Phone app boosts weight loss among low-income patients
A free phone app helped a low-income, obese patient population achieve clinically meaningful weight loss, researchers from Duke University reported in the American Journal of Preventive Medicine.
Gary G. Bennett, PhD, and colleagues randomized 351 patients 1:1 to either usual care or the 12-month app-based intervention, which included behavior change goals with tailored feedback, a smart scale for daily weighing, 18 coaching calls with a dietitian and counseling with a primary care provider during check-up visits. The patients had a mean body mass index of 35.9 at baseline and 67 percent of them reported a combined annual household income below $35,000.
Compared to those receiving usual care, people randomized to the intervention group lost 9.7 more pounds at six months and 8.4 more pounds at one year of follow-up. Forty-three percent of participants in the latter group lost at least 5 percent of their body weight in the first six months of the intervention, compared to 6 percent of patients in the normal care group.
"Obesity continues to wreak havoc on the health of our country and we've had the most difficulty treating low-income Americans, those who are most affected by the condition," Bennett said in a press release. "This study shows we can help patients who are most at risk by embedding treatment in primary care settings and keeping patients engaged using a simple app."
The app, called Track, uses an algorithm to produce monthly behavior change goals, such as avoiding fast food and sugar-sweetened beverages or eating five servings of fruits or vegetables per day.
Bennett et al. speculated the high rate of patient retention—96 percent of intervention participants completed the 12-month study—was due to the continuous feedback of the app as well as the personal touch of clinicians checking in, which may have boosted the patients’ feelings of accountability.
“These findings demonstrate that clinically meaningful weight loss can be achieved among patients in medically vulnerable circumstances and with heightened cardiovascular risk— a group in which such outcomes have been rarely demonstrated,” the researchers wrote. “With rapidly increasing uptake of digital technologies, these approaches might have beneficial health impacts for patients, including those who have been historically challenging for the health system to reach and treat.”