Weight loss mobile applications need to do more to help dieters solve problems

Weight loss mobile applications may work well as basic tracking devices, but need to do more to help dieters improve motivation, reduce stress and solve problems, according to a new report in the American Journal of Preventive Medicine.

Many of the country's 285 million mobile phone subscribers want to lose weight, but neither consumers nor doctors really understand current apps, said lead study author Sherry Pagoto, Ph.D., an associate professor in the division of preventive and behavioral medicine at the University of Massachusetts Medical School.

"Apps are generally good but we need more science behind this effort," she said. "Busy healthcare providers hesitate to recommend apps because they don't really know what they're telling patients to use. Patients also worry about receiving incorrect information or offensive advertising when they open an app."

"But because of their 'advanced technical features,' some apps accomplish what we can't with weight loss behavioral counseling alone," said Pagoto.

The researchers looked for weight loss apps that included behavioral strategies currently used in evidence-based weight loss programs. Out of nearly 900 apps available in "health and fitness" categories, 30 apps designed for both iPhone and Android platforms were reviewed in depth. Basic features of the apps studied included the capacity to track weight, diet and physical activity.

Common behavioral strategies included setting weight loss goals, dietary goal-setting and balancing calories. However, seven evidence-based behavioral strategies for weight loss were completely missing, such as stress reduction, relapse prevention, social cues, negative thinking, developing regular patterns of eating, time management, and instructions on reading nutrition labels.

"We think apps can grow into more sophisticated and impactful tools if they include strategies to help with diet motivation and adherence, which are super important for weight loss," Pagoto noted.

"The ability for real-time information, monitoring and support may help individuals change their diets and exercise in ways that have previously required time-intensive and/or face-to-face intervention, " said Wendy Nilsen, Ph.D., a health scientist administrator at the NIH Office of Behavioral and Social Sciences Research (OBSSR). "The authors' findings, similar to work in smoking cessation, highlight the lack of integrated behavioral science in app development."

There's more to do, Nilsen added. "For apps to be able to effect maximal behavior change, developers are missing important opportunities to improve their applications by overlooking a well established literature in the behavioral sciences and to incorporate existing knowledge into new technologies. Further, this work can help determine when a well-designed app alone is most likely to help someone to reach their health goals and when more intensive intervention, such as the use of a coach, is needed. With technology and science paired, the optimal app strategies can be developed in a way that helps people live healthier lives."