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Effectiveness of a Smartphone Application for Weight Loss Compared With Usual Care in Overweight Primary Care Patients: A Randomized, Controlled Trial

Open access
Laing, Brian Yoshio, Mangione, Carol M., Tseng, Chi-Hong, Leng, Mei, Vaisberg, Ekaterina, Mahida, Megha, Bholat, Michelle, Glazier, Eve +2 more·2014·Annals of Internal Medicine
DOI 10.7326/m13-3005PMC PMC4422872
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Abstract

BACKGROUND: Many smartphone applications (apps) for weight loss are available, but little is known about their effectiveness. OBJECTIVE: To evaluate the effect of introducing primary care patients to a free smartphone app for weight loss. DESIGN: Randomized, controlled trial. (ClinicalTrials.gov: NCT01650337). SETTING: 2 academic primary care clinics. PATIENTS: 212 primary care patients with body mass index of 25 kg/m2 or greater. INTERVENTION: 6 months of usual care without (n = 107) or with (n = 105) assistance in downloading the MyFitnessPal app (MyFitnessPal). MEASUREMENTS: Weight loss at 6 months (primary outcome) and changes in systolic blood pressure and behaviors, frequency of app use, and satisfaction (secondary outcomes). RESULTS: After 6 months, weight change was minimal, with no difference between groups (mean between-group difference, -0.30 kg [95% CI, -1.50 to 0.95 kg]; P = 0.63). Change in systolic blood pressure also did not differ between groups (mean between-group difference, -1.7 mm Hg [CI, -7.1 to 3.8 mm Hg]; P = 0.55). Compared with patients in the control group, those in the intervention group increased use of a personal calorie goal (mean between-group difference, 2.0 d/wk [CI, 1.1 to 2.9 d/wk]; P < 0.001), although other self-reported behaviors did not differ between groups. Most users reported high satisfaction with MyFitnessPal, but logins decreased sharply after the first month. LIMITATIONS: Despite being blinded to the name of the app, 14 control group participants (13%) used MyFitnessPal. In addition, 32% of intervention group participants and 19% of control group participants were lost to follow-up at 6 months. The app was given to patients by research assistants, not by physicians. CONCLUSION: Smartphone apps for weight loss may be useful for persons who are ready to self-monitor calories, but introducing a smartphone app is unlikely to produce substantial weight change for most patients. PRIMARY FUNDING SOURCE: Robert Wood Johnson Foundation Clinical Scholars Program, National Institutes of Health/National Center for Advancing Translational Sciences for the UCLA Clinical and Translational Science Institute, and the Resource Centers for Minority Aging Research Center for Health Improvement of Minority Elderly under the National Institutes of Health/National Institute on Aging.

AI snapshot

Written from the paper’s full text.

TL;DR

In a 6-month randomized trial in overweight primary care patients, helping patients download the MyFitnessPal weight-loss app did not produce significantly greater weight loss than usual care. App use dropped sharply after the first month, though some motivated users reported high satisfaction and a few lost substantial weight.

Key findings

  • No significant between-group difference in weight change at 6 months: mean difference −0.67 lb (CI, −3.3 to 2.1 lb; p = 0.63). Control group gained an average of 0.60 lb; intervention group lost 0.07 lb.
  • No significant between-group difference in systolic blood pressure change: mean difference −1.7 mmHg (CI, −7.1 to 3.8; p = 0.55).
  • Intervention participants reported using a personal calorie goal more often than controls: mean difference 2.0 days per week (CI, 1.1 to 2.9; p < .001) at 6 months.
  • App logins declined rapidly: median total logins over 6 months was 19; median logins were 8 (IQR 2, 24) in month 1 and 0 (IQR 0, 2) in month 6. Among intervention participants, 94 used the app in month 1 versus 34 in month 6.
  • Among app users completing the 6-month survey, 79% were somewhat or completely satisfied, 92% would recommend it, and 80% planned to continue using it.

Methods

  • Randomized controlled trial conducted at two UCLA primary care clinics; 212 primary care patients with BMI ≥25 kg/m² and smartphone ownership were randomized to usual care (n = 107) or usual care plus research-assistant help downloading MyFitnessPal (n = 105).
  • Assessments at baseline, 3 months, and 6 months; primary outcome was weight change at 6 months; secondary outcomes included systolic blood pressure, behavioral mediators, satisfaction, and app use.
  • Main analysis used linear mixed-effects models comparing weight, SBP, and behavioral survey changes between groups while controlling for clinic site; sensitivity analyses addressed informative dropout and one control-group outlier who used MyFitnessPal extensively.

Limitations

  • The paper states that 14 control participants (16%) used MyFitnessPal despite blinding to the app name, 32% of intervention participants and 19% of control participants were lost to follow-up at 6 months, and the app was given by research assistants rather than physicians.
  • The paper also notes that readiness for change or motivation was not explicitly measured, follow-up was only 6 months, and clinicians did not recommend or follow up on app use.
  • The text makes evident that the trial tested one version of a commercial app whose features may change over time, and that the control group received no specified alternative weight-loss intervention beyond usual care.

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

Integrity signals

Registry

Crossref · 10.7326/m13-3005

Cites

16 of 16 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 17 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    There was no statistically significant difference between the intervention and control groups in weight change at 6 months (mean between-group difference, −0.67 lb [CI, −3.3 to 2.1 lb]; p = 0.63).

    “There was no significant difference between intervention and control groups in weight change (mean between group difference, −0.67 lb [CI, −3.3 to 2.1lb]; p = 0.63)”
    • Also stated in: § Weight Loss, and Systolic Blood Pressure · plain
      “At 6 months, the control group gained an average of 0.60 pounds and the intervention group lost .07 pounds for a between group difference of −0.67 lbs [CI, −3.3 to 2.1], (p = 0.63) (Table 2).”
    • Also stated in: § DISCUSSION · plain
      “The principal finding of this six-month trial was that the MyFitnessPal app delivered to overweight patients in primary care did not result in increased weight loss compared to usual primary care.”
    Quote in the paperSubstantial claim
  • Findingown data

    Among the 58 intervention participants who stopped using MFP and responded, 84% reported it was tedious.

    “Of the 58 individuals who responded, 84% reported it was tedious, 24% reported it was not easy to use, and 88% reported “Other.””
    Quote in the paperNot a substantial claim
  • Findingown data

    There was no statistically significant association between baseline characteristics and extent of app usage or weight change.

    “There was no statistically significant association between baseline characteristics and extent of app usage or weight change.”
    Quote in the paperNot a substantial claim
  • Findingown data

    At 3 months, there was no statistically significant difference between groups in weight change (mean between-group difference, −0.60 lb [CI, −2.5 to 1.3 lb]; p = 0.53).

    “At 3 months, the control group gained an average of .54 pounds whereas the intervention group lost 0.06 pounds for a between group difference of −0.60 lbs [CI, −2.5 to 1.3 lb]; (p = 0.53).”
    Quote in the paperSubstantial claim
  • Findingown data

    There was no statistically significant difference between the intervention and control groups in systolic blood pressure change at 6 months (mean between-group difference, −1.7 mmHg [CI, −7.1 to 3.8]; p = 0.55).

    “or in SBP (mean between group difference, −1.7 mmHg [CI, −7.1 to 3.8]; p = 0.55)”
    • Also stated in: § Weight Loss, and Systolic Blood Pressure · plain
      “Difference in systolic blood pressure change between groups was also minimal.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 32
  • May combine two claims. 19

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Most intervention participants who completed the 6-month survey reported high satisfaction with MyFitnessPal (79% somewhat or completely satisfied; 92% would recommend it; 80% planned to continue using it).

    “Most users reported high satisfaction with MyFitnessPal but logins dropped sharply after the first month.”
    • Also stated in: § Reviews of MyFitnessPal · plain
      “Although app usage dropped during the study, participants who completed the survey reported high satisfaction at 6 months, with 79% of participants stating they were somewhat or completely satisfied with the app and 92% reporting they would recommend it to a friend. 80% indicated they plan to continue using MFP.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Baseline self-efficacy was not associated with weight loss either alone or when interacted with group assignment.

    “Baseline self-efficacy was not associated with weight loss either alone or when interacted with group assignment, indicating those with greater baseline self-efficacy did not lose more weight and did not differentially lose more with the intervention.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The number of intervention participants who actually used the app was 94 in the first month and 34 in the sixth month.

    “The number of participants who actually used the app in the first month was 94 compared to 34 in the sixth month.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among participants with 6-month measurements, 16% of control participants and 18% of intervention participants lost at least 6 lbs.

    “Among participants with 6 month measurements, 14 of 87 participants (16%) in the control group lost 6 lbs or more whereas 13 of 71 in the intervention group (18%) lost 6 lbs or more.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The individual who used MyFitnessPal the most (782 logins) and lost the most weight (29 lbs) was from the control group.

    “The individual who used the app the most (782 logins) and lost the most weight (29 lbs) was from the control group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Over the 6-month study period, the mean total MyFitnessPal logins was 61 and the median total logins was 19.

    “Over the six month study period, the mean total logins was 61 and median total logins was 19.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Most participants did not use the app regularly, and the most common reported reasons for ceasing use were that it was tedious or that they were too stressed or busy.

    “Most participants, however, did not use the app regularly and they reported the most common reasons for ceasing use of the app were that it was tedious or that they were too stressed or busy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Usage of the social networking feature was minimal, with 80% of participants reporting having no friends in the MFP app.

    “Overall, usage of the social networking feature was minimal with 80% of participants reporting having “no friends” in the MFP app.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    To the authors' knowledge, no studies have examined the effectiveness of delivering or prescribing an app for weight loss to patients in a clinical setting.

    “To our knowledge, however, no studies have examined the effectiveness of delivering or “prescribing” an app for weight loss to patients in a clinical setting.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Adherence to diet self-monitoring is higher among patients using a smartphone app compared to patients using a paper diary.

    “One pilot trial recently demonstrated that adherence to diet self-monitoring is higher among patients using a smartphone app compared to patients using a paper diary (13).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Carter MC Burley VJ Nykjaer C Cade JE Adherence to a Smartphone Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized Controlled Trial J Med Internet Res 2013 15 4 e32 JMIR Publications Inc. Toronto, Canada 23587561 PMC3636323 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The institutional review board of the University of California, Los Angeles approved the study, and all participants provided written informed consent.

    “The institutional review board of the University of California, Los Angeles approved the study and all participants provided written informed consent.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The goal enrollment was 180 to account for attrition rates as high as 55%.

    “We set a goal enrollment of 180 to account for rates of attrition as high as 55%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Delivering engaging messages to educate users about the importance of self-monitoring and to incentivize patients to use the app may increase adherence.

    “Delivering engaging messages to educate users about the importance of self-monitoring and to incentivize patients to use the app may increase adherence (18).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Patrick K Raab F Adams MA Dillon L Zabinski M Rock CL A text message-based intervention for weight loss: randomized controlled trial J Med Internet Res 2009 11 1 e1 9 19141433 PMC2729073

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Study data were collected on iPads using REDCap electronic data capture tools hosted at UCLA.

    “Study data were collected on iPads® using REDCap™ electronic data capture tools hosted at UCLA.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    MFP and similar weight-loss apps may need to be substantially more engaging or less time-consuming to produce weight reduction in the average overweight patient.

    “An alternative explanation of our results is that MFP and similar weight-loss apps may need to be substantially more engaging or less time-consuming to produce weight reduction in the average overweight patient.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    As many as 40,000 health-related apps were available in 2012, comprising a $718 million industry.

    “The nascent field of mobile health (mHealth) is rapidly expanding with experts estimating as many as 40,000 health related apps available in 2012, comprising a $718 million industry (7).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] Cohn M Tens of thousands of health apps available, but which ones work? [Internet]. Baltimore Sun 2012 [cited 2012 May 30]. Available from: http://articles.baltimoresun.com/2012-03-14/health/bs-hs-mobile-health-apps-20120314_1_health-apps-mhealth-mobile-health

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The analysis of the dichotomous outcome (proportion losing at least 6 lbs) had not been pre-specified in the protocol.

    “The analysis of this dichotomous outcome had not been pre-specified in the protocol but was added to assess subgroups of patients who achieved significant weight loss.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The primary analysis included all participants based on their randomized intervention assignment, except for one intervention patient who became pregnant and no longer met inclusion criteria.

    “All participants were included in this primary analysis based upon their randomized intervention assignment, except for one patient in the intervention group who became pregnant and no longer met inclusion criteria.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Setting a realistic weight loss goal of 0.5 to 2 lbs per week is supported in self-regulation theory and is a standard setting of the MFP app.

    “Setting a realistic weight loss goal of 0.5 to 2 lbs per week is supported in self-regulation theory and is a standard setting of the MFP app (10).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Bandura A Simon KM The role of proximal intentions in self-regulation of refractory behavior Cogn Ther Res 9 1977 1 3 177 93

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Combining a weight loss app with a proven weight-loss counseling program could be a powerful combination of tools.

    “Combining a weight loss app with a proven weight-loss counseling program could also be a powerful combination of tools (3).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Wadden TA Volger S Sarwer DB Vetter ML Tsai AG Berkowitz RI A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice The New England Journal of Medicine 24 11 2011 365 21 1969 79 22082239 PMC3282598 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    A total sample size of 82 patients (41 per arm) was determined to provide 80% power to detect a 5.5 lb difference in weight change at 6 months, assuming a standard deviation of 8.8 lbs.

    “We determined that a total sample size of 82 patients (41 per arm) would allow us 80% power to detect a 5.5 lb difference in weight change at six months between the two groups, assuming a standard deviation of 8.8 lbs.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Study design and conductnone given

    Smartphone apps are constantly undergoing updates, so the features of MyFitnessPal have changed over time, although the core features in the version tested here have remained constant.

    “Of note, smartphone apps are constantly undergoing updates so the features of MyFitnessPal have changed over time, although the core features in the version tested here have remained constant.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Participants were block randomized by BMI 25-30 and BMI >30 to ensure roughly equal distribution of overweight and obese patients between groups.

    “Participants were block randomized by BMI 25-30 and BMI >30 to ensure roughly equal distribution of “overweight” and “obese” patients between intervention and control groups.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The app was given to patients by research assistants, not by physicians.

    “The app was given to patients by research assistants, not by physicians.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Primary care providers often omit discussing weight loss with obese patients and rarely spend adequate time on counseling.

    “It is no surprise that primary care providers often omit discussing weight loss with obese patients and rarely spend adequate time on counseling (4,5).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [4] Galuska D Will J Serdula M Are health care professionals advising obese patients to lose weight? JAMA 1999 16 1576 8 10546698 source

      Not checked in the free run.

    • cites [5] Heath C Grant W Marcheni P Do family physicians treat obese patients? Family Medicine 1993 6 401 2 8349062

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The social networking feature of MFP may be important given prior studies demonstrating the benefits of social support on weight loss.

    “The social networking feature of MFP may be important given prior studies demonstrating the benefits of social support on weight loss (11).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] McLean N Griffin S Toney K Hardeman W Family involvement in weight control, weight maintenance and weight-loss interventions: a systematic review of randomised trials International Journal of Obesity 2003 987 1005 12917703 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In December 2013, 58% of Americans owned smartphones and ownership was increasing among every demographic group including low-income populations.

    “In December 2013, a Pew survey found that 58% of Americans own smartphones and ownership is increasing among every demographic group including low-income populations (6).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Smith A Smartphone Ownership: 2013 Update. pewinternetorg 3 6 2013 1 12

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    The study was a randomized controlled trial with participants randomized to usual primary care or usual primary care plus the MFP app.

    “The Mobile Fitness Study (mFit) was a randomized controlled trial with participants randomized to either usual primary care (n = 107) or usual primary care plus MFP app (n = 105) (Figure 1).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    MFP incorporates elements of social cognitive theory, including self-monitoring, goal setting, and feedback.

    “MFP incorporates elements of social cognitive theory, including self-monitoring, goal setting, and feedback.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Bandura A Simon KM The role of proximal intentions in self-regulation of refractory behavior Cogn Ther Res 9 1977 1 3 177 93

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    A linear mixed effects model was used to compare outcomes between groups while controlling for clinic site.

    “We used a linear mixed effects model (PROC MIXED) to compare weight change, SBP change, and change in behavioral survey items between groups from baseline to 3 and 6 months, while controlling for clinic site.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Control group participants were blinded to the name of the app.

    “Control group participants were aware that they were participating in a study of a weight loss app but were blinded to the name of the app.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    The participants may have wanted to lose weight but were not ready to put in the necessary work to self-monitor their diet.

    “One possible explanation for our negative results is that our participants may have wanted to lose weight but were not ready to put in the necessary work to self-monitor their diet.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The behavioral survey items were adapted from the TRIAD study and the Diabetes Empowerment Scale.

    “The behavioral survey items were adapted from the TRIAD (Translating Research into Action for Diabetes) study (14) and the Diabetes Empowerment Scale (15).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] TRIAD Study Group The Translating Research Into Action for Diabetes (TRIAD) study: a multicenter study of diabetes in managed care Diabetes Care 2 2002 25 2 386 9 11815515 source

      Not checked in the free run.

    • cites [15] Anderson RM Funnell MM Fitzgerald JT Marrero DG The Diabetes Empowerment Scale: a measure of psychosocial self-efficacy Diabetes Care 6 2000 23 6 739 43 10840988 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Clinicians did not recommend the app to patients, and the study did not ask clinicians to follow up with patients regarding app use or weight loss progress.

    “Finally, we did not have clinicians recommending the app to patients nor did we ask clinicians to follow-up with patients regarding use of the app or the patients’ progress with weight loss.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisenone given

    MyFitnessPal is free and could be introduced to patients by a medical assistant in less than five minutes.

    “MFP is free and could be introduced to patients by a medical assistant in less than five minutes.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    Providers and clinic staff were blinded to the name of the app and to group assignment.

    “To minimize contamination of the control group, providers and clinic staff were also blinded to the name of the app and to group assignment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Brief, daily or weekly feedback and encouragement could boost usage and self-efficacy in dieting.

    “Brief, daily or weekly feedback and encouragement could also boost usage and self-efficacy in dieting (13).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Carter MC Burley VJ Nykjaer C Cade JE Adherence to a Smartphone Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized Controlled Trial J Med Internet Res 2013 15 4 e32 JMIR Publications Inc. Toronto, Canada 23587561 PMC3636323 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Premisecitation

    Gamification of the app, financial incentives, or delivering the app in a setting of group competition could be important adjuncts to increase motivation to use the app and lose weight.

    ““Gamification” of the app, financial incentives, or delivering the app in a setting of group competition could also be important adjuncts to increase motivation to use the app and lose weight (19).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Kullgren JT Troxel AB Loewenstein G Asch DA Norton LA Wesby L Individual-versus group-based financial incentives for weight loss: a randomized, controlled trial Annals of Internal Medicine 2 4 2013 158 7 505 14 23546562 PMC3994977

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Allocation was concealed using a permuted block sequence generated in R and placed in opaque envelopes.

    “Our statistician used R to generate the permuted block sequence. We printed the sequence and placed it in opaque envelopes.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The study did not explicitly measure readiness for change or motivation.

    “Although all participants responded that they were “interested in losing weight” during the screening process, we did not explicitly measure readiness for change or motivation.”
    Quote in the paperSubstantial claim
40 of 40

  • The authors state this as an assumption.

    Non-completers lost less weight than participants who completed the study.

    “If we assume that the non-completers lost less weight than participants who completed the study, our estimate of treatment effect is on the conservative end.”

  • The authors state this as an assumption.

    The sensitivity analysis model assumes the existence of unobserved factors related to both outcomes and missingness (missing not at random).

    “This model assumes the existence of unobserved factors related to both outcomes and missingness, considered as a “missing not at random” (MNAR) assumption.”

  • The paper relies on this without support.

    Exceedingly few health-related apps have been rigorously evaluated.

    “Many of these apps aim to help individuals change behaviors to improve health, including weight loss, yet exceedingly few have been rigorously evaluated.”

  • The paper relies on this without support.

    MyFitnessPal receives the highest possible rating, five out of five stars, from thousands of reviewers on the Apple and Android app stores.

    “MFP receives the highest possible rating, five out of five stars, from thousands of reviewers on the Apple and Android app stores.”

  • The paper relies on this without support.

    MyFitnessPal has nearly one million likes on Facebook and over 50 million registered users.

    “MFP has nearly one million “likes” on Facebook and the company reports having over 50 million registered users.”
5 of 5

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?

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Heath C, 1993, Fam Med, 25, 401

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Related

Authors
Laing, B. Y., Mangione, C. M., Tseng, C.-H., Leng, M., Vaisberg, E., Mahida, M., Bholat, M., Glazier, E., Morisky, D. E., & Bell, D. S.
Affiliations
RAND Corporation (US)
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2014-11-18
Volume
161
Issue
10_Supplement
Pages
S5-S12
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/m13-3005
PMC
PMC4422872
OpenAlex
W2053044172
Semantic Scholar
1655e36c43dc70a13662a4ad198379fd95490ecd
Cited by
353
References
16
Citations by year
2026: 12 · 2025: 15 · 2024: 22 · 2023: 19 · 2022: 29 · 2021: 50 · 2020: 39 · 2019: 33 · 2018: 43 · 2017: 40 · 2016: 30 · 2015: 19 · 2014: 1
FWCI
54.19
Type
journal article
Language
en
Open access
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Robert Wood Johnson Foundation (UL1TR000124)
  • National Institutes of Health (UL1TR000124, P30-AG02-1684)
  • University of California, Los Angeles (P30-AG021684, UL1 TR000124)
  • National Institute on Aging (P30AG021684)
  • National Cancer Institute (R43CA094404)
  • National Center for Advancing Translational Sciences
  • Clinical and Translational Science Institute, University of California, Los Angeles (UL1TR000124)
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
MyFitnessPal, mobile application, weight loss, overweight, primary care, dietary behavior, systolic blood pressure, app use, patient satisfaction, digital health interventions, usual care comparison, body mass index, loss to follow-up, health disparities
MeSH terms
Adult, Blood Pressure, Female, Humans, Male, Middle Aged, Primary Health Care, Software, Weight Loss, Health Behavior, Body Mass Index, Patient Satisfaction, Cell Phone, Overweight

About these checks

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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