Weight loss apps are new, so features that promote adherence and have the greatest effect are still being discovered.
For people with type 2 diabetes, weight control can correlate with disease management. Studies have found associations between weight loss and lower doses of insulin and fewer diabetes complications. One study found that remission of diabetes could be obtained by a ten-pound weight loss in newly diagnosed individuals. Managing weight can be difficult, especially for people with obesity, so newer ways to assist in weight management are needed. Many people with T2DM are not educated on weight-loss strategies and are unaware of the resources available to them. Mobile applications can provide a convenient resource and help change behavior and habits that lead to weight loss. The purpose of this study was to identify the weight loss effects that mobile apps can provide for people who have diabetes.
This meta-analysis featured a search for studies on mobile apps and type 2 diabetes. The inclusion criteria for a study to be considered were: (1) enroll participants with type 2 diabetes aged ≥ 18 years; (2) employ interventions that used mobile apps as the primary component; (3) compare with controls that received usual care but without mobile app interventions; (4) report any of the following outcomes: body weight (BW), body mass index (BMI), waist circumference (WC), fat mass, or body fat; (5) be randomized controlled trials (RCTs); and (6) get published in English. Studies were excluded if they enrolled participants with type 1 diabetes, did not report outcomes on weight loss or were reviews or meta-analyses. Studies were also excluded if mobile apps were simply used for communication between patients and health care providers.
This study included 14 randomized controlled trials (RCTs) that included 2,129 patients with type 2 diabetes. The focus of the RCTs was on body weight, body mass index, waist circumference, fat mass, and percentage of body fat. The mean age and BMI were 58.4 years and 30, respectively. The duration of use ranged from 3 to 12 months. Heterogeneity was assessed by the I2 test, with its value > 50% indicating substantial heterogeneity. Subgroup and meta-regression analyses were conducted to sort out potential sources of heterogeneity, which included age, BMI, HbA1c, and disease duration of type 2 diabetes at baseline, sex, study location, intervention duration, and mobile app functionalities.
The results of the study were broken down by the primary outcome of the RCT. Although nine trials focused on body weight, only two favored mobile app interventions. Mobile apps were associated with a reduction of body weight by 0.84 kg. Subgroup analysis found more significant reductions in body weight in people with obesity >30 BMI (p=0.001). When combined with behavioral interventions, mobile apps yielded more significant BMI reductions (p=0.08) results.
Nine trials focused on BMI reductions and found that mobile apps had nonsignificant effects in reducing BMI (−0.08, 95% CI: −0.41 to 0.25). No key patient characteristics played a role in the results. Five RCTs focused on losses of waist circumference. Results showed that mobile app interventions decreased WC by 1.35 cm (95% CI: 2.16 to 0.55 cm). Subgroup analysis found a more significant reduction in waist circumference in patients with obesity or in studies that combined mobile app and behavioral interventions.
Fat mass and percentage of body fat only had one trial, in which each was measured using bioelectrical impedance analysis. This study showed that mobile app interventions decreased fat mass by 0.4 kg and lowered the percentage of body fat by 0.6%.
The results of this meta-analysis suggest mobile app interventions are associated with significant reductions in body weight by 0.84 kg and waist circumference by 1.40 cm but merely with a nonsignificant decrease in BMI by 0.08. Reductions were more significant in patients with obesity and in studies where behavioral interventions were also included. The functionalities of the mobile app, such as exercise/physical activity, diet, weight, or glucose recording/monitoring, did not have significant effects on the results. Future studies should include a follow–up period to identify strategies that maintain weight loss and prevent weight regain. Dropout rates were less than 20%, so mobile apps proved to be attractive and attainable. Functionalities that contribute to weight loss and adherence need to be identified so future apps can focus on those factors that contribute to greater weight control.
- Mobile apps can contribute to reductions in weight loss and waist circumference in people with obesity.
- When combined with behavioral interventions, mobile apps showed more significant effects in reducing body weight.
- More research is needed to identify the features of the apps that yield more significant results.
Cai, Xue, et al. “Mobile Application Interventions and Weight Loss in Type 2 Diabetes: A Meta‐Analysis.” Obesity, Blackwell Publishing Inc., Jan. 2020, p. oby.22715, doi:10.1002/oby.22715.
Losing Weight Following Type 2 Diabetes Diagnosis Boosts Chance of Remission. 21 Nov. 2019, doi:10.3310/signal-000841.
Pagoto, Sherry, et al. “Evidence-Based Strategies in Weight-Loss Mobile Apps.” American Journal of Preventive Medicine, vol. 45, no. 5, Elsevier, Nov. 2013, pp. 576–82, doi:10.1016/j.amepre.2013.04.025.
Antonio Bess, Pharm D Candidate, Florida A&M University