Addition Of Technology To Standard Weight Loss Plan Appears Beneficial For Greater Weight Loss

Source : JAMA and Archives Journals

CHICAGO – Use of a personal digital assistant (PDA) and telephone coaching appears to enhance short-term weight loss when used in conjunction with an existing physician-directed weight loss treatment program, according to a report posted Online First by Archives of Internal Medicine, a JAMA Network publication.

"Little is known about whether the outcome of physician-directed weight loss treatment can be improved by adding mobile technology," the authors write as background. However, "self-monitoring of diet and physical activity is associated with weight loss success and can be performed conveniently using handheld devices."

Bonnie Spring, Ph.D., with Northwestern University Feinberg School of Medicine, Chicago, and colleagues conducted a two-group 12-month study involving 69 adults from October 2007 through September 2010. Patients were randomly assigned to a standard care only treatment group (standard group) or to a standard treatment with mobile technology system (+mobile group). All patients attended biweekly weight loss groups held by Veterans Affairs outpatient clinics, and the +mobile group also received a personal digital assistant (PDA) to self-monitor diet and physical activity, and biweekly coaching calls for six months. Weight was measured at randomization, and at 3-, 6-, 9- and 12-month follow-up.

Patients assigned to the +mobile group lost an average of 3.9 kg (8.6 pounds) more than the control group at each weigh-in, and the authors found no evidence that this varied across time. Specifically, weight loss among the +mobile group was greater than weight loss in the control group at three and six months, nine months and 12 months.

More than 36 percent of participants in the +mobile group lost at least 5 percent of their initial body weight at three months, compared with 0 percent in the standard group, and this effect also did not vary significantly across time.

"In sum, this study highlights the promise of a mobile technology system as a scalable, cost-effective means to augment the effectiveness of physician-directed weight loss treatment," the authors conclude. "Technology offers new channels to reconfigure the provision of effective components of behavioral weight loss treatment (i.e., self-monitoring, goal setting, lifestyle counseling and in-person sessions)."

(Arch Intern Med. Published online December 10, 2012. doi:10.1001/jamainternmed2013.1221.)

Editor's Note: This study was supported by a VA Merit Review F442291 Rehabilitation Research and Development-funded study at Hines VA Medical Center. The development of the PDA tool used in the study was funded by a grant from the National Heart, Lung, and Blood Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Commentary: The Future of Obesity Treatment

In an accompanying commentary, Goutham Rao, M.D., and Katherine Kirley, M.D., of the University of Chicago Pritzker School of Medicine, and NorthShore University Health System, Evanston, Ill., write, "The articles by Ma et al and Spring et al represent a foundation for future work. There are still many unanswered questions. Technology changes so quickly that many tools are obsolete by the time they have been thoroughly studied."

"We need to know what specific features of technology make it successful for weight loss. Is it, for example, convenience, personalization, or interactivity? These features could be incorporated into future tools no matter what form they take," they continue.

"These and related questions are now becoming the focus of intense research. Stay tuned!" the authors conclude.

(Arch Intern Med. Published online December 10, 2012. doi:10.1001/.jamainternmed.2013.1232.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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To contact Bonnie Spring, Ph.D., call Marla Paul at 312-503-8928 or email marla-paul@northwestern.edu. To contact commentary corresponding author Goutham Rao, M.D., call Andy Buchanan at 847-570-5732 or email abuchanan@northshore.org.

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