An addiction model-based mobile health weight loss intervention in adolescents with obesity

A P Vidmar; R Pretlow; C Borzutzky; C P Wee; D S Fox; C Fink; S D Mittelman

doi:10.1111/ijpo.12464

An addiction model-based mobile health weight loss intervention in adolescents with obesity

Pediatr Obes. 2019 Feb;14(2):e12464. doi: 10.1111/ijpo.12464. Epub 2018 Aug 16.

Authors

A P Vidmar¹, R Pretlow², C Borzutzky³, C P Wee⁴, D S Fox⁵, C Fink¹, S D Mittelman¹

Affiliations

¹ Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
² eHealth International, Inc., Seattle, WA, USA.
³ Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles and Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
⁴ CTSI Biostatics Core, Saban Research Institute, Los Angeles, CA, USA.
⁵ Department of Pharmaceutical and Health Economics, School of Pharmacy of the University of Southern California, Los Angeles, CA, USA.

Abstract

Background: Clinical approaches to treating childhood obesity can be expensive and poorly reimbursed, and often produce suboptimal results. It has been theorized that overeating may have addictive qualities, and a sizable number of adolescents with obesity endorse addictive habits. Interestingly, few weight management interventions have tested techniques founded in addiction medicine principles. We therefore performed a pilot study of an addiction model based mHealth weight loss intervention in adolescents.

Methods: Adolescents with obesity were recruited from an multidisciplinary weight management clinic (EMPOWER). Adolescents without significant obesity comorbidities, who exhibited signs of addictive eating, based on the Yale Food Addiction Scale, were enrolled in a pilot study of an interactive, addiction-based, weight loss smartphone app with coaching (http://clinicaltrials.gov: NCT02689154). The app was designed to help subjects omit problem foods, avoid snacking and reduce meal size. A contemporary cohort of adolescents who completed the EMPOWER program were evaluated. Feasibility of recruitment, adherence, retention rates, BMI change and cost of intervention were examined.

Results: Eighteen participants were recruited to app intervention. App participants had higher retention (100% vs. 37%) and lower total cost per patient ($855.15 vs. $1428.00) than the EMPOWER clinic participants. App participants exhibited a significant decrease in zBMI and %BMI_p95 over the 6 months (p < 0.001 and p = 0.001), which was comparable to the age-matched EMPOWER program completers (p = 0.31 and p = 0.06).

Conclusions: An addiction medicine-based mHealth intervention targeted for adolescents was feasible to implement, resulted in high retention and adherence rates, and reduced zBMI and %BMI_p95 in a more cost-effective manner than an in-clinic intervention.

Keywords: Eating addiction; food addiction; mobile health; obesity; paediatrics; weight loss.

Publication types

Clinical Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Body Mass Index
Child
Costs and Cost Analysis
Feasibility Studies
Female
Food
Food Addiction / therapy*
Humans
Mobile Applications / statistics & numerical data
Pediatric Obesity / therapy*
Pilot Projects
Retrospective Studies
Telemedicine / economics
Telemedicine / methods*
Treatment Adherence and Compliance / statistics & numerical data
Weight Loss
Weight Reduction Programs / economics
Weight Reduction Programs / methods*

Associated data

ClinicalTrials.gov/NCT02689154

Abstract

Publication types

MeSH terms

Associated data

Grants and funding