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Cited by 666Mobile Health and mHealth ApplicationsDigital Mental Health InterventionsMobile Learning in Education

The DOI matches its Crossref record; 39 of the 40 references it cites were found in a registry or an index; none of the 14 sources its claims cite is checked for support yet.

Adherence to a Smartphone Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized Controlled Trial

Open access
Carter, Michelle Clare, Burley, Victoria Jane, Nykjaer, Camilla, Cade, Janet Elizabeth·2013·Journal of Medical Internet Research
DOI 10.2196/jmir.2283PMC PMC3636323
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Abstract

BACKGROUND: There is growing interest in the use of information communication technologies to treat obesity. An intervention delivered by smartphone could be a convenient, potentially cost-effective, and wide-reaching weight management strategy. Although there have been studies of texting-based interventions and smartphone applications (apps) used as adjuncts to other treatments, there are currently no randomized controlled trials (RCT) of a stand-alone smartphone application for weight loss that focuses primarily on self-monitoring of diet and physical activity. OBJECTIVE: The aim of this pilot study was to collect acceptability and feasibility outcomes of a self-monitoring weight management intervention delivered by a smartphone app, compared to a website and paper diary. METHODS: A sample of 128 overweight volunteers were randomized to receive a weight management intervention delivered by smartphone app, website, or paper diary. The smartphone app intervention, My Meal Mate (MMM), was developed by the research team using an evidence-based behavioral approach. The app incorporates goal setting, self-monitoring of diet and activity, and feedback via weekly text message. The website group used an existing commercially available slimming website from a company called Weight Loss Resources who also provided the paper diaries. The comparator groups delivered a similar self-monitoring intervention to the app, but by different modes of delivery. Participants were recruited by email, intranet, newsletters, and posters from large local employers. Trial duration was 6 months. The intervention and comparator groups were self-directed with no ongoing human input from the research team. The only face-to-face components were at baseline enrollment and brief follow-up sessions at 6 weeks and 6 months to take anthropometric measures and administer questionnaires. RESULTS: Trial retention was 40/43 (93%) in the smartphone group, 19/42 (55%) in the website group, and 20/43 (53%) in the diary group at 6 months. Adherence was statistically significantly higher in the smartphone group with a mean of 92 days (SD 67) of dietary recording compared with 35 days (SD 44) in the website group and 29 days (SD 39) in the diary group (P<.001). Self-monitoring declined over time in all groups. In an intention-to-treat analysis using baseline observation carried forward for missing data, mean weight change at 6 months was -4.6 kg (95% CI -6.2 to -3.0) in the smartphone app group, -2.9 kg (95% CI -4.7 to -1.1) in the diary group, and -1.3 kg (95% CI -2.7 to 0.1) in the website group. BMI change at 6 months was -1.6 kg/m(2) (95% CI -2.2 to -1.1) in the smartphone group, -1.0 kg/m(2) (95% CI -1.6 to -0.4) in the diary group, and -0.5 kg/m(2) (95% CI -0.9 to 0.0) in the website group. Change in body fat was -1.3% (95% CI -1.7 to -0.8) in the smartphone group, -0.9% (95% CI -1.5 to -0.4) in the diary group, and -0.5% (95% CI -0.9 to 0.0) in the website group. CONCLUSIONS: The MMM app is an acceptable and feasible weight loss intervention and a full RCT of this approach is warranted. TRIAL REGISTRATION: ClinicalTrials.gov NCT01744535; http://clinicaltrials.gov/ct2/show/NCT01744535 (Archived by WebCite at http://www.webcitation.org/6FEtc3PVB).

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In a 6-month pilot randomized controlled trial, a stand-alone smartphone app for weight loss self-monitoring (My Meal Mate) produced higher trial retention and dietary self-monitoring adherence than a website or paper diary. The app was rated acceptable and feasible, and the authors concluded that a full RCT is warranted.

Key findings

  • Trial retention at 6 months was 40/43 (93%) in the smartphone group, 19/42 (55%) in the website group, and 20/43 (53%) in the diary group.
  • Mean days of dietary recording were 92 (SD 67) in the smartphone group, 35 (SD 44) in the website group, and 29 (SD 39) in the diary group (P<.001); self-monitoring declined over time in all groups.
  • In intention-to-treat analysis with baseline observation carried forward, mean weight change at 6 months was –4.6 kg (95% CI –6.2 to –3.0) for smartphone, –2.9 kg (95% CI –4.7 to –1.1) for diary, and –1.3 kg (95% CI –2.7 to 0.1) for website.
  • Clinically significant weight loss (≥5% of initial weight) was achieved by 16/43 (37.2%) in the smartphone group, 12/43 (27.9%) in the diary group, and 7/42 (16.7%) in the website group.

Methods

  • Three-arm parallel-group pilot RCT: 128 overweight volunteers with BMI ≥27 kg/m², aged 18–65 years, recruited from large employers in Leeds, UK; randomized by minimization to smartphone app, website, or paper diary for 6 months.
  • The smartphone intervention (My Meal Mate) included goal setting, self-monitoring of diet and activity, and weekly tailored text-message feedback; comparator groups used a commercial slimming website or paper diary plus calorie-counting book, all based on the same Weight Loss Resources food database.
  • Primary outcomes were feasibility and acceptability, including trial retention and intervention adherence/frequency of use; anthropometric measures were taken at baseline, 6 weeks, and 6 months, with descriptive analyses, ANOVA/Kruskal-Wallis tests, and intention-to-treat and completer analyses.

Limitations

  • The paper states that generalizability is limited because the sample was predominantly white, female, and employed in managerial/professional occupations; the app was a prototype and participants reported frequent bugs causing it to close; and contamination occurred, with 20 participants reporting use of another intervention, including one diary-group participant who used MyFitnessPal and lost 32 kg, strongly influencing the diary-group mean.
  • The paper also states that unequal dropout among groups is a potential source of bias for a larger RCT, and that the pilot was not statistically powered to detect change in anthropometric measures.
  • Evident from the text: the small pilot sample and high overall attrition (38%) limit interpretation of weight-loss effect sizes.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/jmir.2283

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 14 cited sources checked · 0 supported · 0 flagged

Show all 29 claims

  • It may state two separate claims as one. 34
  • Probably not a substantial claim. 18
  • The quote only partly states this claim. 1
42 of 42

  • The paper relies on this without support.

    Smartphone apps are likely to be used as a stand-alone intervention rather than as an adjunct to another intervention.

    “A trial of this type is necessary because smartphone apps are readily available to the public to download and likely to be used as a stand-alone intervention rather than as an adjunct to another intervention (such as podcasts or face-to-face advice).”

  • The paper relies on this without support.

    Commercial diet tracking apps have not been comprehensively evaluated to date.

    “Despite their apparent popularity, these commercial apps have not been comprehensively evaluated to date.”

  • The paper relies on this without support.

    There have been no large RCTs of smartphone apps for weight loss.

    “To our knowledge, there have been no large RCTs of smartphone apps for weight loss and this pilot trial provides valuable data that could be used to inform such a trial.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Diary retention percentage is incorrect

    Major

    At 6 months, 20 of 43 diary participants were retained, or 46.5%, not 53%. The stated 53% is approximately the percentage who did not return.

    Reported 53 · recomputed 46.511628

  • Website retention percentage is incorrect

    Major

    At 6 months, 19 of 42 website participants were retained, or 45.2%, not 55%. The stated 55% is approximately the percentage who did not return.

    Reported 55 · recomputed 45.238095

  • Smartphone baseline weight differs between tables

    Minor

    Tables 1 and 5 both give baseline weight for all 43 smartphone participants, but report means of 96.4 kg and 96.8 kg, respectively.

  • Six-week follow-up count differs between text and Table 6

    Minor

    The text says 94 participants returned for six-week follow-up measurements, but Table 6 describes recorded anthropometric measures at six weeks for 95 participants.

  • Six-month intervention-use P value differs between text and table

    Minor

    The text reports P=.001 for the between-group difference at 6 months, whereas Table 4 reports P<.001.

  • Percentage for 31 diary participants does not match group size

    Minor

    Table 4 labels the diary group as n=43. Thus 31 participants represent 72.1%, not the reported 78%; no different denominator is specified for this row.

    Reported 78 · recomputed 72.093023

  • Six-week intervention-use P value differs between text and table

    Minor

    The text reports P<.001 for the between-group difference at 6 weeks, whereas Table 4 reports .004 for that comparison.

  • Claimed significant weight difference has a confidence interval crossing zero

    Minor

    The reported 95% confidence interval for the smartphone-website difference extends from a negative value to a positive value, contradicting the statement that this difference was statistically significant.

8 of 8

Citations

Cites

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Show all 40 references

1 of the 40 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. National Institute for Health and Clinical ExcellenceNational Collaborating Centre for Primary CareObesity: the prevention, identification, assessment and management of overweight and obesity in adults and children2006122013-02-08http://www.ncbi.nlm.nih.gov/books/NBK63696/pdf/TOC.pdf6EHmUsiDu
  2. Kellow, J, 2011, Calorie, Carb & Fat Bible
  3. 10.1038/oby.2010.208 · DOI · Paper page

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Metadata

Authors
Carter, M. C., Burley, V. J., Nykjaer, C., & Cade, J. E.
Affiliations
University of Leeds (GB)
Corresponding author
Carter, Michelle Clare
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2013-04-15
Volume
15
Issue
4
Pages
e32
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.2283
PMC
PMC3636323
OpenAlex
W2016679476
Cited by
666
References
40
Citations by year
2026: 20 · 2025: 19 · 2024: 29 · 2023: 30 · 2022: 53 · 2021: 36 · 2020: 66 · 2019: 72 · 2018: 63 · 2017: 76 · 2016: 85 · 2015: 71 · 2014: 40 · 2013: 6
FWCI
121.96
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Journal of Medical Internet Research (publishedVersion, public-domain)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Physical Sciences › Computer Science › Information Systems › Mobile Learning in Education
Keywords
mobile application, weight loss, obesity, self-monitoring, dietary self-monitoring, paper diaries, intervention adherence, acceptability, feasibility, weight management, goal setting, overweight adults, trial retention, weight change, physical activity, self-guided intervention, information and communication technologies
MeSH terms
Adult, Female, Humans, Male, Middle Aged, Obesity, Patient Acceptance of Health Care, Patient Compliance, Pilot Projects, Diet Records, Telemedicine, Internet, Cell Phone, Weight Reduction Programs, Mobile Applications

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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