Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 8, 2022
Date Accepted: Jul 18, 2022
The sustainability of weight loss through smartphone apps: A systematic review and meta-analysis on anthropometric, metabolic, and dietary outcomes
ABSTRACT
Background:
Evidence on the long-term effects of weight management smartphone apps on various outcomes remains scarce.
Objective:
We aimed to examine the effects of smartphone apps on anthropometric, metabolic, and dietary outcomes at various time points.
Methods:
We searched for articles published from the database inception through 10 March 2022 from seven databases (Embase, CINAHL, PubMed, PsycINFO, The Cochrane Library, Scopus, Web of Science) using forward and backward citation tracking. All randomized controlled trials (RCTs) of weight management smartphone apps on weight loss in healthy adults with a high body mass index (BMI) or classified as living with overweight or obesity were included. We performed separate meta-analyses using random-effects models for weight, waist circumference, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood glucose level, blood pressure and total energy intake per day. Methodological quality was assessed using the Cochrane risk of bias tool. This study was registered with PROSPERO (Ref: CRD42022329197).
Results:
Based on our meta-analyses, weight loss was sustained between 3 to 12 months, with a peak of -2.18kg at 3 months that tapered down with time to -1.63 at 12 months. Both our narrative synthesis and meta-analysis did not show the benefits of weight loss on the secondary outcomes except for a slight improvement in systolic blood pressure at 3 months. Most of the included studies included app-based interventions beyond purely food logging including real-time self-monitoring of diet and exercise, personalised and remote progress tracking, timely feedback, smart devices that synchronized activity and weight data to smartphones and libraries of dietary and physical activity ideas.
Conclusions:
Smartphone weight loss apps are effective in initiating and sustaining weight loss between 3 to 12 months, but effects are minimal at the current state. Future studies could consider including more influencing factors of weight management at every level of the socio-ecological model. Interactive components that simulate health coaches could also be useful to enhance user engagement and outcome effectiveness. Clinical Trial: NA
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