Weight-loss app works for low-income people with obesity

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Low-income people with obesity and signs of cardiovascular risk lost a clinically meaningful amount of weight when using a free phone app, a new study reports.

The study is among the first to report successful weight loss within a low-income population—a group that suffers from skyrocketing rates of obesity but is hard to treat, says lead author Gary Bennett, a professor of psychology and neuroscience at Duke University.

“Obesity continues to wreak havoc on the health of our country and we’ve had the most difficulty treating low-income Americans, those who are most affected by the condition,” Bennett says.

“This study shows we can help patients who are most at risk by embedding treatment in primary care settings and keeping patients engaged using a simple app,” he says.

Track app

In the study, patients in a primary care clinic used a free app called Track to monitor behavior changes. The app wasn’t used in isolation: Doctors were well-versed in the app and dietitians also followed up with coaching calls. Patients who used the app and received coaching calls fared much better than a control group that received routine care.

Among Track program participants, 43 percent lost more than 5 percent of their body weight over the course of a year. Their waist sizes decreased, as did their blood pressure. And an even larger number of participants—56 percent—lost at least 3 percent of their body weight over 12 months, which doctors consider a healthy amount of weight loss.

The results are among the best obesity treatment outcomes seen in a medically vulnerable population, Bennett says.

At a time when obesity remains epidemic, the research also offers encouraging evidence of a treatment approach that can work in a primary care setting. That’s important, as primary care settings are where most patients receive health care. Yet primary care settings rarely offer effective weight-loss treatment, and very few studies have measured delivery of a weight loss app in such setting.

Other health problems

Most weight-loss research to date has focused on otherwise healthy people who just want to lose weight. Yet obesity very often exists side by side with other health problems. For that reason, the researchers focused on obese people who were sick: In addition to obesity, study participants suffered from either hypertension, high cholesterol, or diabetes.

“Most of what we know about obesity treatment is based on people who are reasonably healthy and highly motivated to lose weight,” Bennett says. “We’ve shown an ability to promote clinically meaningful weight loss among patients who need help the most, those with low motivation who already have the health risks associated with obesity.”

The study, which appears in the American Journal of Preventive Medicine, took place in a mostly rural area. The successful results suggest that digital obesity treatments can help close the gap between obesity care in urban and rural settings, Bennett says.

“Digital treatments allow us to reach into the most remote settings to deliver high-quality care. Expanding broadband services to all Americans should be a public health priority,” he explains.

The National Institutes of Health, National Institute of Diabetes, and Digestive and Kidney Diseases funded the work.

Source: Duke University