Technology-assisted weight loss interventions in primary care: a systematic review

Area of Science:

• Obesity treatment
• Digital health interventions
• Primary care research

Background:

• Obesity management is recommended by the US Preventive Services Task Force, but primary care (PC) faces significant treatment barriers.
• Technology-assisted weight loss interventions show promise but are often studied outside PC, limiting their applicability.
• This systematic review focuses on technology-assisted weight loss interventions specifically tested within ambulatory PC settings.

Purpose of the Study:

• To systematically review technology-assisted weight loss interventions evaluated in primary care (PC) settings.
• To assess the effectiveness and characteristics of these interventions.
• To identify gaps and future directions for technology-assisted obesity treatment in PC.

Main Methods:

• Systematic literature search from January 2000 to March 2014.
• Included randomized controlled trials using internet, personal computer, or mobile devices in ambulatory PC settings.
• Assessed bias using Cochrane EPOC and Delphi criteria, and pragmatism using PRECIS criteria.

Main Results:

• Sixteen trials met inclusion criteria; 12 demonstrated statistically significant weight loss compared to controls.
• Interventions varied in personnel, technology (web-based apps most common), and behavior change strategies (self-monitoring most frequent).
• Clinician-guided or personnel-feedback interventions showed greater weight loss than automated ones; few used publicly available technologies.

Conclusions:

• Technology-assisted interventions in PC settings offer viable options for weight loss compared to usual care.
• Best practices for these interventions remain unclear, with many studies lacking pragmatic design or using proprietary technology.
• Future research should prioritize longitudinal, pragmatic, interdisciplinary, and open-source technology-assisted interventions for obesity in PC.