Abstract
BackgroundLaboratory studies suggest that eating more ‘attentively’ (e.g. attending to food being eaten and recalling eating episodes) can reduce food intake among participants with both healthy weight and overweight. The aim of this trial was to assess whether a smartphone application that encourages a more attentive eating style reduces energy intake and promotes weight loss.MethodsIn an open-label, single centre, parallel groups, individually randomised controlled trial, 107 adults with overweight/obesity in Merseyside, UK used an attentive eating smartphone application along with standard dietary advice (intervention group) or standard dietary advice only (control group) for 8 weeks. The primary outcomes were change in body weight at 8 weeks and energy intake at 4 and 8 weeks. Additional outcomes included self-reported eating behaviours measured at 8 weeks. Differences between groups were assessed with linear regression (adjusted) using multiple imputation for missing data. Study protocol registered prospectively at (https://doi.org/10.17605/osf.io/btzhw).ResultsThere was no significant difference between the intervention and control group in weight lost at 8 weeks, or change in self-reported 24 h or objective taste-test energy intake at 4 or 8 weeks. Mean weight loss in the intervention group (n = 53) was 1.2 kg and 1.1 kg in the control group (n = 54), adjusted difference of − 0.10 (− 1.6 to 1.3) kg. Self-reported eating behaviours at 8 weeks also did not differ across groups. The intervention was largely used as intended and a per protocol analysis confined to participants in the intervention group that used the attentive eating smartphone application regularly and as intended also showed no effect on energy intake or weight loss.ConclusionsA smartphone based attentive eating intervention and standard dietary advice did not result in reduced energy intake or greater weight loss at 4 or 8 week follow-up than standard dietary advice alone.Trial registrationClinicalTrials.gov, NCT03602001. Registered retrospectively on 26th July 2018.Prospectively registered on the Open Science Framework on 11th August 2017.
Highlights
Laboratory studies suggest that eating more ‘attentively’ can reduce food intake among participants with both healthy weight and overweight
There was no significant difference between the intervention and control group in weight lost at 8 weeks, or change in self-reported 24 h or objective taste-test energy intake at 4 or 8 weeks
The intervention was largely used as intended and a per protocol analysis confined to participants in the intervention group that used the attentive eating smartphone application regularly and as intended showed no effect on energy intake or weight loss
Summary
Laboratory studies suggest that eating more ‘attentively’ (e.g. attending to food being eaten and recalling eating episodes) can reduce food intake among participants with both healthy weight and overweight. Increasing awareness of recent eating episodes has been found to reduce later snacking [13] and paying more attention to food as it is being consumed has been found to reduce later snacking in most [14,15,16], (but not all [17]) laboratory studies in participants with healthy weight and overweight These promising results from the laboratory suggest that an intervention approach that promotes a more ‘attentive’ style of eating by encouraging participants to attend to food being eaten and recall eating episodes may be an effective way of reducing food intake and aiding weight loss [18]. Because such an approach would not rely on conscious and vigilant calorie counting, it may be relatively acceptable to users [19]
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