Adult Overweight and Obesity Managements Comparing Digital Interventions Versus In-Person Sessions, Self-Help, or Waiting List Group A Systematic Review of Randomised Control Trials

Abstract

Abstract Background: The high prevalence of obesity in the adult population warrants consideration of comprehensive prevention or treatment plans with a broad reach. Digital health (DH) has been integrated into many national health programmes, but it is still used primarily to provide general information rather than as a tool to support behavioural change. Aim: This systematic review aims to examine the role of DH in obesity management compared to usual care, self-help, and waiting lists based on retention rates and weight changes. Methodology: A search was conducted using the Wiley, PubMed/MEDLINE, and OVID databases. Randomised control trials were selected that involved DH based on web-based video conferences and DVD sessions to deliver nutrition interventions alone or in combination with usual care to overweight or obese adults. Adults receiving usual care, self-help, and those on waiting lists were used as a control group. Results: Three out of eight studies reported significantly lower retention rates, which were used to determine the compliance rates among the intervention groups compared to the controls (p ≤ 0.05). However, the rest of the studies illustrated higher but non-significant retention rates in the intervention groups compared to the controls. Six studies reported higher mean weight loss in the intervention groups compared to the control range (-0.48 to -6.7 kg); three of these studies identified a significantly higher weight loss in the intervention group compared to the controls (p<0.005). However, only one study reported a weight gain in the intervention and control groups (1.7 vs 1.8 kg). The participants’ engagement level had a major impact on the amount of weight loss within the intervention groups. Four studies examined this relation, and three reported a significantly higher weight loss among participants who had higher intervention engagement levels (p<0.005). Conclusion: This systematic review shows that using DH for weight management is more effective when it is delivered using a comprehensive approach. However, due to the variations in the definition of DH the results are not generalisable. The dearth of evidence supporting the use of DH in weight management highlights the need for further research in this area.