Very Few Mobile Weight-Loss Apps Have Professional Input

Liam Davenport

June 04, 2016

GOTHENBURG, Sweden — Only half a per cent of applications (apps) regarding weight management available for mobile devices have been developed with the help of professional healthcare input, UK and Belgian researchers have found.

In a study of almost 29,000 apps across five mobile app stores in 10 countries, presented at the European Obesity Summit 2016, only 17 were verifiably based on professional expertise.

Lead researcher Charoula Nikolaou, PhD, Marie Curie Research Fellow, Catholic University of Louvain, Belgium, said that, as there is so much online activity relating to weight loss, weight-gain prevention, and weight management, publishers should be "encouraged to have evidence that their online resources are effective."

She also suggested that there could be a different category on the app stores, "where there could be apps certified by any official healthcare organization."

Dr Nikolaou added that such certified apps could then be prescribed by doctors, as there are limited resources for obesity treatment and prevention and yet "a need for advice" in the population.

She said: "Potentially, prescribing apps could be a good solution that could be very low cost, so it could work even in low-income and low-resource countries."

Commenting, Hermann Toplak, MD, president of the European Association for the Study of Obesity and a specialist for endocrinology and metabolism at the University of Graz, Austria, said he was "not really astonished" when he saw the findings.

He told Medscape Medical News: "To believe that people go somewhere to the internet, download an app, and that will solve some problems….It was expected, I think, that would not work."

Dr Toplak noted that one of the most important things in patient management is human interaction. "It's behavior modification, and behavior modification is normally not done by an apparatus or book," he said, adding, "Many people have a Bible at home, but they never read it."

He agreed with Dr Nikolaou's assertion that "official" certification would help to identify apps targeting weight loss that make reliable health claims and that this would help to "clean the market." However, he feels that nothing can replace the doctor–patient relationship.

Dr Toplak continued: "A good weight-loss program…is like psychotherapy, where you're talking with your patient, giving advice, making negotiations. 'Are you going to make this, are you willing to do this? If yes, come back in 4 weeks, let's talk again about it.' "

He said: "That's the way to do these things, and then it works, at least in a higher percentage of people."

Almost 30,000 Weight-Management Apps Identified

Mobile health is one of the fastest-developing electronic health sectors, with more than 100,000 health-related apps currently available for downloading to mobile phones and portable devices.

To examine the market for weight-management apps, Dr Nikolaou and Mike Lean, MD, chair of human nutrition, University of Glasgow, Scotland, searched the Apple, Google, Amazon, Blackberry, and Windows app stores in the United Kingdom, the United States, Russia, Japan, Germany, Italy, France, China, Australia, and Canada.

The search focused on several keywords, including "weight," "calorie," "weight loss," "diet," "slimming," and "dietician" and revealed a total of 28,905 relevant apps across the stores and territories.

Of the apps identified, 34% were focused on fitness and physical activity; while 31% were related to nutrition and diet; 23% dealt with body weight, exercise, and calorie-intake recording and monitoring; and 12% focused on other aspects of weight loss, such as meditation, hypnotherapy, and healthy recipes.

The total number of apps on each store across all territories was 8559 on the Apple store, 1762 on the Google store, 13,569 on the Amazon store, 2596 on the Blackberry store, and 2419 on the Windows store.

However, the researchers found that just 17 (0.5%) of the apps across all stores had been developed with any identifiable healthcare professional input.

Dr Nikolaou told Medscape Medical News that, owing to the large number of apps they identified, they were not able to perform a quality assessment.

However, she added: "There are a few studies out there that have looked at some of the apps in terms of quality, and usually they looked at the most popular apps. Their results are the same: that they are quite low quality, unfortunately."

She believes that, as well as certifying apps, the barrier for being listed on the app stores could be raised to improve the overall quality, "but we need to have a collective effort in doing that — healthcare professionals working with healthcare organizations or any other authorities."

Dr Nikolaou noted that there has been "some movement" in the United States to try to achieve that.

"Healthcare professionals came together and they tried to develop their own apps that would be certified for content" and could only be used if they had been prescribed to a specific person, she said.

The idea was that "users would need a password to get access, to ensure that those who are getting the apps really need them and also to monitor their progress, of course."

Drs Nikolaou, Lean, and Toplak report no relevant financial relationships.

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European Obesity Summit 2016; June 2, 2016; Gothenburg, Sweden. Poster PP4.09.

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