Comparison of Smartphone-based Behavioral Obesity Treatment to Gold Standard Group Treatment and Control: A Randomized Trial

OBJECTIVE: Determine whether weight losses from a primarily smartphone-based behavioral obesity treatment differed from those of a more intensive group-based approach and a control condition. METHODS: 276 adults with overweight/obesity were randomized to 18-months of: GROUP-based treatment with meetings weekly for 6 months, bi-weekly for 6 months, and monthly for 6-months and self-monitoring via paper diaries with written feedback; SMARTphone-based treatment with online lessons, self-monitoring, and feedback and monthly weigh-ins; or a CONTROL condition with self-monitoring via paper diaries with written feedback and monthly weigh-ins. RESULTS: Among the 276 participants (17% men; 7.2% minority; mean [SD] age, 55.1 [9.9] years; weight, 95.9 [17.0] kg; BMI, 35.2 [5.0] kg/m(2)), 18-month retention was significantly higher in both GROUP (83%) and SMART (81%) compared to CONTROL (66%). Estimated mean (95% CI) weight change over 18 months did not differ across the three conditions; 5.9 kg (95% CI, 4.5 to 7.4) in GROUP, 5.5 kg (95% CI, 3.9 to 7.0) in SMART, and 6.4 kg (95% CI, 3.7 to 9.2) in CONTROL. CONCLUSIONS: Mobile online delivery of behavioral obesity treatment can achieve weight loss outcomes that are at least as good as those obtained via the more intensive gold standard group-based approach.