S775 Advancing Health Equity Through Telehealth: A Systematic Review and Meta-Analysis of Remote vs In-Person Weight-Loss Interventions Among Black Women With Obesity

Introduction: Obesity is a major U.S. public health issue, disproportionately affecting non-Hispanic Black women. This population faces elevated risks of obesity-related gastrointestinal (GI) diseases, such as non-alcoholic fatty liver disease (NAFLD), gastroesophageal reflux disease (GERD), and colorectal cancer. Structural barriers, including poverty, limited healthcare access, and lower educational attainment, impede effective weight management. The expansion of telehealth presents an opportunity to enhance health equity. However, the comparative effectiveness of remote versus in-person weight-loss interventions in this high-risk group remains uncertain. This systematic review and meta-analysis assess the effectiveness of remote versus in-person interventions for Black women with obesity, aiming to support equitable, GI-focused obesity care. Methods: We conducted a systematic review and meta-analysis per PRISMA guidelines, searching PubMed, Embase, and Cochrane through April 2025. Eligible studies were randomized controlled trials (RCTs) comparing remote ± in-person vs in-person weight-loss interventions among Black or African American women with a body mass index (BMI) ≥30 kg/m². Random-effects meta-analyses estimated pooled changes in weight, percentage weight loss, BMI, blood pressure, and lipid levels (total cholesterol, low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglycerides). Results: Four RCTs (N = 576) were included. The analysis found no statistically significant differences in primary outcomes of weight change (SMD - 0.22, 95% CI: - 0.68; 0.24), percentage weight loss (SMD - 0.80, 95% CI: - 3.86; 2.26), and BMI (SMD - 0.26, 95% CI: - 1.61; 1.11). Secondary outcomes, such as blood pressure and lipid profiles (HDL, LDL, total cholesterol, triglycerides), also showed no statistically significant difference across intervention formats. Conclusion: Remote weight-loss interventions are comparably effective to traditional in-person programs in reducing weight and improving metabolic outcomes among Black women with obesity. These findings underscore the potential of telehealth-based approaches to expand access to obesity care in underserved populations. For gastroenterologists managing obesity-related GI and metabolic disorders, digital interventions offer a scalable and equitable solution to close racial and structural gaps in preventive health services. Note: ChatGPT (OpenAI) was used for language clarity and grammar refinement. All scientific content, data, and analysis are original and solely by the authors.