A pilot study of a digital weight loss program for people with obesity in four diverse cohorts

In this pilot study of a digital weight loss program for cancer prevention, we evaluated program feasibility and acceptability for weight loss and improvement of healthy behaviors among racially/ethnically diverse individuals with overweight and obesity. A 16-week low-touch digital weight loss program, based on the diabetes prevention program, was implemented to promote healthy eating, physical activity, and portion control among four unique cohorts in Texas, USA. Participants received fully digital program materials via email, 5-10 text message reminders per week, Fitbit activity trackers and Wi-Fi-connected scales for daily self-monitoring of physical activity and weight. Weight, physical activity, dietary intake, weight-related eating behaviors, and quality of life were assessed remotely at baseline and follow-up (16-week). Program completion and satisfaction were assessed after the program. Pre-post changes in outcomes were examined using paired t-tests and Pearson's chi-squared tests. Among 48 enrolled participants, 37 completed the program (77% completion rate). Participants had moderate adherence to weekly weighing, and high adherence to Fitbit wear and responding to text messages. They reported a high level of satisfaction with the program, with a mean score of 4.06 out of 5. At follow-up, we observed loss of ~ 2% of baseline weight (range - 13.8% to + 3.4%) and significant improvements in weight-related eating behaviors and dietary habits (i.e., 30% decrease in total daily calorie intake (p < .001), 14% increase in protein intake (p = .044), and 56% decrease in added-sugar intake (p < .001), etc.). This low-touch digital weight loss program was feasible and acceptable for weight loss and improving eating behaviors among racial/ethnic diverse individuals with overweight and obesity. Program completion and engagement appeared to vary across cohorts, suggesting program adaptations and additional support beyond the low-touch digital weight loss program offered in this study may be needed for some groups.