What Can Technology Do for Weight Loss?
Despite all the hype, however, technology can’t seem to stall a leading driver of illness in the United States: chronic disease. Quite simply, that’s because the ways to prevent chronic disease are largely behavioral: eating a healthier diet and increasing physical activity.
Could technology play a truly meaningful role in changing these key behaviors? I recently undertook a review of systematic reviews that look at the effectiveness of obesity prevention and reduction interventions (full results are in the new report “Weighing Solutions to Obesity”). The studies revealed several things about technology.
First, I found that while the literature over time showed increasing incorporation of technology in behavioral-change interventions, there was no corresponding or consistent increase in effectiveness. Some studies observed new technologies designed to facilitate weight loss, while others used computers or phones as a novel delivery modality, compared with in-person care. The new technologies did not appear to be consistently effective, nor were they cost-effective. This may change as technology adapts and developers better understand the needs of patients.
Second, health technologies that are targeted at the patient consumer—most notably wearables that track such things as heart rate and physical activity—do not seem to help much with the root problems of poor diet and insufficient exercise. On one hand, technologies that let patients track their health habits can be beneficial. For example, in a meta-analysis of weight-loss interventions based on physical activity, using pedometers was associated with significantly greater weight loss. On the other hand, data collected by these devices may seem exciting to their owners and filled with potential insight, but practically speaking that information may not be clinically useful to their doctors. Further, many new health technologies are more expensive than a regular pedometer, making them unaffordable for the low-income patients who are disproportionately affected by obesity and chronic disease.
Third, a compelling theme from my review was technology’s ability to connect people. When lack of transportation impedes access to care, computers and phones provide a way for health care to proceed. In fact, technology-delivered obesity-reduction interventions were effective overall for weight loss. It is interesting to note that technology-only interventions were significantly less effective than in-person interventions, but when added to an in-person intervention, they were effective at significantly increasing weight loss. Components of technology-delivered interventions that were associated with weight loss included having an e-mail buddy, access to a chat room and contact with the interventionist through the technology. These are all characteristics that increase the social nature of an intervention without requiring patients to leave their home or engage with the formal health-care system.
At its core, health is a personal endeavor, but the practice of health care is inherently social. Technology will undoubtedly enable us to invent better medical treatments, but perhaps an equally important benefit of technology is that it can allow health care to expand beyond what is typically thought of as the health-care system. It can provide more people better access to care and improve their ability to look after themselves, preventing disease before it starts.