Can mobile apps help people lose 

weight...and keep it off?

Many of us may be well accustomed to using health and fitness mobile apps that have the sole purpose of counting calories and measuring activity levels, to help us lose weight. With the majority of people now using Androids and iPhones, downloading apps to our mobile phones is easy and hugely popular. As a result, tracking what we consume on a daily basis has never been so simple. 

However, how effective are these calorie counting apps? Can technology really aid us in reaching our ideal weight, or is it just a fad, a fashion accessory that will be forgotten with the next diet fix?  Furthermore, as with all successful weight loss, does it come down to our own behaviour and self motivation to bring about healthy changes to our life?

A recent study from the Northwestern University Feinberg School of Medicine, identified as the first of its kind, sought to examine the relationship between technology and the impact it had on weight. The study will be published in the Archives of Internal Medicine. 

The Study and Findings

The Northwestern technology research incorporated behaviour change techniques, including self monitoring, goal setting, feedback and social support.

The research examined a cohort of sixty nine overweight and obese men who were an average age of fifty eight. All participants were offered health education classes on nutrition, exercise and behaviour change; every two weeks during the first six months and once monthly for the remainder of the year. 

Each participant received personalised weekly calorie and activity goals to help them lose weight and all participants were encouraged to attend nutrition and health classes. The participants were divided into two groups. One half recorded their activity and diet on paper, whilst the other half used the Northwestern technology mobile device, to transmit their data to a behaviour coach, who monitored and provided feedback twice a month. 

From the evidence, it was found that those who used the mobile device and attended eighty percent of the nutrition classes lost fifteen pounds and maintained this for one year. The weight loss for those who used the mobile app but who did not attend any classes lost almost nine pounds. The group who attended classes but did not use the mobile app, did not loose any weight. 

The lead investigator of the study and Professor at the University, Bonnie Spring, found the results to be positive and argued that mobile devises could have a significant role to play in making people more health aware; "The app is important because it helps people regulate their behaviour, which is really hard to do....Most of us have no idea how many calories we consume and how much physical activity we get. The app gives you feedback on this and helps you make smart decisions in the moment." 

However, Spring also emphasised that weight loss only occurred when people attended health education classes and engaged in regular exercise. The app alone would not be effective.

"The 'widget' is critical but it is not magical by itself," Spring added. "People need all the tools at their disposal." 

Should we all be downloading apps?

Diets usually fail because we end up eliminating certain food groups – and in the long term this is not sustainable. The difference between “diet fads” and calorie counting mobile apps, is that the latter can help set achievable and realistic goals, whilst simultaneously tracking our calorie intake and activity levels. 

It is often the case that we do not realise how many calories certain foods contain, and so, we are ignorant to all the hidden fats/sugars.  Thus, these quick and easy food tracking devices empower us to make sensible and more informed decisions that govern our health and weight. 

A frequent user of a calorie counting mobile app, Koorosh Ashrafi, PhD Research Scientist at BTG International group company, says; “I’ve lost 10 kilos over the past 6 months, and you learn balance is the key.  I’ve lived quite a sedentary lifestyle because of the pressure of work and studying, and I was still consuming the same amount of calories as 10 years ago when I was training as a rugby player.  Although I am a firm believer of everything in moderation, having a device at the tip of your fingertips, really does educate you about food and its content”

Nelly Araujo, Development Administrator at RSPH, and previous user of the mobile app says; “The goal setting was a motivational tool for me, but I found doing the mobile exercise with my partner, is what also drove me to make healthy changes – because we could support and encourage each other”

Bringing about behaviour changes in our life is no easy task.  We have to want to do it and it helps if we have the right tools at our disposal along with a good support network.

Spring believes that one of the big challenges in treating obesity is the need to provide behavioural treatment in a healthcare system where professionals don’t often have the time and training to support people with unhealthy diets or mental problems.

The RSPH is a strong advocator of the benefits of making healthier behavioural changes, but acknowledges that for many this can be challenging. The RSPH Level 2 Awards in Understanding Behaviour Change, is a qualification aimed at helping learners, health trainers and anyone working within the community to engage with individuals to develop strategies to undergo behaviour change and to offer brief advice and interventions to support individuals in improving their health and wellbeing.  Please click here for further information on the qualification, or contact Gina Mohajer.   

Understanding Behaviour Change: 

Happening at all levels

On the 29^th November 2012, the Royal Society for Public Health (RSPH) held a seminar on behaviour change. Led by Graham Rushbrook Development Advisor for RSPH, there was a chance to learn about the RSPH’s new Understanding Behaviour Change qualification, as well as to hear Kent Community NHS Health Trust’s experience of using the qualification. Participants then engaged in discussion about their experiences of obstacles to behaviour change for their clients.

The RSPH Understanding Behaviour Change qualification focuses on how best to support individuals in adopting positive behaviour change. At the heart of effective behaviour change is effective communication and relationship building. Within a one-to-one setting, the needs of the client are at the centre of all interactions, and the focus is on the holistic support of clients – not limiting support to narrow health requirements. As Graham highlighted, behaviour change “is done with, not to people”.

If individuals are to choose to change their lifestyles, any fear or ambivalence first needs to be addressed. It is also essential that an individual’s right not to change their behaviour is respected, and that the context and circumstances that may affect development of a plan to change lifestyle or health behaviour information is understood. The qualification also covers the importance of presenting information appropriately and accurately based on the needs of the individual, and teaches how to develop an effective lifestyle or behaviour change implementation plan and how to evaluate the impact of advice given.

Anne Ford, Head of Self Management and Prevention at Kent Community NHS Health Trust, spoke about her experience of using the RSPH’s behaviour change qualification to enable Health Trainers to support people with chronic health conditions. She highlighted that the effectiveness of behaviour change techniques lies in their client-centred nature and underlined the potentially valuable role of Health Trainers in supporting individuals in self management. The assessment of the Kent Community NHS Health Trust self-management and prevention plan has shown that through behaviour change training, Health Trainers have offered a wide range of support to clients, including referrals, signposting, accessing services from Age UK, organising respite care and supporting improvements in eating habits.

The RSPH qualification is set at Level 2, involves 16 hours guided learning time and is assessed through a multiple choice exam. Graham Rushbrook then led participants through a workshop session, asking participants to assess how the organisations, systems, disciplines and professions that they represent make it harder for clients to change.

Participants suggested that if behaviour change interventions are to be successful and sustainable:

-      There needs to be a holistic focus on the client, enabling underlying issues as well as health behaviours to be addressed. The client needs to be at the centre of the decision making process and interventions must be tailored to their needs.

-         Frontline staff need to buy into behaviour change techniques and training needs to be provided to enable them to work effectively with clear and consistent models. Communication between frontline services is vital if clients are to be treated holistically and effectively.

-    Behaviour change interventions need to be better understood by funders and management. This will involve recognition of the timescales involved (behaviour change interventions are not quick-fix) and also that quantifying results may not be possible in traditional ways.

Participants then looked at how these difficulties could be turned into opportunities for improving health. The focus in behaviour change theory on joined up services and holistic interventions, as well as developing partnerships was deemed an opportunity. In addition, moving the focus from assessing interventions based on quantity to assessment based on quality was seen as a huge opportunity for health improvement. It was also noted that behaviour change training can be achieved with little funding where training is offered in-house and that by sharing best practice between organisations and services, there is a great opportunity to ensure that behaviour change interventions meet their potential.

Next Steps

RSPH Training Solutions, will be running training sessions throughout 2013 to build understanding about behaviour change and to also build capacity to deliver the Behaviour Change qualification and training.  Our first date for this will be on the 26th February followed by a Train the Trainer programme on the 5th March.  For further information on opportunities to share best practice and offer in house training please contact Gina Mohajer, 0207 265 7327 or visit Training Solutions homepage. 

We will also be hosting further seminars around behaviour change to facilitate an engaged discussion with funders and commissioners about the case for supporting this type of intervention.  The next one will be in March, to register your interest, please contact Gina.