Mobile applications for weight loss: a guide for use in the primary care setting
Semmer, Mollie Elizabeth
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BACKGROUND: Seven out of every 10 adults in the United States can benefit from weight loss. Overweight and obesity have emerged at the forefront of public health concerns and are associated with significant morbidity and mortality. Primary care providers have the opportunity to identify overweight/obese patients and initiate weight loss efforts with an efficacious treatment plan that addresses individual challenges and barriers. Modest weight loss of 5-10% can be achieved with referral to a high-intensity, on-site, comprehensive lifestyle intervention program. However, most overweight/obese patients do not enroll in these programs; thus, there is a significant demand for alternative weight loss strategies. Providers can help patients individualize and apply the 3 evidence-based components of lifestyle intervention (reduced calorie diet, increased physical activity, and behavior modification) to create a plan that defines weight loss goals, dietary and physical activity targets, and behavior change strategies. LITERATURE REVIEW: mHealth applications show promise for augmenting weight loss efforts, likely by facilitating behavior change strategies such as self-monitoring. High-quality data is lacking to define the precise role of mHealth apps in weight loss, but a limited number of studies report significant app features and average frequency of use associated with weight loss. PROPOSED PROJECT: Preliminary evidence-based recommendations advise patients to use an mHealth app to log dinner and 1 other meal every day, log all minutes of moderate-to-vigorous physical activity, and log body weight 2-3 times per week. Wearable sensors can be used to enhance user experience, but should not substitute for manually logging physical activity. Patients should monitor their caloric intake, minutes of physical activity, and body weight frequently with reference to their goals and prescribed recommendations. CONCLUSION & SIGNIFICANCE: Overweight/obesity is a disease that demands attention from the medical profession due to the high prevalence and associated morbidity and mortality. Primary care providers can begin to address the obesity epidemic by propagating patient weight loss efforts. Clinically significant weight loss can be accomplished with lifestyle modification, so providers should be encouraged to prescribe evidence-based lifestyle recommendations for reduced caloric intake, increased physical activity, and behavior change strategies. Patients can actively engage with these recommendations by using an mHealth app with guidance from their providers. Employing pragmatic lifestyle interventions that incorporate evidence-based strategies and encourage longevity may decrease the prevalence of overweight/obesity and its’ associated chronic conditions.