Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 18, 2025
Date Accepted: Dec 2, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Implementation of a WeChat mini-program-driven lifestyle intervention among overweight or obese individuals with metabolic dysfunction-associated fatty liver disease
ABSTRACT
Background:
Weight loss is the standard recommendation for patients with metabolic dysfunction-associated fatty liver disease (MAFLD), but its successful implementation is difficult in practice. Digital lifestyle interventions may provide an efficient and scalable solution to enhance patient self-management.
Objective:
This study aimed to assess the effects of a WeChat mini-program-delivered lifestyle intervention on weight loss and hepatic steatosis among overweight or obese individuals with MAFLD
Methods:
Overweight or obese adults with clinically diagnosed MAFLD with transient elastography examination were enrolled in this prospective randomized controlled trial. Patients were randomly assigned to receive either WeChat mini-program management (intervention group) or standard care (control group) at a 1:1 ratio. Body weight and clinical parameters were assessed at baseline and then at 6 months.
Results:
Among the 89 included MAFLD patients, 60.0% achieved ≥5% weight loss, and 24.4% had ≥10% weight loss in the intervention group, which were greater than those in the control group (P <0.05). Importantly, patients receiving the intervention were significantly more likely to achieve a ≥10% controlled attenuation parameter （CAP）reduction or CAP normalization than those in the control group were (57.8% vs. 31.8%, P <0.05). In parallel, the intervention group presented greater reductions in liver enzymes (ALT, AST, and GGT) and metabolic parameters (fasting insulin, HbA1c, TG, and HDL-C) than the control group (P <0.05). According to the fibrosis assessment, only the FibroScan-aspartate aminotransferase (FAST) score decreased more in the intervention group than in the control group (P <0.05). No significant difference was found in the liver stiffness measurement (LSM) values or noninvasive scores (APRI, FIB-4, NFS, and Agile 3+) between the groups (P>0.05).
Conclusions:
Digital lifestyle coaching via a WeChat mini-program demonstrates efficacy in enhancing weight reduction, improving hepatic steatosis, and ameliorating metabolic disorders, offering novel perspectives regarding the practicality and therapeutic value of digital tools in managing MAFLD through behavioral interventions. Clinical Trial: Chinese Clinical Trial Registry ChiCTR2500100197; https://www.chictr.org.cn/
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