Do weight loss apps work? Actually, experts can’t answer that question yet, since there haven’t been any official tests. But a new study did assess how many evidence-based behavioral practices are incorporated into the most popular apps.
In a study published in The American Journal of Preventive Medicine this month, researchers examined 30 popular mobile apps including Livestrong, FitBit and MyFitnessPal. They looked for the 20 evidence-based behavioral strategies for weight management outlined in the Centers for Disease Control’s Diabetes Prevention Program.
“For all we know, apps as they are might be really effective.”
Researchers found that the top two apps included 13 of the strategies, like calorie or exercise goals, portion control and problem solving; the rest included five or fewer.
Since experts don’t yet know what constitutes an “effective” app, they can’t say whether it is a good or bad thing that some apps included only a few evidence-based strategies.
Might be good tools for some
“For all we know, apps as they are might be really effective,” lead author Sherry Pagoto told HealtBiz Decoded. “I certainly know plenty of people who’ve lost weight using them without any other programs or services.”
Pagoto, a behavioral psychologist, is also co-founder the UMass Center for mHealth-Based Behavioral Sensing and Interventions.
“These apps are a tool, but not the only tool, for helping people lose a clinically significant amount of weight.”
Apps with all 20 behavioral strategies might not work any better than those with only a few, Pagoto said. She didn’t see much (if anything) that seemed like it didn’t make sense as a weight loss strategy in the apps, she said.
“Most of the apps that are out right now are, in effect, trackers. They’re no different from a person writing down what they eat and how they exercise on a paper record,” said Gary Bennet, director of the Duke Obesity Prevention Program.
“They don’t do skills training, provide feedback, prescribe the right kind of caloric deficits, and some of them don’t even have basic safety precautions,” he said.
Pagoto believes the apps could be good tools for people who are already motivated to lose weight, and will use the app consistently.
“Low adherence, lower motivation people need a different type of help,” she observed. “That’s where I think the apps aren’t going to be as useful.”
“Consumers really need to understand that these apps are a tool, but not the only tool, for helping people lose a clinically significant amount of weight,” Bennett said.
Docs reluctant to recommend
Pagoto points out that patients tend to encounter these apps on social networks and on the Internet more than in the doctors office. But it might be useful for physicians to act as guides and help patient pick apps that aren’t “nonsense.”
“There are a lot of nonsense ones out there, although we didn’t choose to focus on those for our study,” she said.
“The commercial market would really benefit from data at this point.”
But physicians themselves need guidance on which apps work and which don’t, a question her study sets the stage to investigate.
“We thought this study would be a good way to inform app developers and also doctors who tend to be hesitant to recommend these apps because they don’t know what they’re recommending,” Pagoto said.
Industry moves faster than academia
“What we don’t have right now are clinical trials testing the efficacy of these apps,” Bennett said.
The National Institutes of Health have resisted getting into it, but government funding and developer sponsorship could fuel that type of research.
“The commercial market would really benefit from data at this point,” he said.
Research groups, like Pagoto’s and Bennett’s, are working to build evidence-based tools for developers that will help them build effective apps.
The not too distant future
“Fifty million people have downloaded these apps, and the top apps have very large user bases of very happy people, but we just don’t know yet whether or not they actually help people lose weight,” Bennett said.
That could change very soon, in the next few months or years, he said.
“With more partnerships we could easily get the science out of academic journals and into some of these apps.”
“The digital health space is tremendously exciting right now, especially in obesity,” he said. “All of the things that we think are necessary for patients to lose weight could be easily integrated into the next generation of digital health.”
Those include more sophisticated feedback, links to resources, coaching, and integrating apps with electronic health records, he said.
“Really what we need are more partnerships between the science community and developers to make that happen,” he said. “With more partnerships we could easily get the science out of academic journals and into some of these apps.”