A Mobile Phone App Designed to Support Weight Loss Maintenance and Well-Being (MotiMate): Randomized Controlled Trial

Abstract

Background: Few people successfully maintain lost weight over the longer term. Mobile phones have the potential to deliver weight loss management programs that can encourage self-monitoring while also providing some behavioral therapy to assist users in developing personal skills that may be necessary for improved longer term weight loss maintenance.

Objective: The aim of this study was to evaluate a program supporting weight maintenance, which uses a behaviorally based mobile phone app to manage weight, food, exercise, mood, and stress.

Methods: In a randomized controlled trial over 24 weeks, the full version of the app (MotiMate) was compared with a control app (monitoring only; excluding mood and stress) for its effect on weight, diet, and psychological well-being. Both apps had the same visual appearance and were designed to deliver all intervention content without face-to-face contact. The control version included features to track weight, food intake, and exercise with limited feedback and no encouraging/persuasive features. The intervention app included more persuasive and interactive features to help users track their weight, food intake, and physical activity and prompted users to enter data each day through notifications and included a mood and stress workshopping tool. Participants were recruited through advertising and existing databases. Clinic visits occurred at baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks. At all visits, the clinical trial manager recorded body weight, and participants then completed a computer-delivered survey, which measured psychological and lifestyle outcomes. Objective app usage data were recorded throughout the trial.

Results: A total of 88 adults who had lost and maintained at least 5% of their body weight within the last 2 years were randomized (45 MotiMate and 43 control). Overall, 75% (66/88) were female, and 69% (61/88) completed week 24 with no differences in dropout by condition (χ²_1,87=0.7, P=.49). Mixed models suggested no significant changes in weight or psychological outcomes over 24 weeks regardless of condition. Of 61 completers, 53% (32/61) remained within 2% of their starting weight. Significant increases occurred over 24 weeks for satisfaction with life and weight loss self-efficacy regardless of app condition. Diet and physical activity behaviors did not vary by app or week. Negative binomial models indicated that those receiving the full app remained active users of the app for 46 days longer than controls (P=.02). Users of the full version of the app also reported that they felt more supported than those with the control app (P=.01).

Conclusions: Although some aspects of the intervention app such as usage and user feedback showed promise, there were few observable effects on behavioral and psychological outcomes. Future evaluation of the app should implement alternative research methods or target more specific populations to better understand the utility of the coping interface.

Trial registration: Australia New Zealand Clinical Trials Registry ACTRN12614000474651; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366120.

Keywords: body weight; happiness; lifestyle; mobile phone; mood.

Figure 1

Study protocol. Activity: physical activity; Diet: diet quality; Evaluation: evaluation questions; Psych: self-esteem, restraint, satisfaction with life; Well-being: battery of measures.

Figure 2

(A) Home screen for intervention app. (B) Mood entry interface for intervention app. (C) Food intake interface for intervention app. (D) Home screen for control app. (E) Information regarding weight tracking tool for control app. (F) Information regarding weight tracking tool for intervention group.

Figure 3

Consolidated Standards of Reporting Trial (CONSORT) participant flow diagram for trial.

Figure 4

Adjusted means for Satisfaction With Life Score (SWLS) over the study period pooled for both intervention groups. Significant comparisons: baseline to week 8 (P=.046); baseline to week 12 (P<.01); and baseline to week 24 (P=.01). Means adjusted for participants’ sex and age, neuroticism, self-esteem, and dispositional optimism.

Figure 5

(A) Number of days data were recorded by the participants. (B) Participants’ overall membership duration (the amount of time between when the user started using the app and the final time they used it).

Figure 6

Number of data entries made per person each week over the study period for exercise, food, and mood (intervention group only).

Figure 7

Adjusted means for weight loss self-efficacy (WLSE) over the study period. Significant comparisons baseline and week 8 (P=.001), week 12 (P<.01), and week 24 (P<.001).

Figure 8

Intention to use app for the next 4 weeks. Adjusted means based on mixed models, pooled across app condition. Changes from baseline to week 8 onward were all significant (all P ≤.005). min: minimum; max: maximum.