The most effective weight loss interventions are multidisciplinary and recognize the individual motivations and struggles of each patient. They encompass personalized diagnosis and diet, physical activity and stress management, self-empowerment and motivation, participation and health literacy. Try packing that into the average 19 minutes a patient spends with a primary care physician - not easy.
Could a virtual weight loss clinic offer the solution?
Given the advantages of an effective systems approach to weight management, the area seems ripe for digital health technology interventions. Such technologies may also hold benefits for diabetes and other chronic health issues linked with excess body weight. Indeed, in a 2016 paper published in the journal, Clinical Diabetes, researchers asked if digital health technologies could help address major challenges in diabetes care.
Iyengar and colleagues noted that digital health technologies have ‘excellent potential to collect data more seamlessly, make collected data more useful, and drive better outcomes at lower costs in less time.’ In 2019, it’s safe to say that such potential is rapidly being realized with innovative mobile health platforms and other digital interventions linked to impressive improvements in patient health, particularly in regard to weight loss, physical activity, blood glucose management and other key components of a systems approach to good health.
How Digital Health Technologies Support Weight Loss and Diabetes Care
Digital health addresses one of the most significant barriers in weight loss and diabetes care – too many patients and too few providers. The result of this major challenge is that patients in need of tailored support rarely have meaningful interactions with qualified healthcare providers. Digital health technologies can overcome this barrier and surmount other significant problems facing healthcare providers such as:
- Inconsistent data - body weight and blood glucose are typically recorded every few months with traditional approaches; a virtual weight loss clinic offers the potential for daily self-reporting and vastly improved data analysis.
- Slow improvement in key outcomes - leading to decreased patient motivation and poor patient retention, hurting both the patient’s chances for good health and the clinic’s bottom line.
Digital health coaching via a virtual weight loss clinic enhances accessibility and outcomes while reducing the cost of care. Patients who find it difficult to consistently attend in-person weight loss group support sessions because of work commitments, transit problems, childcare difficulties or other reasons can instead log-in to a supportive virtual clinic offering tailored support when it is most convenient for them.
Key stumbling blocks affecting weight loss include maintaining motivation for physical activity, making meaningful dietary changes, and adhering to prescribed medications. For some patients, the challenge is simply getting started without professional help and support. A virtual weight loss clinic addresses all of these potential barriers and more, offering consistent, personalized guidance and support long after most traditional weight management programs end.
What the Research Says
We now have a wealth of data supporting the use of digital health interventions for weight loss. In one study, participants who completed a digital health program lost an average of 4.9% of their initial body weight after 1 year. Unlike in traditional weight loss programs, participants largely maintained that weight loss (4.3%) after two years. Participants also had reductions in glycated hemoglobin (A1C) of 0.40% at 1 year and 0.46% after 2 years (31). A later studyusing the same program showed similar results, with successful weight loss associated with website logins and participation in a virtual weight loss group.
In an Australian study, adults aged 18-60 years who were overweight or obese (BMI 25-40 kg/m2) were randomized to one of three groups: a standard online weight loss program; an enhanced version of the online program that offered additional personalized feedback and reminders; or a wait-list control group. Those in the online groups lost significantly more weight than the control group after 12 weeks (basic -2.2 kg, enhanced -3.0 kg, control 0.4 kg). Dietary quality was greatly improved in the enhanced group, and this was significantly associated with greater weight loss.
A combination of digital health and human coachingwas also associated with a loss of 7.5% of initial body weight after 12 months in one study. Participants also had improved glucose control and decreases in total cholesterol, as well as improvements in self-reported well-being, depression, and self-care.
In a Finnish study, an online health behavior change support system (HBCSS) in combination with cognitive behavioral therapy was associated with significant weight loss (4.1% of body weight) and success in maintaining that weight loss over two years, with a third of participants in this group achieving a weight loss of 5% or more at 24 months. In fact, participants in the HBCSS intervention group were three times more likely to lose more than 10% of their body weight compared to controls.
In this study, the 52‐week web‐based HBCSS comprised a virtual weight loss clinic where patients could set goals, record body weight and physical activity, and receive weekly reminders for new tasks including a suggested exercise and tip for healthy lifestyle changes, plus an informational article to support weight loss. The system was based on theories of CBT and current scientific and practical knowledge of eating behavior, diet, physical activity and health information literacy. Users could track their progress and record their feelings and experiences.
Beyond the Web – The Internet of Things as a Virtual Weight Loss Clinic
Logging into a web browser on a desktop or laptop computer may present difficulties for some patients, reducing meaningful engagement in a virtual weight loss clinic. Fortunately, mobile phone-based coaching interventionsused alongside wireless devices appear promising.
Participants received 4 months of intensive health coaching via live video, phone, and text message through a health application on their cellphones and were given a wireless scale, pedometer, and blood pressure cuff. The intervention group lost an average of 3.23% total body weight at 4 months of coaching. More than a quarter (28.6%) achieved a clinically significant weight loss of 5% or more, with an average of 9.46% weight loss in this group. In contrast, the matched-pair control group gained an average 1.81% of total body weight over 4 months without coaching.
Almost half (49.1%) of participants in the digital coaching group also had a meaningful reduction in elevated blood pressure after 4 months.
A similar study also reported success with a mobile phone-based digital health intervention for diabetes. In this study, participants were highly engaged, with 80% completing the majority of lessons over 24 weeks. Weight loss was significant, ranging from 6.15% to 7.36% for those engaging with the program during core weeks and 8.98% in those completing the program and continuing to engage with the materials afterwards. This kind of phone-based intervention has long-term potential it seems as a more accessible and successful alternative to purely in-person weight loss programs and other forms of virtual intervention.
Research also strongly suggests that using a virtual weight loss clinic paired with wireless fitness tracking devices leads to greater patient retentionand better results. This offers both an evidence-based strategy for clinicians to improve patient outcomes and a helpful income stream.
Why it Matters
A staggering 71% of American adults were overweight in 2014, with 35% of men and 40% of women diagnosed with obesity. Digital health programs are increasingly recognized as having distinct advantages over traditional approaches for sustainable, healthy weight loss and weight management.
Acknowledging the merits of digital health technology, Medicare now reimburses select providers for administering digital versions of the Diabetes Prevention Program (DPP), an evidence-based program that helps individuals with prediabetes make lifestyle changes including losing weight and improving physical activity. The U.S. Centers for Disease Control officially recognizes at least 11 digital versions of the DPP as effective, evidence-based interventions, demonstrating that digital health interventions are becoming more mainstream and acceptable to both patients and providers alike.
The conventional approach of a short-lived intensive weight loss intervention typically results in participants losing weight only to gain it back (and more) in the weeks following. In contrast, a virtual weight loss clinic links seamlessly to a patient’s holistic digital health profile through technology such as CoachCare, allowing for ongoing and on-demand support.
The CoachCare technology platform powers health clinics across a number of specialties, including weight loss, pain management and chiropractic care. A custom-branded mobile app, coach dashboard and connected devices combine in one integrated platform to improve patient care and increase clinic revenues. Contact us to learn more.
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