Previously submitted to: JMIR Formative Research (no longer under consideration since Dec 22, 2019)
Date Submitted: Jul 1, 2019
Open Peer Review Period: Jul 5, 2019 - Aug 30, 2019
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Does the higher goal weight, the more weight you lose? Focusing on a short-term mobile diet program: an observational cohort study
ABSTRACT
Background:
Obesity rates are rising worldwide, and represent a major healthcare challenge. Digital therapies, using technological aids, have emerged as a new approach to this global health challenge. The majority of digital therapy tools for combatting obesity include contents based on behavior therapy. However, guidelines for setting the goal weight for individual patients, which is the first step in the behavioral transformation, have yet to be established. Hence, with users of digital therapies, little is known of changes in outcome in relation to goal weight, usage, and dietary patterns, as these have not been studied in detail.
Objective:
The purpose of this study was 1) to investigate the association between goal weight and weight loss in relation to baseline BMI, and 2) to identify the relationship between goal weight and usage patterns of digital therapies for obesity in relation to baseline BMI.
Methods:
The analyses were based on data obtained from Noom users who enrolled in the coaching program between January 2017 and January 2019. A total of 3,098 users aged between 18 and 65 were selected, based on the criteria of having a BMI ≥ 23 (kg/m^2) and being a continuous user. Based on the BMI criteria defined by the WHO for the Asia-Pacific region, and goal weight, we hierarchically classified users into three BMI groups (Pre-obese, Obese class I, Obese class II), with each BMI group classified into three-goal weight subgroups (Goal weight: <5%, 5-10%, >10%). We performed a t-test and an ANOVA to compare weight loss, usage, and dietary pattern within BMI groups and goal weight groups.
Results:
3,098 participants paid coaching program between January 1, 2017, and January 1, 2019, were included in the analysis. 1,892, 1,513, 503 participants were classified in pre-obese, Obese class I, Obese class II. Average weight loss according to goal weight was significantly different only within obese class I (P<0.01). 6.9 % of users in the obese class I changed their weight to normal weight (n=105). On the other hand, obsess class II rarely lose weight to under two-level stage (n=1). In usage pattern, the number of sent and received message was, was significantly different (P<.001) within obese class 1, number of steps was not a significant difference in all BMI groups according to goal weight. In the dietary pattern, there was a significant difference in skipping rate, intake calories, food types, the number of eating high calories-density food in obese class I and II, (P<.05 All variables).
Conclusions:
This study found that weight loss depending on goal weight was different in obese class I using digital therapeutics; also demonstrated the goal weight was more related to the dietary pattern than usage pattern of the mobile application for body weight management.
Citation
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