For the paper, published in January 2020 in Obesity, researchers looked at changes in waist circumference, weight, and body mass index (BMI) in 2,129 people with type 2 diabetes who participated in one of 14 different clinical trials testing a variety of mobile apps for diabetes self-management. These trials randomly assigned some participants to use apps, while others did not, and interventions lasted between 3 and 12 months. By the end of the trials, people who used diabetes apps lost an average of 0.84 kilograms (about 1.9 lbs) more than participants who didn’t. With mobile apps, people also reduced their waist circumference by 1.35 centimeters (about ½ inch) more on average. BMI appeared lower with apps than without these tools, but the difference was too small to rule out the possibility that it was due to chance. Reductions in weight, waist circumference, and BMI appeared more pronounced when people were obese and when participants used apps in combination with other interventions designed to promote healthy eating and exercise habits. Some of the trials in the analysis allowed participants to pursue other approaches to weight loss with or without also using a mobile app to manage diabetes. “Mobile application interventions combined with other behavior components lead to a larger magnitude of weight loss,” says senior study author Mingzi Li, PhD, of Peking University in Beijing. “However, the mobile application functionalities do not moderate weight loss significantly.” Face-to-face or supervised lifestyle modification programs have long been considered a cornerstone of diabetes care, Dr. Li and colleagues wrote. Obesity is a risk factor for developing diabetes and for experiencing potentially serious complications, like blindness, amputations, kidney failure, heart attacks, and strokes. People who lose at least 5 percent of their body weight in the first year after a diabetes diagnosis may cut their 10-year risk of events like heart attacks and strokes roughly in half, according to a study published in May 2019 in Diabetologia. And people who lose less weight may still see benefits. Patients with diabetes who lost no more than 2.5 percent of their body weight, for example, were able to lower their blood sugar, cholesterol, and blood pressure, according to a review and meta-analysis published in June 2016 in Obesity Reviews. RELATED: The Best Apps for Managing Diabetes
The Type of App Didn’t Matter — All Led to Modest Reductions in Weight
In the current study, people typically lost less than 2.5 percent of their body weight. This doesn’t seem like much, but it might be enough for them to see improvements in blood sugar, cholesterol, and blood pressure, Li and colleagues wrote. Weight loss didn’t appear to be influenced by whether apps had certain features, like tracking physical activity, logging food, counting calories, monitoring weight, or monitoring or recording blood sugar levels. “This might be because all studied mobile apps had four to five functionalities on average, and it is therefore difficult to distinguish between individual effects,” Li said. At the start of the trials, participants were 58 years old on average and had an average BMI of 30, meaning they typically had obesity. People who started out with a higher BMI appeared to benefit more from using apps. For each additional unit in BMI as measured at the start of the trials, people using apps achieved of 0.15 kilograms (about 0.3 lbs) more weight loss on average.
Whether Apps Can Facilitate Sustained Weight Loss Is Still Unclear
Even though the current study pooled results from randomized controlled clinical trials — considered the gold standard for medical research — there are still some limitations. One big drawback is that the studies didn’t provide long-term weight loss outcomes, particularly because so many people who lose weight struggle to keep it off. Another limitation is that the results don’t show what types of apps or features within apps might help the most with weight loss. More research is needed to determine whether apps might help people who don’t have time or money to do face-to-face appointments with psychologists, nutritionists, or other clinicians who might help them develop and stick to a weight loss plan, Li and colleagues pointed out. It’s possible, they argue, that apps might help some busy people stick with weight loss efforts because it’s easier and more convenient to use a smartphone every day to monitor progress than it is to go to checkups. People with diabetes who try and fail to lose substantial amounts of weight using only an app shouldn’t be discouraged that they don’t get results, says Susan Roberts, PhD, a professor of nutrition at Tufts University in Boston and founder of iDiet. “Don’t feel guilty if an app isn’t helping you,” Dr. Roberts says. “They don’t help the average person much based on these results, and there are other ways to lose weight.” Whether or not people use apps, regular monitoring of progress with lifestyle changes and weight loss efforts is one key to success, according to the Centers for Disease Control and Prevention. “Besides mobile app interventions, there has been a growing evidence that interventions like step counters could be effective in weight loss as well,” Li said. “If combined with additional behavior change components, including multidisciplinary diabetes care management or health coaching, they will be more effective.” RELATED: ‘Smart Health: I Tried Noom for Weight Loss — and It Worked’
