JMIR Publications

ABSTRACT

Background:

Obesity and overweight are serious public health problems involving more than 1.9 billion and 650 million, respectively, of global population. Research indicates that internet-based weight management can more efficiently control calorie intake, alter dietary habits, facilitate regular weight monitoring, and improve emotional eating patterns, ultimately establishing healthy lifestyles to achieve weight loss.

Objective:

This study amied to evaluate the effectiveness of a mobile health technology–based lifestyle intervention for weight management among overweight or obese occupational groups. Explore factors that influence intervention outcomes. Provide scientific evidence for weight management in this population.

Methods:

From November 2024 to January 2025, 5859 overweight or obese working adults were recruited from 16 districts in Beijing, China. A three-month comprehensive lifestyle intervention was delivered via WeChat mini-programs and group chats. Generalized linear mixed models and generalized estimating equations were used to analyze the effects of the intervention on participants' weight, body fat percentage, waist circumference, hip circumference, and lifestyle behaviors. A multivariable logistic regression model was used to identify key factors that influence weight loss success.

Results:

After the intervention, 68.07% of the participants achieved weight reduction, 10.80% returned to a normal BMI (<24), and 17.05% attained weight loss of ≥5%. After adjusting for confounding factors, body weight decreased by an average of 2.2%, body fat percentage decreased by an average of 4.0%, waist circumference decreased by an average of 1.7%, and hip circumference decreased by an average of 1.5%. The proportion of participants who ate breakfast daily (OR = 1.132) and ate three meals on time (OR = 1.309) increased significantly. The proportion of participants who consumed fatty foods (OR = 0.897), fried foods (OR = 0.804), pastries and desserts (OR = 0.855), and sugary drinks (OR = 0.570) ≥4 days per week decreased significantly. The proportion of participants who exercised ≥3 times per week (OR = 1.548) and exercised ≥1 hour per session (OR = 1.388) increased significantly.The proportion of participants who sleep for at least seven hours per day (OR=1.500) increased significantly, while the proportion of people who frequently drink alcohol (OR=0.814) and who smoke daily (OR=0.772) decreased significantly. Multivariate analysis showed that women (OR=1.367), aged 35 or younger (OR=1.700), aged 36-45 (OR=1.211), baseline obesity (OR=1.384),urban residence (OR=1.155), occupation as enterprise employee (OR=1.401),  using the mini-program learning module ≥4 times per week (OR=1.252), and practicing Baduanjin ≥4 times per week (OR=1.231) were more likely to lose weight successfully.  Compared with combined diet and exercise control, no control (OR=0.383), exercise-only (OR=0.657), or diet-only approaches (OR=0.566) were associated with lower success rates.

Conclusions:

Lifestyle interventions based on mobile health technology can effectively reduce the weight and body composition of overweight/obese working adults, improve health behaviors, and have good feasibility and short-term effects.