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Effectiveness of mobile electronic devices in weight loss among overweight and obese populations: a systematic review and meta-analysis

Background: Mobile electronic devices, such as mobile phones and PDAs, have emerged as potentially useful tools in the facilitation and maintenance of weight loss. While RCTs have demonstrated a positive impact of mobile interventions, the extent to which mobile electronic devices are more effective than usual care methods is still being debated.

Results: Electronic databases were systematically searched for RCTs evaluating the effectiveness of mobile electronic device interventions among overweight and obese adults. Weighted mean difference for change in body weight was the primary outcome. The search strategy yielded 559 citations and of the 108 potentially relevant studies, six met the criteria. A total of 632 participants were included in the six studies reporting a mean change in body weight. Using a random-effects model, the WMD for the effect of using mobile electronic devices on reduction in body weight was ?1.09 kg (95% CI ?2.12, ?0.05). When stratified by the type of mobile electronic device used, it suggests that interventions using mobile phones were effective at achieving weight loss, WMD = ?1.78 kg (95%CI ?2.92, ?0.63).

Conclusions: This systematic review and meta-analysis suggests that mobile electronic devices have the potential to facilitate weight loss in overweight and obese populations, but further work is needed to understand if these interventions have sustained benefit and how we can make these mHealth tools most effective on a large scale. As the field of healthcare increasingly utilizes novel mobile technologies, the focus must not be on any one specific device but on the best possible use of these tools to measure and understand behavior. As mobile electronic devices continue to increase in popularity and the associated technology continues to advance, the potential for the use of mobile devices in global healthcare is enormous. More RCTs with larger sample sizes need to be conducted to look at the cost-effectiveness, technical and financial feasibility of adapting such mHealth interventions in a real clinical setting.

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Alex’s Notes: About a month ago we learned that smartphone apps could represent a novel and feasible dietary self-monitoring method for individuals looking to lose weight. But this is not the only trial to examine the effectiveness of our smartphones or PDAs to promote “mHealth” – the overarching term used to describe the practice of medicine and public health with the support of mobile devices. The current meta-analysis conducted a search of all randomized controlled trials through May of 2014 to examine the relationship mobile devices have in promoting weight loss in overweight adults.

No doubt this research field is new, as only six RCTs were included for review. The studies’ sample sizes ranged from 65 to 174 people, the durations from 1-24 months, and the age from 38-53 years. Three trials used text messaging via mobile phones as the intervention and were compared to a control group who were given printed material, two trials used PDAs and were compared to control groups who kept a paper diary, and one trial used a weight loss application on a smartphone and was compared to a control group who kept a paper diary. There was no evidence of publication bias.

A total of 612 persons were included in the meta-analysis, and every study showed weight-loss as a result of the mobile device intervention, although the magnitude was highly variable. Nonetheless, the average weight loss was 1.09 kg (2.4 lbs), and there were no differences between studies lasting longer than six months to those of shorter duration. However, the type of mobile device was a significant player. Mobile phones were significantly more effective than PDAs, and one study that found a significant weight loss benefit with the use of a smartphone app compared to other studies that merely used text messaging reminders. When this study was removed from the analysis, the results were significantly attenuated, suggesting that smartphones apps are a power-player in the mHealth field.

Now, it must be mentioned that the population of interest for this study was healthy participants, ruling out the opportunity to address those populations with chronic diseases associated with obesity such diabetes and cardiovascular conditions. Nonetheless, this small meta-analysis does support the notion that smartphone’s and their apps can effectively assist in weight loss. Whether this is due to nutritional advice or adherence remains to be seen.

 
 

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