Technology alone led to worse weight loss compared to technology and telehealth coaching
Dr. Bonnie Spring, Director of the Center for Behavior and Health and Professor of Preventive Medicine at the Institute of Public Health Medicine (IPHAM).
A new study from Northwestern Medicine published in JAMA shows that technology alone cannot replace human touch to produce meaningful weight loss in obesity treatment.
“Giving people technology alone in the early stages of obesity treatment results in unacceptably worse weight loss than treatment that combines technology and a human coach,” said lead study author and researcher at the Institute for Behavioral Health. said Dr. Bonnie Spring, director of the center. He is a PhD in Public Health Medicine (IPHAM) and Professor of Preventive Medicine.
As the ongoing obesity epidemic exacerbates rising healthcare costs, the need for technology-enabled low-cost yet effective obesity treatments has become urgent.
However, Spring said current technology is not advanced enough to replace human coaches.
The new SMART study finds that people who initially received technology alone without the support of a coach were more likely to see significant weight loss, thought to be at least 5% of their body weight, compared to those who initially had a human coach. was low.
Researchers quickly intensified treatment (adding resources after just two weeks) if a person had not reached optimal weight loss, but found that weight loss for those who began their weight loss efforts without the support of a coach The study showed that the disadvantages lasted for 6 months.
Eventually, Spring said, more advanced technology may be able to replace human coaches.
“At this stage, the average person still needs a human coach to achieve clinically meaningful weight loss goals because the technology is not yet fully developed,” Spring said. Ta. “AI chatbots that can replace humans may not be far away, but we're not there yet. They're within reach. Technology is developing really quickly.”
Previous research has shown that mobile health tools for tracking diet, exercise, and weight increase participation in behavioral obesity treatment. Until this new study, it was not clear whether clinically acceptable weight loss could be achieved without the support of a human coach.
Scientists are currently trying to analyze what human coaches do to lead to success and how AI can better mimic humans, not only in content but also in emotional tone and context awareness. , said Spring.
amazing results
“We predicted that initiating treatment with technology alone would save money and reduce burden without compromising clinically beneficial weight loss, because once insufficient weight loss is detected, Because additional treatments can be added very quickly,” Spring said. “But that hypothesis has been disproved.”
Although pharmacological and surgical interventions are available for obesity, they have some drawbacks. “They are very expensive, have medical risks and side effects, and are not equitably accessible,” Spring says. She noted that most people who start taking a GLP-1 agonist stop taking the drug within a year, against medical advice.
Many people can achieve clinically meaningful weight loss without anti-obesity drugs, bariatric surgery or even behavioral therapy, Spring said. In the SMART study, 25% of those who started treatment with technology alone, without any augmentation of treatment, achieved a 5% weight loss after 6 months. (In fact, he had to retrieve the research technology after three months for the team to recycle into new participants.)
An unresolved issue in obesity treatment is matching the type and intensity of treatment to individual needs and preferences. “If we can know in advance who needs which treatments and at what intensity, we may be able to manage the obesity epidemic,” Spring said.
Research structure
The SMART Weight Loss Management study is a randomized controlled trial comparing two different stepped care treatment approaches for adult obesity. Stepped care provides a way to distribute treatment resources to more people who need treatment. Treatments that use the least resources and benefit some people are offered first. Treatment is then intensified only for patients with inadequate response. Half of the participants in the SMART study began weight loss treatment using technology alone. The other half started with gold standard treatment, which included both technology and a human coach.
The technology used in the SMART trial was a wireless feedback system (integrated app, Wi-Fi scale, Fitbit) that participants used to track and receive feedback about their diet, activity, and weight.
Four hundred obese adults aged 18 to 60 years were randomly assigned to begin 3 months of StepCare behavioral obesity treatment, beginning with either a wireless feedback system (WFS) alone or WFS plus telehealth coaching. He measured weight loss after 2, 4, and 8 weeks of treatment and intensified treatment at the first sign of suboptimal weight loss (less than 0.5 pounds per week).
Treatment for both groups began using the same WFS tracking technology, but the standard of care sent participants' digital data to coaches, who used it to provide behavioral coaching via telehealth. Patients who had suboptimal weight loss in either group were rerandomized once to one of two levels of treatment intensification. Moderate (additional inexpensive technology elements – supportive messaging) or Active (both messaging and the addition of more expensive traditional weight loss treatment elements – coaching) meal replacement for those not already receiving coaching; (Meal replacement for those who are receiving it).
Other Northwestern authors include Dr. Juned Siddique, professor of preventive medicine in the Department of Biostatistics; Dr. Gene Reading. Samuel Batario. Elise Daly. Laura Scanlan. and H. Gene McFadden.
This research was supported by National Institute of Diabetes and Digestive and Kidney Diseases grant R01DK108678, National Heart, Lung, and Blood Institute grant F31HL162555, National Cancer Institute grant T32CA193193, and all National Institutes of Health grants. I received support.
