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Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.
Metzendorf MI, Wieland LS, Richter B (2024)
Cochrane - DOI: 10.1002/14651858.CD013591.pub2.
Evidence Categories
Care setting: Community setting
Care setting: Workplace setting
Care setting: Primary care
Population group: Adults living with overweight and obesity
"To assess the effects of integrated smartphone applications for adolescents and adults with overweight or obesity."
Findings
The authors state:
"We included 18 studies with 2703 participants. Interventions lasted from 2 to 24 months. The mean BMI in adults ranged from 27 to 50."
"Ten studies measured dietary behaviour, using different questionnaires and measurements. The most common outcomes were energy intake in kilocalories/day used in five studies, and fruit and vegetable servings/day used in three studies."
"Thirteen studies compared a smartphone app versus no or minimal intervention in adults"
"The comparator comprised minimal health advice, handouts, food diaries, smartphone apps unrelated to weight loss, and waiting list."
"A smartphone app intervention resulted in an MD of 0.04 (95% CI −1.0 to 1.1; 1 study, 23 participants; Analysis 1.6.1; Kliemann 2019) and an MD of 0.8 (95% CI 0.6 to 1.1; 1 study, 127 participants; Analysis 1.6.1; Wilson 2023) in servings per day at short-term followup of three to four months. Both studies had an overall high risk of bias, and one study was conducted on airline pilots."
"A smartphone app intervention resulted in an MD decrease of 14.3 kcal/day (95% CI −127.8 to 99.1; 1 study, 650 participants; Analysis 1.7.1; EVIDENT3 2022), an MD decrease of 77.1 kcal/day (95% CI −259.6 to 105.4; 1 study, 52 participants; Analysis 1.7.1; Hurkmans 2018) and an MD increase of 46.5 kcal/day (95% CI −115.9 to 208.9; 1 study, 140 participants; Analysis 1.7.1; Nakata 2022) at short-term follow-up of three months. Two studies were at high overall risk of bias."
"A smartphone app compared with no or minimal intervention probably resulted in little to no difference in energy intake (MD −72.4 kcal/day, 95% CI −203.0 to 58.2; 1 study; 650 participants; moderate-certainty evidence; Analysis 1.7.2) at 12 months' followup."
"Two studies compared different versions of the same app in adults, showing no or minimal differences in outcomes."
"Only one study compared a smartphone app with personal coaching in adults, presenting data at three months."
"Compared to a personal coaching intervention, a smartphone app intervention resulted in a higher energy intake at short-term followup of three months (MD 200.5 kcal/day, 95% CI 57.6 to 343.4; 1 study, 58 participants; Analysis 2.4), based on one study with an overall high risk of bias and a high SD in both groups (Hurkmans 2018)."
Conclusions
The authors state:
"The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Evidence is also scarce for low- and middle-income countries as well as for people with different socio-economic and cultural backgrounds. The 34 ongoing studies suggest sustained interest in the topic, with new evidence expected to emerge within the next two years. In practice, clinicians and healthcare practitioners should carefully consider the potential benefits, limitations, and evolving research when recommending smartphone apps to adolescents and adults with overweight or obesity."
