title: Integrating technology into standard weight loss treatment: a randomized controlled trial.
abstract: BACKGROUND
  A challenge in intensive obesity treatment is making care scalable. Little is known about whether the outcome of physician-directed weight loss treatment can be improved by adding mobile technology.
  
  
  METHODS
  We conducted a 2-arm, 12-month study (October 1, 2007, through September 31, 2010). Seventy adults (body mass index >25 and ≤40 [calculated as weight in kilograms divided by height in meters squared]) were randomly assigned either to standard-of-care group treatment alone (standard group) or to the standard and connective mobile technology system (+mobile group). Participants attended biweekly weight loss groups held by the Veterans Affairs outpatient clinic. The +mobile group was provided personal digital assistants to self-monitor diet and physical activity; they also received biweekly coaching calls for 6 months. Weight was measured at baseline and at 3-, 6-, 9-, and 12-month follow-up.
  
  
  RESULTS
  Sixty-nine adults received intervention (mean age, 57.7 years; 85.5% were men). A longitudinal intent-to-treat analysis indicated that the +mobile group lost a mean of 3.9 kg more (representing 3.1% more weight loss relative to the control group; 95% CI, 2.2-5.5 kg) than the standard group at each postbaseline time point. Compared with the standard group, the +mobile group had significantly greater odds of having lost 5% or more of their baseline weight at each postbaseline time point (odds ratio, 6.5; 95% CI, 2.5-18.6).
  
  
  CONCLUSIONS
  The addition of a personal digital assistant and telephone coaching can enhance short-term weight loss in combination with an existing system of care. Mobile connective technology holds promise as a scalable mechanism for augmenting the effect of physician-directed weight loss treatment.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00371462.
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr, Ste 1220, Chicago, IL 60611, USA. bspring@northwestern.edu
authors.forename: Bonnie
authors.initials: B
authors.lastname: Spring
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Duncan
authors.forename: E Amy
authors.initials: EA
authors.lastname: Janke
authors.forename: Andrea T
authors.initials: AT
authors.lastname: Kozak
authors.forename: H Gene
authors.initials: HG
authors.lastname: McFadden
authors.forename: Andrew
authors.initials: A
authors.lastname: DeMott
authors.forename: Alex
authors.initials: A
authors.lastname: Pictor
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Epstein
authors.forename: Juned
authors.initials: J
authors.lastname: Siddique
authors.forename: Christine A
authors.initials: CA
authors.lastname: Pellegrini
authors.forename: Joanna
authors.initials: J
authors.lastname: Buscemi
authors.forename: Donald
authors.initials: D
authors.lastname: Hedeker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D034201:Computers, Handheld; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D013672:Technology; D013689:Telephone; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*