Digital Health Obesity Interventions Deliver Underwhelming, Short-Term Results

Obesity is a widespread epidemic, responsible for myriad life-threatening illnesses, reduced quality of life and, in some cases, death. But can new digital health tools help? A new study in which researchers analyzed the results of 11 trials found that web-based weight loss programs can provide moderate short-term results among obese individuals.

While the hope was that web-based approaches would prove more effective due to their scale and ability to provide round-the-clock support and reach remote patients, researchers found only short-term progress. The limited success of web-based interventions can be attributed to high attrition rates, heterogeneity in those who participated in the studies and low digital engagement, according to the findings, published in the Journal of Medical Internet Research.

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To be eligible for analysis, studies were required to supply data on randomized controlled trials. The majority of the 1,525 patients in the selected studies were female. All participants had a body mass index that qualified as overweight or obese and were between 18 and 65 years old.

Researchers used meta-analysis and qualitative analysis to track participants’ anthropometric changes and lifestyle shifts, respectively. Participants in the selected studies engaged in web-based interventions. The control groups responded to solely in-person intervention or were wait-listed, experiencing no intervention at all.

According to Andre Andrade, co-author of the study, and Senior Research Fellow in Digital Health at the University of South Australia, researchers need more guidance when it comes to a coherent body of best practices to guide intervention development.

“In the meta-analysis, we couldn’t identify which components predicted good results,” Andrade said. “Other studies suggest that theory-based interventions are more effective, but don’t point out which theory gives more effective interventions.”

Researchers are looking to solve the issues that led to lower success rates, specifically low web engagement. Private social networks, wearable activity trackers, economic and non-economic incentives, and several gamification/behavioral economics techniques are among the strategies that have been explored.

“The issue is that the evidence for any single implementation is typically very small,” Andrade said.

Another challenge is that individuals respond to catalysts differently. “We tend to treat all patients that need to lose weight as similar, but they have very different mindsets. Some patients just need a small motivational push, others require a complete environment change. Web-based interventions can help most patients, but for each need, it is a completely different solution.”

Although digital approaches have the potential to improve cost-effectiveness, Andrade cautioned that the research is not there yet. “At the moment, web-based interventions are better suited for increasing access than for saving money.”

The studies also showed a dearth of data in terms of the disadvantages of web-based interventions. More disastrous results could have included appetite disorders and muscle and bone mass reduction — all common unintended effects of obesity intervention.

Still, Andrade is optimistic. “Similar to other domains, service delivery over internet has potential of changing the entire industry.”

If done correctly, reduced cost of treatment, increased access to care, greater anonymity and the ability to save time are just a few of the possible benefits of web-based approaches to weight loss intervention.

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