Today I’m returning to the topic of ‘telehealth’, with the latest evidence on how computers may help people who are struggling with their weight.
A new Cochrane review, published this week, looks at the evidence for the effectiveness of interactive computer programmes in helping overweight or obese people lose weight and to help maintain weight loss. After the usual systematic searches, 14 weight loss studies involving 2537 adults were included and four weight maintenance studies with 1603 adults. 17 were randomised controlled trials and one a quasi-randomised controlled trial. Interactive computer-based treatment was compared with no intervention or minimal interventions (pamphlets, ‘usual care’) and with in-person interventions. Treatment lasted between four weeks and 30 months. Here’s what they found:
- At six months computer-based interventions led to more weight loss than minimal interventions (mean difference (MD) -1.5 kg; 95% confidence interval (CI) -2.1 to 0.9; 2 trials) but less than in-person treatment (MD 2.1 kg; 95% CI 0.8 to 3.4; 1 trial)
- At six months, computer-base interventions were better than a minimal intervention in limiting weight regain (MD -0.7 kg; 95% CI -1.2 to -0.2; 2 trials) but less effective than infrequent in-person interventions (MD 0.5 kg; 95% CI -0.5 to 1.6)
- No differences in diet or exercise between groups in either weight loss or weight maintenance trials
- No data available of adverse effects or health-related quality of life
- The overall quality of the studies ranged between ‘moderate’ and ‘low’
The authors concluded:
Compared to no intervention or minimal interventions…interactive computer-based interventions are an effective intervention for weight loss and weight maintenance. Compared to in-person interventions interactive computer-based interventions result in smaller weight losses and lower levels of weight maintenance. The amount of additional weight loss, however, is relatively small and of brief duration, making the clinical significance of these differences unclear.
One of the strengths of Cochrane reviews is that their authors undertake to update them, searching for new studies and incorporating new data into the review. The authors of this review note that, whilst they are not aware of any randomised trials of interactive weight loss programs on smartphones, as smartphones now have the capacity to function as fully mobile computers they plan to search for and include trials of smartphones for the update of this review.
Wieland LS, Falzon L, Sciamanna CN, Trudeau KJ, Brodney S, Schwartz JE, Davidson KW. Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD007675. DOI: 10.1002/14651858.CD007675.pub2
Cochrane summary of this review.