Smartphone-Based Behavioral Therapy for Obesity Comparable to Group Therapy Outcomes

The weight loss benefits of smartphone-based behavioral obesity treatment are similar to those of intensive group-based treatment for obesity, according to study results published in Obesity.

To compare the efficacy of smartphone-based behavioral obesity treatment and the gold standard group-based treatment, researchers randomly assigned 276 overweight or obese patients (average age, 55.1 ± 9 years; 83% women) to complete either 18 months of group-based treatment, smartphone-based treatment, or a control condition.

Participants in group-based treatment (n = 106; groups of 15 to 20 participants) completed 6 months of weekly meetings, 6 months of biweekly meetings, and 6 months of monthly meetings plus self-monitoring with paper diaries and written feedback. Patients in the smartphone-based treatment group (n = 114) completed online lessons and self-monitoring and received written feedback plus monthly weigh-ins. Participants in the control group (n = 56) completed self-monitoring with paper diaries and written feedback and had monthly weigh-ins.

At baseline, overall mean weight was 95.9 kg and mean body mass index was 35.2 kg/m². Compared with group-based treatment and smartphone-based treatment, control conditions had significantly lower retention at 18 months (66.1% vs 83.0% in group treatment and 80.7% in smartphone-based treatment).

All 3 groups yielded similarly significant reductions in weight at 18 months, with an average estimated weight loss of 5.5 kg in the smartphone-based treatment group, 5.9 kg in the group-based treatment group, and 6.4 kg in participants under control conditions. There were also no significant between-group differences for weight loss at 6 or 12 months.

Likewise, there were no significant differences in the percentage of clinic visits attended. Although rates of self-monitoring weight, diet, and physical activity decreased gradually in all 3 groups over 18 months, rates for body weight monitoring were significantly lower in group-based participants (21.2%) than in patients with smartphone-based treatment (30.7%) and control participants (29.7%).

Differential attrition was noted as one significant limitation to this study, with the highest dropout rate being in the control condition.

In summarizing their findings, the researchers said that 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.”

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Reference

Thomas JG, Bond DS, Raynor HA, Papandonatos GD, Wing RR. Comparison of smartphone-based behavioral obesity treatment with gold standard group treatment and control: a randomized trial [published online February 19, 2019]. Obesity. doi:10.1002/oby.22410