Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial
Open accessAbstract
Importance: Effective long-term treatments are needed to address the obesity epidemic. Numerous wearable technologies specific to physical activity and diet are available, but it is unclear if these are effective at improving weight loss. Objective: To test the hypothesis that, compared with a standard behavioral weight loss intervention (standard intervention), a technology-enhanced weight loss intervention (enhanced intervention) would result in greater weight loss. Design, Setting, Participants: Randomized clinical trial conducted at the University of Pittsburgh and enrolling 471 adult participants between October 2010 and October 2012, with data collection completed by December 2014. Interventions: Participants were placed on a low-calorie diet, prescribed increases in physical activity, and had group counseling sessions. At 6 months, the interventions added telephone counseling sessions, text message prompts, and access to study materials on a website. At 6 months, participants randomized to the standard intervention group initiated self-monitoring of diet and physical activity using a website, and those randomized to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity. Main Outcomes and Measures: The primary outcome of weight was measured over 24 months at 6-month intervals, and the primary hypothesis tested the change in weight between 2 groups at 24 months. Secondary outcomes included body composition, fitness, physical activity, and dietary intake. Results: Among the 471 participants randomized (body mass index [BMI], 25 to <40; age range, 18-35 years; 28.9% nonwhite, 77.2% women), 470 (233 in the standard intervention group, 237 in the enhanced intervention group) initiated the interventions as randomized, and 74.5% completed the study. For the enhanced intervention group, mean base line weight was 96.3 kg (95% CI, 94.2-98.5) and 24-month weight 92.8 kg (95% CI, 90.6- 95.0) [corrected]. For the standard intervention group, mean baseline weight was 95.2kg (95%CI,93.0-97.3)and24-month weight was 89.3 kg (95%CI, 87.1-91.5) [corrected]. Weight change at 24 months differed significantly by intervention group (estimated mean weight loss, 3.5 kg [95% CI, 2.6-4.5} in the enhanced intervention group and 5.9 kg [95% CI, 5.0-6.8] in the standard intervention group; difference, 2.4 kg [95% CI, 1.0-3.7]; P = .002). Both groups had significant improvements in body composition, fitness, physical activity, and diet, with no significant difference between groups. Conclusions and Relevance: Among young adults with a BMI between 25 and less than 40, the addition of a wearable technology device to a standard behavioral intervention resulted in less weight loss over 24 months. Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches. Trial Registration: clinicaltrials.gov Identifier: NCT01131871.
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17 studies reported activity tracker adherence data, with 13 of these reporting activity tracker wear on at least 50% of the study intervention days.
“Moreover, 17 studies reported activity tracker adherence data [21,22,30,32,34,35, 37,38,40,41,43-45,50-52,54], with 13 of these studies [21,22,30,34,35,40,41,43,44,50-52,54] reporting activity tracker wear on at least 50% of the study intervention days.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [37]
The Results (page unavailable) report device-wear data for this trial, supporting its identification as a study that reported activity-tracker adherence. This single trial does not establish the citing paper’s aggregate counts of 17 studies or 13 studies with wear on at least 50% of intervention days; it reports a median of 170 days worn, without stating that threshold was met. (LLM, conf=0.82)
Experimental — accuracy not yet measured4 studies reported low activity tracker wear time, with 1 study reporting that all participants had ceased wearing their activity tracker by the end of the intervention.
“Furthermore, 4 studies [32,37,38,45] reported low activity tracker wear time, with 1 study [32] reporting that all participants had ceased wearing their activity tracker by the end of the intervention.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [37]
The Results report limited wearable-device use: among participants who wore the device at least once, median use was 170 days, with a median of 241.1 minutes on days worn. The paper does not report that all participants had stopped wearing it by the end of the intervention. The statement about four studies is supported by multiple citations, not established by this source alone. (LLM, conf=0.84)
Experimental — accuracy not yet measuredOne study reported a reduction in daily steps, one reported a reduction in MVPA participation, and three reported a reduction in energy expenditure in at least one included intervention group.
“One study reported a reduction in daily steps [42], 1 study reported a reduction in MVPA participation [37], and 3 studies reported a reduction in energy expenditure [46,47,52] in at least one of the included intervention groups.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [37]
The Results section (page unavailable) reports that MVPA in bouts of at least 10 minutes changed significantly over time, but does not say it decreased in either intervention group. It also reports no significant change in total MVPA. Citation [37] applies to the MVPA portion of the sentence, not the separately cited steps or energy-expenditure claims. (LLM, conf=0.76)
Experimental — accuracy not yet measuredThe two studies that were 12 months or longer reported lower adherence rates compared with shorter duration studies.
“The 2 studies that were 12 months or longer [32,37] reported lower adherence rates compared with shorter duration studies.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [37]
The Results (page not provided) describe a 24-month study and report wearable-device use: among 237 participants assigned to the wearable group, 191 wore it for at least one day, with a median of 170 days worn after the device was introduced at month 6. This supports the claim’s characterization of device use in this long-duration study, but the paper does not report a comparison of adherence rates with shorter-duration studies. (LLM, conf=0.82)
Experimental — accuracy not yet measuredLess time was spent in sedentary behavior for those receiving a consumer-based wearable activity tracker intervention compared with control groups; however, the finding was not significant, and the quality of the evidence was graded as very low.
“Less time was spent in sedentary behavior for those receiving a consumer-based wearable activity tracker intervention compared with control groups; however, the finding was not significant, and the quality of the evidence was graded as very low [29,31-33,37-40].”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [37]
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Previous studies showed that merely adding tracking tools to BWL may be of no benefit, or even have iatrogenic effects.
“Given previous studies showing that merely adding tracking tools to BWL may be of no benefit, or even have iatrogenic effects, use of these tools would have to be accompanied by a careful intervention strategy to guide participants in summarizing and interpreting their data to inform behavior change (Jakicic et al., 2016; Thomas et al., 2017).”
From Associations Between Self-Monitoring and Weight Change in Behavioral Weight Loss Interventions (2019) · cites this paper as Jakicic et al., 2016
17 studies specified that participants must have regular access to the internet, a computer, tablet, and/or smartphone.
“Furthermore, 17 studies specified that the participant must have regular access to the internet, a computer, tablet, and/or smartphone [21,30,33,35-37,39,41-47,51-53]”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [37]
13 studies included young adults (≤39.9 years), 15 included middle-aged adults (40-64.9 years), and 1 included adults over 65 years.
“Thirteen studies included young adults (≤39.9 years) [30-34,37,38,42,44,46-48,50], 15 included middle-aged adults (40-64.9 years) [21,22,29,35,36,39-41, 43,45,51-54], and 1 study included adults aged over 65 years [49].”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [37]
Eight studies that reported physical activity outcome measures had greater than 20% loss to follow-up, with three of these reporting a reduction in physical activity participation.
“In addition, 8 studies [29,32,33,37,42,43,46,48] that reported physical activity outcome measures had greater than 20% loss to follow-up, with 3 of these studies reporting a reduction in physical activity participation.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [37]
In one weight loss intervention study, there were no changes in weight for those participants who wore a wearable physical activity device and tracked intake through a food tracking website compared with participants who completed MVPA and food diaries [6].
“For example, in one weight loss intervention study, there were no changes in weight for those participants who wore a wearable physical activity device and tracked intake through a food tracking website compared with participants who completed MVPA and food diaries [6].”
From Estimating Accuracy at Exercise Intensities: A Comparative Study of Self-Monitoring Heart Rate and Physical Activity Wearable Devices (2017) · cites this paper as [6]
Wearable device technologies have long been used in health interventions in clinical settings with promising results.
“While wearable device technologies have long been used in health interventions in clinical settings with promising results [11], the ease and accessibility of consumer-level devices containing such integrated sensors, be it in clothes or other accessories, could further democratize their use and might provide health benefits to users suffering from anxiety and depression.”
From Wearable devices for anxiety & depression: A scoping review (2023) · cites this paper as [11]
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- Authors
- Jakicic, J. M., Davis, K. K., Rogers, R. J., King, W. C., Marcus, M. D., Helsel, D., Rickman, A. D., Wahed, A. S., & Belle, S. H.
- Affiliations
- University of Pittsburgh (US)
- Bastyr University (US)
- Slippery Rock University (US)
- Corresponding author
- Jakicic, John M.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2016-09-20
- Volume
- 316
- Issue
- 11
- Pages
- 1161
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC5480209
- OpenAlex
- W2522531501
- Cited by
- 621
- References
- 33
- Citations by year
- 2026: 16 · 2025: 22 · 2024: 23 · 2023: 29 · 2022: 44 · 2021: 83 · 2020: 141 · 2019: 87 · 2018: 91 · 2017: 76 · 2016: 7 · 2015: 1
- FWCI
- 161.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (P30AG024827)
- National Heart, Lung, and Blood Institute (U01HL096770)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- wearable devices, weight loss, obesity, lifestyle intervention, behavioral weight loss, hypocaloric diet, physical activity, self-monitoring, mobile health, telephone counseling, body composition, dietary intake, long-term weight maintenance, technology-based interventions, young adults, body mass index, exercise adherence, dietary adherence, group counseling
- MeSH terms
- Healthy Lifestyle, Wearable Electronic Devices, Adolescent, Adult, Female, Humans, Male, Obesity, Weight Loss, Body Mass Index, Caloric Restriction, Young Adult
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