Phone App Aids Weight Loss by Promoting Attentive Eating

Rachel Pugh

May 14, 2013

LIVERPOOL, United Kingdom — Smartphone apps could help people to lose weight by encouraging them to notice and record the amount of food they consume as they eat, according to a new feasibility study presented here at the ECO2013, the 20th European Congress on Obesity.

The research by Eric Robinson, PhD, from the University of Liverpool, United Kingdom, and colleagues builds on their previous work on attentive eating, which concluded that distractions, such as radio, television, and computers, increased food intake by up to 50%, both during a meal and later in the day.

On the basis that paying attention to what is eaten and remembering it clearly help reduce energy intake, Dr. Robinson and colleagues designed a smartphone application that would help promote food memory in overweight or obese people.

The 1.5-kg average weight loss observed in their 4-week study "is similar to a recent more intensive 2-month trial that investigated the impact of dietary/exercise advice and habit formation," said Dr. Robinson. This suggests that "raising awareness of eating and weight loss achieved" could be a fruitful approach, he observed.

Approached by Medscape Medical News for comment, Allan Geliebter, PhD, from the New York Obesity Research Center at Columbia University, New York City, said that heightening awareness of food intake is an important factor in combating excessive food consumption. And the use of a phone app is particularly exciting, because of its practicality and the intrinsic attractiveness of such technology, he noted.

Promising Findings, but Longer-Term Trials Needed

The app consists of 3 main parts. Before eating or drinking, users photograph the food/drink about to be consumed under a "snap" function; they are reminded by text to complete a "most-recent" photograph when they have finished.

Second, users focus on the on-screen “most-recent” image after the meal and answer questions on quantity eaten and feelings of satiety.

The final part opens a chronological slide show of the consumption episodes recorded during that day. A short text message instructs users to remember what they have eaten and reminds them to eat attentively and to snap their next meal.

Twelve overweight (n = 5) and obese (n = 7) participants took part in the trial. Mean body mass index (BMI) was 32.1, mean weight was 96.3 kg, and mean age was 42 years. They were compensated with £30 ($45) for their time.

Mean weight loss was -1.5 kg over the 4 weeks. Half the participants (6/12) lost 1 kg or more, 4 lost between 0 and 1 kg, and the remaining 2 gained between 0.1 and 0.4 kg. The individuals accessed the application on average 5.7 times a day, and the mean number of eating and drinking episodes recorded daily was 2.7.

"Our study introduces a new attentive eating approach aimed at reducing dietary intake and promoting weight loss, supported by theoretical models of the role of memory on energy intake regulation," said Dr. Robinson.

"Results suggest that a simple smartphone…intervention based on these principles is feasible and could promote healthier dietary practices. Maybe you can't imagine people using this app for the rest of their lives, but it might help them to develop better eating habits.

"Given that our trial was a very brief intervention with little contact time and no nutritional advice or support, this is a promising finding," he added.

However, he stressed that a larger, randomized controlled trial "testing proof of principle for an attentive eating intervention on weight loss is now warranted," because long-term maintenance of changes to the diet and weight loss are hard to achieve.

Dr. Geliebter told Medscape Medical News: "This has huge potential for taking action on obesity on a population basis, particularly since it is an app — which makes it intrinsically attractive." However, one of the important factors determining whether it will ultimately prove successful when it is rolled out will be "whether [or not] the app is free," he observed.

Research was funded by the UK National Institute for Health Research National School for Primary Care Research. Neither Dr. Robinson nor Dr. Geliebter has reported relevant financial relationships.


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