Integrating Technology Into Standard Weight Loss Treatment：A Randomized Controlled TrialFREEONLINE FIRST

Bonnie Spring, PhD; Jennifer M. Duncan, PsyD; E. Amy Janke, PhD; Andrea T. Kozak, PhD; H. Gene McFadden, BA; Andrew DeMott, BA; Alex Pictor, BA; Leonard H. Epstein, PhD; Juned Siddique, PhD; Christine A. Pellegrini, PhD; Joanna Buscemi, PhD; Donald Hedeker, PhD

Arch Intern Med. 2012;():1-7. doi:10.1001/jamainternmed.2013.1221.

ABSTRACT

Background  A challenge in intensive obesity treatment is making care scalable. Little is known about whether the outcome of physician-directed weight loss treatment can be improved by adding mobile technology.

Methods  We conducted a 2-arm, 12-month study (October 1, 2007, through September 31, 2010). Seventy adults (body mass index >25 and ≤40 [calculated as weight in kilograms divided by height in meters squared]) were randomly assigned either to standard-of-care group treatment alone (standard group) or to the standard and connective mobile technology system (+mobile group). Participants attended biweekly weight loss groups held by the Veterans Affairs outpatient clinic. The +mobile group was provided personal digital assistants to self-monitor diet and physical activity; they also received biweekly coaching calls for 6 months. Weight was measured at baseline and at 3-, 6-, 9-, and 12-month follow-up.

Results  Sixty-nine adults received intervention (mean age, 57.7 years; 85.5% were men). A longitudinal intent-to-treat analysis indicated that the +mobile group lost a mean of 3.9 kg more (representing 3.1% more weight loss relative to the control group; 95% CI, 2.2-5.5 kg) than the standard group at each postbaseline time point. Compared with the standard group, the +mobile group had significantly greater odds of having lost 5% or more of their baseline weight at each postbaseline time point (odds ratio, 6.5; 95% CI, 2.5-18.6).

Conclusions  The addition of a personal digital assistant and telephone coaching can enhance short-term weight loss in combination with an existing system of care. Mobile connective technology holds promise as a scalable mechanism for augmenting the effect of physician-directed weight loss treatment.