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The effect of electronic self-monitoring on weight loss and dietary intake: a randomized behavioral weight loss trial. However, small sample sizes, short follow-up periods, and the lack of intent-to-treat analyses make it difficult to make any strong conclusions. The studies completed to date help to provide insight on the potential of smartphone apps. Yet, specific treatment effects are difficult to decipher due to the differing app features, frequency of interventionist contact, and the varying levels of other included intervention components.
A recent review on mobile phone interventions to increase physical activity and weight loss by Stephens and Allen 63 suggested that these technologies are well-accepted by participants; however, more empirical evidence is needed in order to fully evaluate the efficacy of this technology on weight loss. Many of the studies published to date demonstrate the promise that smartphones and apps have for improving program adherence and producing clinically meaningful weight losses at a small cost; however, many gaps remain in the field before the full potential of smartphone use for weight loss can be evaluated.
Intervention components that are now standard in traditional weight loss programs need further investigation when delivered as a feature on a smartphone. While greater adherence has been observed in technology-supported interventions, it is still unclear as to whether increased adherence translates to greater weight loss, more sustained engagement, or long-term maintenance. In order to maintain engagement, an app must be enjoyable, have perceived value, and not be too burdensome.
Further, engagement with the app should result in successful behavior change. The optimal duration of app use for weight loss initiation or maintenance is unclear. Moreover, there remains a question as to how effective an intervention can be when the human support is removed. Further, more prospective longitudinal trials investigating the types of self-monitoring tools and how human intervention delivery impacts weight loss outcomes are needed. As an additional step, research needs to also focus on what users will be motivated to use over time to optimize the potential impact of the interventions.
Collectively, the field would greatly benefit from additional collaborations between behavioral scientists and experts in computer science and human—computer interaction.
These collaborations could help to better identify ways to enhance engagement and motivation to use an app. Numerous larger and longer term clinical trials are ongoing that may provide more evidence on the effects of smartphone-based programs on weight loss. This trial is currently underway to examine if the addition of acceptance-based behavioral treatment can help nonresponders to treatment. As human behavior is often dynamic, and weight loss involves several health behaviors, it would also be advantageous for researchers to explore the use of different behavioral theories and models.
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Dynamical system models from control systems engineering, for example, may be particularly relevant for smartphone-based weight loss interventions. Given that sensor data could be collected in-the-moment, interventions may well be delivered at the time they are most needed, providing a potentially powerful strategy to change behaviors through a smartphone.
Smartphones have the potential to deliver accessible, low-cost, and scalable smartphone-based programs to a large proportion of the population.
The dramatic increase in smartphone ownership and further advancing technological capabilities provide unprecedented opportunities to provide in-the-moment and continuous weight loss support. Smartphones and apps could be leveraged to provide scalable evidence-based behavior change to facilitate weight loss across a population level. However, while smartphone apps and complementary technologies have been rapidly developing, little is known about the optimal ways to maintain engagement and the effectiveness of behavior change techniques when delivered by this technology.
Early evidence shows promise, yet the research has difficulty keeping pace with the rapidly changing smartphone capabilities and surge of nonevidence-based weight loss apps available on the market. Additional research and methods are needed to evaluate specific aspects of smartphone-based programs in more novel, rapid, and dynamic ways. Prevalence of obesity and trends in the distribution of body mass index among US adults, — National, regional, and global trends in adult overweight and obesity prevalences.
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Analyst Pulse: Trends in Global Weight Loss Diets
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Related Trends in Weight Management 2011
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