Currently submitted to: JMIR mHealth and uHealth
Date Submitted: May 12, 2026
Open Peer Review Period: May 12, 2026 - Jul 7, 2026
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The impact of digital health interventions on eating behavior traits in adults with overweight or obesity: A systematic review and meta-analysis
ABSTRACT
Background:
Digital health interventions offer a scalable approach to modern weight management but their specific efficacy in modifying psychological eating behavior traits remains underexplored. Synthesizing this evidence is critical for optimizing future digital therapeutics.
Objective:
To evaluate the impact of digital health interventions on specific eating behavior traits among adults with overweight or obesity compared to standard care and to determine the influence of intervention duration and theoretical frameworks on these outcomes.
Methods:
A comprehensive literature search was conducted across six major electronic databases to identify relevant randomized controlled trials. Eligible studies included adults with elevated body mass indices and measured psychological constructs of eating behavior. Standardized mean differences were calculated using a random effects model and evidence certainty was evaluated utilizing the GRADE framework.
Results:
Fifteen unique trials comprising 1518 participants met the inclusion criteria. The pooled synthesis demonstrated that digital interventions yielded robust reductions in both emotional eating and uncontrolled binge eating supported by a moderate certainty of evidence. Subgroup analysis indicated that sustained digital engagement exceeding eight weeks is essential to achieve definitive improvements in emotional eating. The overall impact on cognitive restraint was highly variable. However this statistical inconsistency was systematically driven by underlying therapeutic frameworks where traditional cognitive behavioral therapies significantly increased restrictive behaviors while mindfulness and acceptance based approaches distinctly reduced them.
Conclusions:
Digital health platforms effectively mitigate maladaptive eating patterns particularly when user engagement is sustained beyond eight weeks. The theoretical divergence observed in cognitive restraint outcomes highlights the necessity for a precision medicine approach in digital behavioral care. Clinicians should evaluate dominant eating phenotypes prior to prescribing digital tools to ensure therapeutic algorithms match individual psychological profiles. Clinical Trial: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261285265
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