Related Experiment Video
Updated: Aug 14, 2025
Control of Eating Behavior Using a Novel Feedback System
Published on: May 8, 2018
Feasibility and outcomes from using a commitment device and text message reminders to increase adherence to
Alexander C Fanaroff1, Samantha Coratti2, Rim Halaby3
1Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, PA; Center for Health Economics and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Penn Center for Digital Cardiology, University of Pennsylvania, Philadelphia, PA.
Bidirectional texting effectively supports patients with obesity and hypertension in adopting time-restricted eating. However, adding a commitment device did not significantly improve adherence or health outcomes in this feasibility study.
Area of Science:
- Cardiovascular Disease Research
- Obesity Management
- Nutritional Science
Background:
- Obesity is a significant risk factor for cardiovascular disease, often linked to elevated blood pressure.
- Traditional low-calorie diets present adherence challenges for long-term weight management.
- Time-restricted eating (TRE), a form of intermittent fasting (IF), offers a potentially more sustainable dietary approach.
Purpose of the Study:
- To assess the feasibility of a bidirectional texting strategy for initiating and maintaining TRE in patients with obesity and hypertension.
- To determine if a commitment device enhances adherence to TRE compared to standard bidirectional texting.
Main Methods:
- Patients with obesity and hypertension were randomized to either an attention control group or a commitment device group.
- Both groups received education on TRE and daily/weekly text message check-ins.
- The commitment device group additionally received a contract, implementation intentions, and support partner involvement.
Main Results:
- The bidirectional texting strategy was feasible for TRE adherence in this population.
- No significant difference in TRE adherence (4.7 vs. 5.4 days/week) was observed between the control and commitment device groups (P=.23).
- Overall reductions in systolic blood pressure (P=.006) and weight (P=.25) were noted, but without significant between-group differences.
Conclusions:
- Bidirectional texting is a feasible method to support TRE initiation and adherence in patients with obesity and hypertension.
- A commitment device did not significantly improve TRE adherence or clinical outcomes in this study.
- Larger trials are needed to evaluate the scalability and efficacy of this intervention on blood pressure and weight.
