The effectiveness of technology-based distance weight loss interventions on body composition in health care: a systematic review, meta-analysis and meta-regression (Preprint)

Abstract

BACKGROUND Overweight and obesity are major problems worldwide and they lead to an increased risk for several diseases. The use of technology in the treatment of obesity is promising, but there is considerable uncertainty regarding its efficacy in the current literature. OBJECTIVE The aim of this systematic review was to study the effectiveness of technology-based distance weight loss interventions in health care on body composition in comparison to control groups that do not use technology. The aim of the meta-regression was to evaluate the factors associated with the changes in body composition outcomes in a comprehensive PICOS -framework. METHODS Studies were searched from eight databases. The inclusion criteria were developed based on the PICOS-framework (population: 18-65 years; intervention: technology-based distance weight loss interventions; comparison: control groups without technology; outcome: BMI, waist circumference or body fat percentage; study design: randomized controlled trial). Meta-analysis and meta-regression were performed. RESULTS The meta-analysis included 30 studies. The quality of the studies was moderate (7/13). A statistically significant difference was observed in BMI (MD 0.83; 95% CI 0.51 to 1.15; P < .0001), waist circumference (MD 2.45; 95% CI 1.83 to 3.07; P < .0001), and body fat percentage (MD 1.07; 95% CI 0.74 to 1.41; P < .0001) in favor of the weight loss groups using technology. According to the findings of the meta-regression, interventions with personal feedback and higher quality of the studies may have been associated with a reduction in waist circumference and lower body fat percentage. CONCLUSIONS Technology-based distance weight loss interventions significantly reduced BMI, waist circumference, and body fat percentage. Future studies should focus on the comparability of the intervention content but also on the relations between the type of technology, behavioral change models, and biopsychosocial factors. CLINICALTRIAL This systematic review is registered in Prospero (CRD42016035831).