012.03.016 (2012).
    1. Burke L. E. et al.. Self-monitoring dietary intake: current and future practices. J Ren Nutr. 15, 281–290 (2005).
    1. Azar K. M. et al.. Mobile applications for weight management: theory-based content analysis. Am J Prev Med. 45, 583–589, doi: 10.1016/j.amepre.2013.07.005 (2013).
    1. Turner-McGrievy G. M. et al.. Comparison of traditional versus mobile app self-monitoring of physical activity and dietary intake among overweight adults participating in an mHealth weight loss program. J Am Med Inform Assoc. 20, 513–518, doi: 10.1136/amiajnl-2012-001510 (2013).
    1. Glynn L. G. et al.. Effectiveness of a smartphone application to promote physical activity in primary care: the smart move randomised controlled trial. Br J Gen Pract. 64, e384–e391, doi: 10.3399/bjgp14X680461 (2014).
    1. Burke L. E. et al.. Using instrumented paper diaries to document self-monitoring patterns in weight loss. Contemp Clin Trials 29, 182–193, doi: 10.1016/j.cct.2007.07.004 (2008).
    1. Leidy H. J., Bossingham M. J., Mattes R. D. & Campbell W. W. Increased dietary protein consumed at breakfast leads to an initial and sustained feeling of fullness during energy restriction compared to other meal times. Br J Nutr. 101, 798–803 (2009).
    1. Leidy H. J. & Racki E. M. The addition of a protein-rich breakfast and its effects on acute appetite control and food intake in ‘breakfast-skipping’ adolescents. Int J Obes (Lond) 34, 1125–1133, doi: 10.1038/ijo.2010.3 (2010).
    1. Elfhag K. & Rossner S. Initial weight loss is the best predictor for success in obesity treatment and sociodemographic liabilities increase risk for drop-out. Patient Educ Couns. 79, 361–366, doi: 10.1016/j.pec.2010.02.006 (2010).
    1. Fabricatore A. N. et al.. Predictors of attrition and weight loss success: Results from a randomized controlled trial. Behav Res Ther. 47, 685–691, doi: 10.1016/j.brat.2009.05.004 (2009).
    1. The Australian Online Consumer Landscape, (2012).
    1. Rhee S. Y., Park S. W., Kim D. J. & Woo J. Gender disparity in the secular trends for obesity prevalence in Korea: analyses based on the KNHANES 1998–2009. Korean J Intern Med. 28, 29–34, doi: 10.3904/kjim.2013.28.1.29 (2013).
    1. Wulan S. N., Westerterp K. R. & Plasqui G. Ethnic differences in body composition and the associated metabolic profile: a comparative study between Asians and Caucasians. Maturitas 65, 315–319, doi: 10.1016/j.maturitas.2009.12.012 (2010).
    1. Obesity: preventing and managing the global epidemics. Report of a WHO Consultation. Geneva, Switzerland: Word Health Organization; WHO Technical Report Series 894. 2000.

Source: PubMed

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