User Engagement and Weight Loss Facilitated by a Mobile App: Retrospective Review of Medical Records

Abstract

Background Intermittent fasting (IF) has gained popularity in recent years for its effect on weight loss and supposed additional health benefits, such as a positive effect on body composition and metabolic markers. Mobile apps can act as platforms that help deliver dietary interventions by improving adherence and motivation. Although the effect of IF on weight loss has been demonstrated in earlier trials, there is not much research about the engagement and weight loss results with IF apps. Objective Our main objective was to compare how a nudging platform (including smart scales) influences engagement (the extent to which users interact with the app measured by the number of active days) with the app among users who had obesity at the beginning of use. The secondary objectives were to evaluate the body weight changes among active and nonactive users and, finally, to evaluate the body composition changes of users possessing smart scales during app usage. Through this study, we hope to provide (1) more insight into how nudging (using smart scales as a nudging platform) is associated with engagement with the mobile app, (2) how engagement with the mobile app is associated with weight loss, and (3) how IF is associated with body composition. Methods We performed a retrospective analysis of data from 665 users with obesity (BMI≥30) who started using the IF app DoFasting. Of them, 244 used body composition scales that estimated body fat and body muscle values. Users were stratified into engagement groups in accordance with their activity ratio (number of active days divided by the total time of use). Baseline and final users' weight (in kg), body fat (in %), and body muscle (in %) were compared. Results Our findings suggest an association between the nudging platform (smart scales) and better engagement with the app. Smart scale users had a significantly higher activity ratio than regular users. Additionally, active DoFasting users lost significantly more weight. Further, body composition analysis showed that app usage might be related to body fat loss and an increase in muscle mass. Conclusions We found a possible association between the nudging and gamified elements and higher app engagement. Additionally, increased app engagement is associated with increased weight loss. Thus, nudging and gamified elements of mobile health apps, such as interactive tools, goals, challenges, and progress tracking, are suggested to affect engagement positively and should be investigated further in future research. Finally, the IF regime delivered through the DoFasting app might be related to the body muscle mass gain and reduced fat mass.

The effectiveness of mobile app usage in facilitating weight loss: An observational study

“… 23 Similarly, Valinskas et al., (2023) found that greater engagement with an intermittent fasting app was associated with significantly greater WL in participants with obesity. 24 However, further studies including more participants are needed to validate findings and expand the evidence related to various time periods and to individuals living with overweight.…”

Weight Loss Using an mHealth App Among Individuals With Obesity in Different Economic Regions of China: Cohort Study

“…A new online weight management system, the smart body fat scale, calculates the percentage of body fat (PBF), records and synchronizes the data to mobile health (mHealth) apps, and offers more advantages than a traditional scale [ 14 , 15 ]. In addition to measuring PBF, smart body fat scales usually offer additional features such as the ability to track weight and body fat over time and the ability to measure other health-related metrics such as muscle mass [ 16 ]. The use of mHealth with smart body fat scales has become increasingly popular in recent years, as individuals seek to monitor their health and fitness more closely and make more informed decisions about their diets and physical activity patterns.…”