E-Health and M-Health in Obesity Management: A Systematic Review and Meta-Analysis of RCTs

Area of Science:

• Digital Health
• Obesity Management
• Public Health

Background:

• Adult obesity is a significant global health concern with rising prevalence.
• Current lifestyle interventions (diet, exercise, behavioral therapy) show limitations in long-term weight maintenance.
• Digital health, encompassing eHealth and mHealth, offers potential for improved healthcare delivery and obesity management.

Purpose of the Study:

• To systematically review the effects of digital health interventions (eHealth and mHealth) on anthropometric measures (weight, BMI, waist circumference) and behaviors (energy intake, eating, physical activity).
• To evaluate the efficacy of digital health tools in managing obesity and overweight conditions.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) published up to October 4, 2024.
• Included studies focused on overweight or obese adults (BMI ≥ 25 kg/m²), comparing digital interventions against control groups.
• Outcomes assessed included anthropometric measures and lifestyle behaviors; study quality was evaluated using the Cochrane Risk of Bias Tool (RoB 2).

Main Results:

• Twenty-two RCTs involving diverse populations were analyzed, utilizing various digital interventions like apps and e-coaching.
• A statistically significant reduction was observed only in waist circumference (WMD = -1.77 cm; p = 0.009).
• No significant effects were found for BMI, body weight, physical activity, or eating behaviors; body-fat percentage showed a borderline significant trend toward reduction (p = 0.068).

Conclusions:

• Digital health interventions provide modest but significant benefits for waist circumference in overweight and obese adults.
• High heterogeneity across studies highlights the need for personalized digital health strategies and further research into effective components.
• Digital health should complement, not replace, established obesity treatments, integrating with clinical oversight and behavioral counseling for enhanced outcomes.