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. 2024 Oct 16:12:100133.
doi: 10.1016/j.obpill.2024.100133. eCollection 2024 Dec.

Efficacy of in-person versus digital enhanced lifestyle interventions in adults with overweight and obesity

Diego Anazco  1 , Maria A Espinosa  1 , Lizeth Cifuentes  1 , Blake Kassmeyer  2 , Tara M Schmidt  3 , Sima Fansa  1 , Alejandro Campos  1 , Elif Tama  1   4 , William S Harmsen  2 , Maria D Hurtado  1   4 , Donald D Hensrud  1   5 , Andres Acosta  1
Affiliations

Efficacy of in-person versus digital enhanced lifestyle interventions in adults with overweight and obesity

Diego Anazco et al. Obes Pillars. .

Abstract

Background: Lifestyle interventions (LIs) are the cornerstone for obesity management. The Mayo Clinic Diet (MCD) offers two approaches for LIs: the In-Person LI (IPLI) and the Digital Enhanced LI (DELI). The IPLI includes a 2-day in-person program with monthly follow-ups, whereas the DELI provides on-demand digital tools. The comparative efficacy of these approaches is currently unknown.

Methods: This retrospective study included two cohorts of adults with a body mass index (BMI) of ≥25 kg/m2 and weight metrics at least 3 months after starting either the IPLI or DELI program. The primary endpoint was the total body weight loss percentage (TBWL%) at 6 months.

Results: The study included 133 participants in the IPLI cohort (mean age 46.3 years, 65.4 % female, BMI 36.4) and 9603 in the DELI cohort (mean age 60.1 years, 85.0 % female, BMI 33.1). The DELI group achieved superior TBWL% at 1, 3, and 6 months compared to the IPLI group (3.4 % vs. 1.5 %, 4.7 % vs. 2.4 %, 5.3 % vs. 2.9 %, respectively; p < 0.001). After adjusting for age, gender, and starting weight, the DELI group maintained a higher TBWL% (difference 2.0 %; 95 % CI [1.0, 3.0], p < 0.001) and a greater proportion of participants achieved >5 % TBWL at 6 months (OR 1.66; 95 % CI [1.08, 2.55], p < 0.023).

Conclusion: The DELI approach resulted in superior weight loss outcomes compared to the IPLI. Further research is needed to explore how digital tools can improve weight loss effectiveness.

Keywords: Electronic health; Lifestyle interventions; Mobile health; Obesity.

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Conflict of interest statement

Dr. Acosta is supported by NIH (NIH K23-DK114460). Dr Andres Acosta, and Mayo Clinic hold equity in Phenomix Sciences Inc. and are inventors of intellectual property licensed to Phenomix Sciences Inc. Dr Andres Acosta served as a consultant for Rhythm Pharmaceuticals, General Mills, Amgen, Bausch Health, RareStone; has contracts with Vivus Inc, Satiogen Pharmaceutical, and Rhythm Pharmaceutical.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Participant flowchart.
Fig. 2
Fig. 2
TBWL% outcomes at 1-, 3-, and 6- months. ∗∗∗: p ​< ​0.001 TBWL%: Total Body Weight Loss Percentage. IPLI: In-Person Lifestyle Intervention. DELI: Digitally Enhanced Lifestyle Intervention.
Fig. 3
Fig. 3
Categorical weight loss >5 % ∗∗: p ​< ​0.01; ∗∗∗: p ​< ​0.001.
Fig. 4
Fig. 4
Categorical weight loss >10 % ∗: p ​< ​0.05.
See this image and copyright information in PMC

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