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Cited by 278Mobile Health and mHealth ApplicationsDigital Mental Health InterventionsObesity, Physical Activity, Diet

Web-Based Digital Health Interventions for Weight Loss and Lifestyle Habit Changes in Overweight and Obese Adults: Systematic Review and Meta-Analysis

Open access
Beleigoli, Alline M, Andrade, Andre Q, Cançado, Alexandre G, Paulo, Matheus NL, Diniz, Maria De Fátima H, Ribeiro, Antonio L·2019·Journal of Medical Internet Research
DOI 10.2196/jmir.9609PMC PMC6330028

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Abstract

: Obesity is a highly prevalent condition with important health implications. Face-to-face interventions to treat obesity demand a large number of human resources and time, generating a great burden to individuals and health system. In this context, the internet is an attractive tool for delivering weight loss programs due to anonymity, 24-hour-accessibility, scalability, and reachability associated with Web-based programs. : We aimed to investigate the effectiveness of Web-based digital health interventions, excluding hybrid interventions and non-Web-based technologies such as text messaging, short message service, in comparison to nontechnology active or inactive (wait list) interventions on weight loss and lifestyle habit changes in individuals with overweight and obesity. : We searched PubMed or Medline, SciELO, Lilacs, PsychNet, and Web of Science up to July 2018, as well as references of previous reviews for randomized trials that compared Web-based digital health interventions to offline interventions. Anthropometric changes such as weight, body mass index (BMI), waist, and body fat and lifestyle habit changes in adults with overweight and obesity were the outcomes of interest. Random effects meta-analysis and meta-regression were performed for mean differences (MDs) in weight. We rated the risk of bias for each study and the quality of evidence across studies using the Grades of Recommendation, Assessment, Development, and Evaluation approach. : Among the 4071 articles retrieved, 11 were included. Weight (MD −0.77 kg, 95% CI −2.16 to 0.62; 1497 participants; moderate certainty evidence) and BMI (MD −0.12 kg/m2; 95% CI −0.64 to 0.41; 1244 participants; moderate certainty evidence) changes were not different between Web-based and offline interventions. Compared to offline interventions, digital interventions led to a greater short-term (<6 months follow-up) weight loss (MD −2.13 kg, 95% CI −2.71 to −1.55; 393 participants; high certainty evidence), but not in the long-term (MD −0.17 kg, 95% CI −2.10 to 1.76; 1104 participants; moderate certainty evidence). Meta-analysis was not possible for lifestyle habit changes. High risk of attrition bias was identified in 5 studies. For weight and BMI outcomes, the certainty of evidence was moderate mainly due to high heterogeneity, which was mainly attributable to control group differences across studies (R2=79%). : Web-based digital interventions led to greater short-term but not long-term weight loss than offline interventions in overweight and obese adults. Heterogeneity was high across studies, and high attrition rates suggested that engagement is a major issue in Web-based interventions.

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  • A meta-analysis by Beleigoli et al found that web-based interventions resulted in modest but significant additional weight loss compared with standard care.

    “a meta-analysis by Beleigoli et al [53] found that web-based interventions resulted in modest but significant additional weight loss compared with standard care.”

    From Impact of Digital Engagement on Weight Loss Outcomes in Obesity Management Among Individuals Using GLP-1 and Dual GLP-1/GIP Receptor Agonist Therapy: Retrospective Cohort Service Evaluation Study (2025) · cites this paper as [53]

    The Results (Sensitivity Analyses) report significantly greater weight loss with web-based interventions in studies with less than six months of follow-up. But the Results and Discussion (Principal Findings) say weight loss was not significantly different overall or at six months or longer. The claim omits that short-term limitation and describes the comparator as standard care, whereas the paper compares web-based interventions with varied offline control interventions. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Digital technology-based programs have resulted in increased physical activity and reduced body weight, at least for a short duration.

    “Several systematic reviews and meta-analyses [15–19] have shown that these digital technology-based programs resulted in increased PA and reduced body weight, at least for a short duration.”

    From A systematic review of artificial intelligence chatbots for promoting physical activity, healthy diet, and weight loss (2021) · cites this paper as [17]

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Research works printed but not linked: 1

  1. [10]Review Manager (RevMan) computer program, 5 ed 2014 Copenhagen: The Nordic Cochrane Centre The Cochrane Collaboration

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Authors
Beleigoli, A. M., Andrade, A. Q., Cançado, A. G., Paulo, M. N., Diniz, M. D. F. H., & Ribeiro, A. L.
Affiliations
  • Universidade Federal de Minas Gerais (BR)
  • University of South Australia (AU)
Corresponding author
Beleigoli, Alline M
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2019-01-08
Volume
21
Issue
1
Pages
e298
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.9609
PMC
PMC6330028
OpenAlex
W2888961673
Cited by
278
References
22
Citations by year
2026: 26 · 2025: 45 · 2024: 45 · 2023: 50 · 2022: 49 · 2021: 36 · 2020: 22 · 2019: 5
FWCI
2.87
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UniSA Research Outputs Repository (University of South Australia) (submittedVersion, other-oa)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
obesity, overweight, weight loss, body mass index, anthropometric outcomes, attrition bias, long-term weight maintenance, waitlist control, adults with obesity, fat mass, waist circumference, effect size heterogeneity, quality of evidence
MeSH terms
Adult, Habits, Humans, Life Style, Obesity, Weight Loss, Telemedicine, Internet, Cell Phone, Overweight, Weight Reduction Programs

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