Last week, Duke University published a study in the journal Obesity that shows neither a specially designed mobile app nor a coaching intervention that utilized a mobile app was any more effective in promoting weight loss than the control intervention (a handful of fliers from a doctor visit). The study was particularly interesting compared to other weight loss studies for a few reasons, including the use of a mobile app and length of its evaluation (over two years). Also, the study focused on 18- to 35-year-olds, a group that is often overlooked for weight loss despite the fact that weight gain is most rapid during these years and, according to studies, predicts future cardiovascular events. The authors expected this age group to see the best results given their familiarity and adoption of mobile technologies.
According to Dr. Laura Svetkey, the lead author of the study, “For some people it did work, but on average, the difference with the control group was insignificant. This doesn’t mean cell phone apps can’t work for weight control, but this one didn’t.”
We wanted to share the study along with a few comments (see below) for individuals to consider when thinking about what this means for the future of digital health.
The Study Included A Non-Commercial App
The definition of a commercial app in this context is a consumer technology that is widely available to everyone. Some most popular commercial weight loss apps today include MyFitnessPal, LoseIt!, and FatSecret. These commercial apps have millions of users on their free and premium versions, the latter of which would suggest that some people see a value in the offering. With millions of users, large budgets, and dedicated development teams, these apps focus on developing robust user experiences that keep individuals engaged. It is unlikely that the app used in and developed for this study has the same quality of user experience. This doesn’t mean the outcomes would have changed, but it is worth exploring.
Over-performance By The Control Group
Unlike most control groups that usually gain a small amount of weight during these studies, the control group in this study lost two to three pounds. With only 365 participants, duplications of this study may result in weight gain for this group and a statistically significant weight loss for app users.
Maintaining Weight Loss Is Often The Hidden Challenge
The study did find that the cohort that used in-person coaching interventions supported by app-based tracking was able to produce statistically significant weight loss at six months, but after a year, that weight loss was not sustained. This is typical with most employee wellness programs, and this study only emphasizes the challenge as a critical barrier to solving sustainable weight loss.
This study evaluating the intersection of new mobile technologies and the old problem of weight loss is incredibly interesting, and we look forward to many more like it. Employers reviewing this new information should still do the same thing we have recommended prior to its publication – stay away from weight loss challenges. First, not all employees need to lose weight and those who do will have different goals as to the amount of weight they need to lose. Second, these programs are often short-sighted and are notorious for having post-program weight gain. Last, one of the main drivers of weight loss challenges is the hope to lower population BMI, and as we all know, BMI is a poor indicator of health.