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Effectiveness of a Smartphone Application for Weight Loss Compared With Usual Care in Overweight Primary Care Patients: A Randomized, Controlled TrialSmartphone Application for Weight Loss in Overweight Primary Care Patients

Brian Yoshio Laing, MD, MPH*; Carol M. Mangione, MD, MSPH; Chi-Hong Tseng, PhD; Mei Leng, MD, MS; Ekaterina Vaisberg, BS; Megha Mahida, BS; Michelle Bholat, MD, MPH; Eve Glazier, MD; Donald E. Morisky, MSPH, ScD; and Douglas S. Bell, MD, PhD
[+] Article, Author, and Disclosure Information

* Former Robert Wood Johnson Foundation Clinical Scholar.

This article is part of the Annals supplement “RWJF Clinical Scholars in Pursuit of the Value Proposition: Evaluations of Low-Cost Innovations for Prevention and Management of Conditions.” The Robert Wood Johnson Foundation provided funding for publication of this supplement. Carol M. Mangione, MD, MPH (co-director of the RWJF Clinical Scholars Program at the University of California, Los Angeles); Jaya K. Rao, MD, MHS (Annals Deputy Editor); and Christine Laine, MD, MPH (Annals Editor in Chief), served as editors for this supplement.


From the Robert Wood Johnson Clinical Scholars Program and David Geffen School of Medicine at UCLA, UCLA Department of Community Health Sciences, RAND Corporation, UCLA Fielding School of Public Health, and Los Angeles County Department of Health Services, Los Angeles, California.

Acknowledgment: The authors thank the leadership at MyFitnessPal and all of the staff of the UCLA Family Health Center and UCLA 16th Street Internal Medicine clinic for making this study possible.

Grant Support: From the Robert Wood Johnson Foundation Clinical Scholars Program (grant 69003), National Institutes of Health/National Center for Advancing Translational Sciences UCLA Clinical and Translational Science Institute (award UL1TR000124), and the Resource Centers for Minority Aging Research Center for Health Improvement of Minority Elderly under the National Institutes of Health/National Institute on Aging (grant P30-AG021684).

Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-3005.

Reproducible Research Statement:Study protocol and statistical code: Available from Dr. Laing (e-mail, blaing@stanfordalumni.org). Data set: Not available.

Requests for Single Reprints: Brian Yoshio Laing, MD, MPH, Martin Luther King Outpatient Center, 1670 East 120th Street, Los Angeles, CA 90059; e-mail, blaing@stanfordalumni.org.

Current Author Addresses: Dr. Laing: Martin Luther King Outpatient Center, 1670 East 120th Street, Los Angeles, CA 90059.

Drs. Mangione and Leng: Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, Box 957394, 10940 Wilshire Boulevard, Suite 700, Los Angeles, CA 90095-7394.

Drs. Tseng, Glazier, and Bell: Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, Box 951736, 911 Broxton Plaza, Los Angeles, CA 90095-1736.

Ms. Vaisberg: 964 Vasco da Gama Lane, Foster City, CA 94404.

Ms. Mahida: 10235 Whitetail Drive, Oakdale, CA 95361.

Dr. Bholat: Department of Family Medicine, University of California, Los Angeles, Box 957197, 1920 Colorado Boulevard, Los Angeles, CA 90095-7197.

Dr. Morisky: Department of Community Health Sciences, UCLA Fielding School of Public Health, Box 951772, 46-071A CHS, Los Angeles, CA 90095-1772.

Author Contributions: Conception and design: B.Y. Laing, C.M. Mangione, C.H. Tseng, M. Bholat, D.S. Bell.

Analysis and interpretation of the data: B.Y. Laing, C.M. Mangione, C.H. Tseng, M. Leng, E. Vaisberg, D.S. Bell.

Drafting of the article: B.Y. Laing.

Critical revision of the article for important intellectual content: B.Y. Laing, C.M. Mangione, C.H. Tseng, E. Vaisberg, D.E. Morisky, D.S. Bell.

Final approval of the article: B.Y. Laing, C.M. Mangione, C.H. Tseng, D.E. Morisky, D.S. Bell.

Provision of study materials or patients: M. Bholat, E. Glazier.

Statistical expertise: B.Y. Laing, C.H. Tseng, M. Leng, D.S. Bell.

Administrative, technical, or logistic support: B.Y. Laing, E. Vaisberg, M. Mahida, M. Bholat, E. Glazier, D.S. Bell.

Collection and assembly of data: B.Y. Laing, E. Vaisberg, M. Mahida, E. Glazier.


Ann Intern Med. 2014;161(10_Supplement):S5-S12. doi:10.7326/M13-3005
Text Size: A A A

Background: Many smartphone applications (apps) for weight loss are available, but little is known about their effectiveness.

Objective: To evaluate the effect of introducing primary care patients to a free smartphone app for weight loss.

Design: Randomized, controlled trial. (ClinicalTrials.gov: NCT01650337)

Setting: 2 academic primary care clinics.

Patients: 212 primary care patients with body mass index of 25 kg/m2 or greater.

Intervention: 6 months of usual care without (n = 107) or with (n = 105) assistance in downloading the MyFitnessPal app (MyFitnessPal).

Measurements: Weight loss at 6 months (primary outcome) and changes in systolic blood pressure and behaviors, frequency of app use, and satisfaction (secondary outcomes).

Results: After 6 months, weight change was minimal, with no difference between groups (mean between-group difference, −0.30 kg [95% CI, −1.50 to 0.95 kg]; P = 0.63). Change in systolic blood pressure also did not differ between groups (mean between-group difference, −1.7 mm Hg [CI, −7.1 to 3.8 mm Hg]; P = 0.55). Compared with patients in the control group, those in the intervention group increased use of a personal calorie goal (mean between-group difference, 2.0 d/wk [CI, 1.1 to 2.9 d/wk]; P < 0.001), although other self-reported behaviors did not differ between groups. Most users reported high satisfaction with MyFitnessPal, but logins decreased sharply after the first month.

Limitations: Despite being blinded to the name of the app, 14 control group participants (13%) used MyFitnessPal. In addition, 32% of intervention group participants and 19% of control group participants were lost to follow-up at 6 months. The app was given to patients by research assistants, not by physicians.

Conclusion: Smartphone apps for weight loss may be useful for persons who are ready to self-monitor calories, but introducing a smartphone app is unlikely to produce substantial weight change for most patients.

Primary Funding Source: Robert Wood Johnson Foundation Clinical Scholars Program, National Institutes of Health/National Center for Advancing Translational Sciences for the UCLA Clinical and Translational Science Institute, and the Resource Centers for Minority Aging Research Center for Health Improvement of Minority Elderly under the National Institutes of Health/National Institute on Aging.

Figures

Grahic Jump Location
Figure 1.

Study flow diagram.

* Among the 6 intervention group participants who withdrew, 3 reported not having enough time to use the app, 2 did not have time to return for follow-up, and 1 was no longer interested in participating in the study.

† Among the 8 control group participants who withdrew, 6 reported not having time to return for follow-up and 2 were no longer interested in participating in the study.

Grahic Jump Location
Grahic Jump Location
Figure 2.

Number of logins among MyFitnessPal users, by month.

Boxes represent the median number of logins and interquartile range.

Grahic Jump Location

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