Can a mobile phone-based behavioral intervention affect weight regain?

A scalable, mobile phone-based intervention designed to slow weight regain after an initial weight loss had no significant effect on participants' weight, according to a study published this week in PLOS Medicine by Falko Sniehotta from Newcastle University, UK and colleagues.

Obesity is a major contributor to preventable life-years lost worldwide and, while effective behavioral weight loss interventions are available, weight loss is often followed by weight regain. In the new study, researchers carried out a randomized controlled trial involving 288 people from North East England with obesity who had recently lost at least 5% of their bodyweight. The NULevel intervention consisted of a single face-to-face goal-setting meeting, self-monitoring, and personalized feedback on weight, diet, and physical activity via SMS text messages with embedded links. The control group received standard lifestyle advice via newsletter.

Overall, 264 participants completed the trial. Those participating in the intervention group weighed themselves more frequently and were more physically active. However, the mean weight gain over the 12 month study period was similar in the two groups, with an average of 1.8 kg (95% CI 0.5 to 3.1) gained in the intervention group and 1.8 kg (95% CI 0.6 to 3.0) gained in the control group. The data suggest that the intervention is unlikely to be considered cost-effective in its current form.

"We conclude that the incremental dose of the NULevel intervention over the active control condition might have been insufficient to affect weight outcomes," the authors say. "This research should inform future intervention design decisions regarding delivery modality and intensity."