For weight loss, ditch the apps

Milwaukee Journal Sentinel - - OPINIONS - Gary Bennett

There are few things worse than be­ing an obe­sity sci­en­tist at a hol­i­day party. Once they learn my pro­fes­sion, most peo­ple skulk away, of­ten hid­ing their food in the process. The brave few who re­main of­ten lean closer and qui­etly ask for the “se­cret” to weight loss —as if we sci­en­tists were a “DaVinci Code”-style ca­bal de­voted to sup­press­ing the true “se­cret” to di­et­ing.

Lately, how­ever, I’m hear­ing dif­fer­ent ques­tions. In­stead of ask­ing about the best weight-loss pro­gram, my in­ter­roga­tors in­creas­ingly ask about the best app. My an­swer is of­ten un­sat­is­fy­ing: Most apps don’t work.

I’ve been study­ing weight loss for more than a decade, dur­ing which we’ve seen tremen­dous shifts. A decade ago, Amer­i­can di­eters tended to join a gym, buy a book or join a com­mer­cial weight-loss pro­gram. Now many use one of thou­sands of weight­loss apps. Es­ti­mates sug­gest the top 10 weight-loss apps have been down­loaded well over 300 mil­lion times.

Yet there’s lit­tle ev­i­dence these apps will help you lose much weight. Sure, some peo­ple have used them suc­cess­fully, but few apps have ever been tested in a sci­en­tific study. Those that have been tested ei­ther show poor re­sults, or show bet­ter re­sults only when com­bined with sup­port from a di­eti­cian or health coach. We know lit­tle about how well most apps work on their own — the way most peo­ple likely use them.

Most of us would never take a med­i­ca­tion that hadn’t been deemed ef­fec­tive in a clin­i­cal trial. Yet we have few qualms about us­ing apps with no sci­en­tific ba­sis — of­ten de­vel­oped by peo­ple with­out sci­en­tific train­ing — to sig­nif­i­cantly change what we eat, drink and do.

Many apps in­clude some com­po­nents backed by strong sci­ence, such as calo­rie track­ing. Yet they rarely in­clude most of the tools and strate­gies that high-qual­ity weight loss treat­ments em­ploy. In fact, most weight­loss apps in­clude less than 10% of the el­e­ments sci­en­tists rec­om­mend for op­ti­mal weight-loss out­comes. That’s in con­trast to lead­ing weight-loss pro­grams, many of which are based on good sci­en­tific ev­i­dence.

What’s the risk of us­ing a weight­loss app that doesn’t work? It prob­a­bly won’t hurt you phys­i­cally. The im­pact on mo­ti­va­tion is an­other story, though. When we “fail” at weight loss, most of us don’t blame the pro­gram, we blame our­selves. Yet the real prob­lem may be the app.

For­tu­nately, the se­cond gen­er­a­tion of more promis­ing apps is start­ing to hit the mar­ket. If you’re in­ter­ested in pick­ing an app with the best chance of help­ing you lose weight, look for all four of these things — I call them “the four S’s.”

Skills: Most of us know what to do to lose weight — eat less, move more. But how do you han­dle eat­ing when you’re away at a con­fer­ence? How do you re­sist stress eat­ing, and avoid get­ting off track on week­ends? What should you do when you overindulge? The best apps teach strate­gies to help you lose weight.

Sup­port: Good ev­i­dence sug­gests peo­ple do bet­ter with weight loss when they’re sup­ported. While sup­port from a close friend or fam­ily mem­ber can help, sup­port from a di­eti­tian, psy­chol­o­gist, health coach or other health ex­pert is much bet­ter. Sup­port can also come from soft­ware de­signed to give per­son­al­ized feed­back about weight­loss ef­forts. The best apps ei­ther link you with sup­port­ers or use ad­vanced ar­ti­fi­cial in­tel­li­gence to mimic hu­man sup­port.

Self-mon­i­tor­ing: This is crit­i­cal to be­hav­ior change. Track­ing calo­ries is best, but track­ing weight, foods or ac­tiv­i­ties can also work. Con­sis­tency is key — peo­ple who track re­li­ably five to seven times each week suc­ceed best with weight loss.

Sci­ence: Ig­nore what you’ve heard from your friends, co-work­ers, latenight in­fomer­cials and tabloids. In­stead, treat be­hav­ior change as se­ri­ously as you treat med­i­ca­tions.

This last point bears em­pha­siz­ing. Sci­en­tists have learned a lot about what it takes to lose weight. The mak­ers of your app should be able to point to sci­en­tific re­search as the ba­sis of their pro­gram.

If they can’t, move on.

Gary Bennett is a pro­fes­sor of psy­chol­ogy and neu­ro­science at Duke Univer­sity, di­rec­tor of the Duke Obe­sity Pre­ven­tion Pro­gram and pres­i­dent of the So­ci­ety of Be­hav­ioral Medicine.

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