Study finds technology alone is not enough to help obese patients meaningfully lose weight

New research from Northwestern Medicine shows that technology alone cannot replace human touch to produce meaningful weight loss in obesity treatment.

Providing people with technology alone in the early stages of obesity treatment results in unacceptably worse weight loss than providing treatment that combines technology and a human coach. ”

Bonnie Spring, corresponding study author, director of the Center for Behavior and Health, and professor of preventive medicine at Northwestern University Feinberg School of Medicine

As the ongoing obesity epidemic exacerbates rising healthcare costs, the need for technology-enabled low-cost yet effective obesity treatments has become urgent.

However, Spring said current technology is not advanced enough to replace human coaches.

The new SMART study finds that people who initially received technology alone without the support of a coach were more likely to see significant weight loss, thought to be at least 5% of their body weight, compared to those who initially had a human coach. was low.

Researchers quickly intensified treatment (adding resources after just two weeks) if a person had not reached optimal weight loss, but found that weight loss for those who began their weight loss efforts without the support of a coach The study showed that the disadvantages lasted for 6 months.

The study is scheduled to be published on May 14th. Japan Automobile Manufacturers Association.

Eventually, Spring said, more advanced technology may be able to replace human coaches.

“At this stage, the average person still needs a human coach to achieve clinically meaningful weight loss goals because the technology is not yet fully developed,” Spring said. . “AI chat bots that can replace humans may not be far away, but we're not there yet. They're within reach. This technology is evolving very rapidly.”

Previous research has shown that mobile health tools for tracking diet, exercise, and weight increase participation in behavioral obesity treatment. Until this new study, it was not clear whether clinically acceptable weight loss could be achieved without the support of a human coach.

Scientists are currently trying to analyze what human coaches do to lead to success and how AI can better mimic humans, not only in content but also in emotional tone and context awareness. , said Spring.

amazing results

“We predicted that initiating treatment with technology alone would save money and reduce burden without compromising clinically beneficial weight loss, because once insufficient weight loss is detected, , because the addition of treatments happens very quickly,” Spring said. “But that hypothesis has been disproved.”

Although pharmacological and surgical interventions are available for obesity, they have some drawbacks. “They are very expensive, have medical risks and side effects, and are not equitably accessible,” Spring said. She noted that most people who start taking a GLP-1 agonist stop taking the drug within a year, against medical advice.

Many people can achieve clinically meaningful weight loss without anti-obesity drugs, bariatric surgery or even behavioral therapy, Spring said. In the SMART study, 25% of those who started treatment with technology alone achieved a weight loss of 5% after 6 months without doing anything. Treatment Augmentation. (In fact, he had to retrieve the research technology after three months for the team to recycle into new participants.)

An unresolved issue in obesity treatment is matching the type and intensity of treatment to individual needs and preferences. “Knowing in advance who needs which treatments and at what intensity could help us manage the obesity epidemic,” Spring said.

Research structure

The SMART Weight Loss Management study is a randomized controlled trial comparing two different stepped care treatment approaches for adult obesity. Stepped care provides a way to distribute treatment resources to more people who need treatment. Treatments that use the least amount of resources and benefit some people are offered first. Treatment is then intensified only for patients with inadequate response. Half of the participants in the SMART study began weight loss treatment using technology alone. The other half started with gold standard treatment, which included both technology and a human coach.

The technology used in the SMART trial was a wireless feedback system (integrated app, Wi-Fi scale, Fitbit) that participants used to track and receive feedback about their diet, activity, and weight.

Four hundred obese adults aged 18 to 60 years were randomly assigned to begin 3 months of stepped care behavioral obesity treatment, beginning with either a wireless feedback system (WFS) alone or WFS plus telehealth coaching. He measured weight loss after 2, 4, and 8 weeks of treatment and intensified treatment at the first sign of suboptimal weight loss (less than 0.5 pounds per week).

Treatment for both groups began using the same WFS tracking technology, but the standard of care sent participants' digital data to coaches, who used it to provide behavioral coaching via telehealth. Patients who had suboptimal weight loss in either group were rerandomized once to one of two levels of treatment intensification. They can be moderate (adding inexpensive technology elements, supportive messaging) or strong (both messaging and adding more expensive traditional weight loss treatment elements). Coaching for those who have not yet taken the course, meal replacement for those who have already taken the course).

The article is titled “Adaptive Behavioral Interventions for Weight Loss Management:

Noninferiority randomized clinical trial. ”

Other Northwestern authors include Dr. Juned Siddiq, Gene Reading, Samuel Battaglio, Ellis Daly, Laura Scanlan, and H. Gene McFadden.

This research was supported by National Institute of Diabetes and Digestive and Kidney Diseases grant R01DK108678, National Heart, Lung, and Blood Institute grant F31HL162555, National Cancer Institute grant T32CA193193, and all National Institutes of Health grants. I received support.