A digital health weight-loss intervention in severe obesity

Abstract

Introduction: Severe obesity is a growing epidemic that causes significant morbidity and mortality, and is particularly difficult to reverse. Efficacious and cost-effective interventions are needed to combat this epidemic. This study hypothesized that obese people (body mass index (BMI) ≥35 kg/m²) using a remote weight-loss program combining a mobile application, wireless scales, and low-calorie meal replacement would experience clinically significant weight loss.

Methods: This study was a retrospective observational analysis of 8275 individuals with a baseline BMI ≥35 kg/m² who used a remote weight-loss program combining mobile applications, frequent self-weighing, and calorie restriction via meal replacement for a minimum of 35 days. Weight changes were evaluated at multiple intervals (42, 60, 90, and 120 days), and weight loss was evaluated for all and for pre-specified subgroups based on demographic features and frequency of self-weighing.

Results: Mean weight loss at 42 days (N = 6781) was 8.1 kg (margin of error (MOE) = 0.126 kg) with 73.6% of users experiencing >5% total body weight loss. Both men (9.1 kg; MOE = 0.172 kg; 7.9% from baseline) and women (7.1 kg; MOE = 0.179 kg; 7.2% from baseline) experienced significant weight loss. At the 120-day interval (N = 2914), mean weight loss was 14 kg (MOE = 0.340 kg), 13% total body weight loss from baseline, and 82.3% of participants had lost >5% of their initial body weight. The decrease in body-fat percent correlated well with weight loss (R = 0.92; p < 0.001).

Conclusions: In a large cohort of individuals with class II or III obesity, a remote weight-loss program combining mobile applications, daily self-weighing, and calorie restriction via meal replacement resulted in dramatic weight loss among subjects who were active users when evaluated through a retrospective observational analysis.

Keywords: Digital health; mobile application; severe obesity; weight loss; wireless scales.

Figure 1.

Screenshots of the MetaWell mobile application. (a) Home screen of application. (b) Weighing screen, shown as users are positioned on the scale. (c )Health summary screen, providing measurement data of current session. (d) Record of weight change over time for an individual user.

Figure 2.

Percentage of total body weight loss (% TWL) displayed as lines, and percentage of body fat loss (% BFL) displayed as bars, among application users classified by sex, age, frequency of application use, and baseline body mass index.