<p>Management of Overweight and Obesity: Technology-Based Interventions Among Generation Y</p>

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

About one third of adolescents in the USA are overweight and/or obese. Obesity during the adolescent years is associated with many adverse health consequences, including type 2 diabetes, hypertension, hyperlipidemia, and psychosocial problems. Because of substantial advances in technologies and wide acceptance by adolescents, it is now possible to use technology for healthy weight management and prevention of obesity. This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and aimed to evaluate the existing literature reported on the effectiveness of technology-based intervention (web-based, e-learning, and active video games) in preventing obesity in adolescents. The primary aim of this review was to explore if components of specific interventions were associated with a reduction in body mass index. Research articles obtained from CINAHL, Embase, PubMed, PsycInfo, and the Cochrane database from1990 to 2014 were reviewed. A total of 131 published articles were identified, and 14 met the inclusion criteria of a randomized or nonrandomized clinical study with body mass index as primary outcome and/or secondary outcomes of diet/physical activity and/or psychosocial function, tested lifestyle interventions to prevent obesity, used technology, and studied adolescents (aged 12–18 years). The results indicated that six of 14 studies found body mass index and/or body fat decreased at short-term (less than 12 months) follow-up. Six of eleven studies that examined physical activity or physical activity-related outcomes found an improved physical activity outcome (time playing active video games and increase in physical activity time), while five of seven studies which assessed dietary outcomes indicated improvement in dietary behaviors. Five of seven studies suggested an improvement in psychosocial function (reduced depression, improved self-esteem and efficacy, improvement on Behavior Assessment Scale) in adolescents involved in the technology-based intervention. All effective interventions utilized dietary and physical activity strategies as part of intervention components. Because of the variation in duration of intervention (range 10 weeks to 2 years), it is not clear what length of intervention is most effective. Future research should assess the long-term impact of technology-based interventions and evaluate mediators and moderators for weight change in adolescents.

The rapid increase in the obese population is a problem indicates the need for measures to prevent and treat obesity. Since the early 2000s, worldwide digital health has focused on obesity management. Information and communication technology (ICT)-based obesity intervention can be an efficient method for treating obesity and metabolic syndrome, has no time limitations, and is an inexpensive and easily accessible treatment modality for both physicians and patients. Previous studies have confirmed the effects of ICT-based interventions for obesity and metabolic syndrome management for behavioral improvement in lifestyle modification. In addition, ICT-based interventions in obese and metabolic syndrome patients are recommended as part of a comprehensive strategy for weight loss and maintenance. The Committee of IT-convergence Treatment of Metabolic Syndrome was established by the Korean Society for the Study of Obesity in 2021, and had been gathering theoretical and clinical evidence in digital therapeutics fields and developing new methods for managing obesity and metabolic syndrome. As part of this effort, if the “obesity management prototype” is commercialized, it will be available for convenient treatment of individuals with obesity and metabolic syndrome.

Obesity is defined as a condition characterized by the abnormal accumulation of fat cells, which results in increased body weight. Worldwide, obesity is progressively on the rise, leading to an increased prevalence of chronic conditions such as cardiovascular disease, type 2 diabetes, and hyperlipidemia. Obesity is a result of the interplay between genetic, metabolic, social, behavioral, and cultural factors, necessitating an interdisciplinary and multimodal management approach. Diet therapy, which includes dietary modifications and nutritional interventions, is a fundamental component of the multifaceted approach to managing obesity. The principle of diet therapy is based on achieving weight loss through a negative energy balance and maintaining weight through an equilibrium of energy intake and expenditure. Strategies for weight loss and control rely on caloric restriction, macronutrient distribution, and dietary patterns such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets. Recently, studies have been conducted on weight control using information and communication technology-based interventions, as well as interventions based on intestinal microorganisms which consider inter-individual variability and long-term adherence. In conclusion, diet therapy stands as a pivotal element in the management of obesity, providing a personalized and comprehensive approach to weight control. By combining evidence-based dietary strategies with behavioral modifications and consistent support, healthcare professionals can enable individuals to attain and sustain a healthier weight, thereby reducing related health risks.

BackgroundTechnology-based physical activity interventions (TbPAI) have recently been shown to be effective for care of obese women (Cotie et al., 2018). Therefore, it is necessary to assess the acceptability of TbPAI to ensure dissemination and usage in the treatment of obesity (Venkatesh et al., 2012).As such, the purpose of this study was to: (1) identify acceptability profiles of three TbPAI in obesity care (e.g., active video games, mobile applications, videoconferencing); (2) examine the issues of consistency or change of acceptability profiles for the same individual across the three technology; and (3) explore whether technology acceptability profiles were associated with motivation for physical activity (PA), general causality orientations for PA and sociodemographic data.MethodsThree hundred and twelve women with a mean age of 30.7 (SD=7.1) years, and a mean BMI of 34.9 (SD=9.2) kg/m2 were recruited from health services that provide obesity management. Enrolled participants completed an online survey including the following measures: motivation for PA, general causality orientations for PA, TbPAI acceptability for the three selected technologies based on the UTAUT2 model (Venkatesh et al., 2012), and sociodemographic data. Ethical approval was gained by local committee, and informed consent were obtained from the participants before data collected. We used a Latent Profile Transition Analysis (LPTA) approach.ResultsA 2-class model (high and low acceptability) best described latent classes for each technology. Acceptability profiles changed over the technologies. Among our sample, only 8.0% (n = 25) of women have low acceptability of all technologies, and 57.7% (n = 180) have high acceptability of all technologies. The covariate effect estimates showed significant effects of: (a) age and control causality orientation on video games acceptability profiles, (b) intrinsic motivation and impersonal causality orientation on videoconferencing profiles, and (c) control and impersonal causality orientations on mobile applications profiles.ConclusionsA LPTA approach may prove usefulness in understanding TbPAI acceptability in the obesity treatment and have implications for implementation and dissemination of such technologies.

The goal of the 8th edition of the Clinical Practice Guidelines for Obesity is to help primary care physician provide safe, effective care to patients with obesity by offering evidence-based recommendations to improve the quality of treatment. The Committee for Clinical Practice Guidelines comprised individuals with multidisciplinary expertise in obesity management. A steering board of seven experts oversaw the entire project. Recommendations were developed as the answers to key questions formulated in patient/problem, intervention, comparison, outcomes (PICO) format. Guidelines underwent multi-level review and cross-checking and received endorsement from relevant scientific societies. This edition of the guidelines includes criteria for diagnosing obesity, abdominal obesity, and metabolic syndrome; evaluation of obesity and its complications; weight loss goals; and treatment options such as diet, exercise, behavioral therapy, pharmacotherapy, and bariatric and metabolic surgery for Korean people with obesity. Compared to the previous edition of the guidelines, the current edition includes five new topics to keep up with the constantly evolving field of obesity: diagnosis of obesity, obesity in women, obesity in patients with mental illness, weight maintenance after weight loss, and the use of information and communication technology-based interventions for obesity treatment. This edition of the guidelines features has improved organization, more clearly linking key questions in PICO format to recommendations and key references. We are confident that these new Clinical Practice Guidelines for Obesity will be a valuable resource for all healthcare professionals as they describe the most current and evidence-based treatment options for obesity in a well-organized format.

BackgroundIn the United States, approximately one-third of adolescents are now overweight or obese, and one in six is obese. This financial cost and the larger nonfinancial costs of obesity make obesity prevention and management for adolescents imperative for the health of the nation. However, primary care visits are typically brief, and primary care providers may lack adequate resources to help overweight or obese adolescents to manage weight issues. To augment the efficacy of primary care visits for adolescent weight management, mobile phone technology can be used as an adjunct treatment that provides additional opportunities for encouraging improvement in lifestyle, attainment, and maintenance of healthy weight.ObjectiveThe purposes of this study were to (1) measure effects of an innovative mobile phone technology-based intervention for overweight and obese adolescents and to (2) examine the intervention’s feasibility for use in primary care clinics.MethodsThe mobile phone-based intervention had three components: use of the Fitbit Flex, participation in an online educational program, and receipt of biweekly text messages during the maintenance phase. A randomized controlled study design was utilized. Data regarding anthropometrics (body mass index [BMI] and waist-to-hip ratio), blood pressure, levels of physical and sedentary activity, diet, and self-efficacy regarding physical activity and diet were collected at baseline and at 3 and 6 months after the baseline assessment.ResultsA total of 40 adolescents participated in the study. At the 6-month follow-up visit, compared to participants in the control group, the mobile phone-based intervention participants had significant improvement in BMI (z=–4.37, P=.001), diastolic blood pressure (z=–3.23, P=.001), physical activity days per week (z=2.58, P=.01), TV and computer time (z=–3.34, P=.001), servings of fruits and vegetables per day (z=2.74, P=.006), servings of soda and sweetened drinks (z=–3.19, P=.001), physical activity self-efficacy (z=2.75, P=.006), and dietary self-efficacy (z=5.05, P=.001). Medium to large effect sizes were found in these outcome variables.ConclusionsThe use of mobile technologies may offer a practical, reliable adjunct to weight management for overweight and obese adolescents in busy primary care clinics serving adolescents.Trial RegistrationClinicaltrials.gov NCT 01693250; https://clinicaltrials.gov/ct2/show/NCT01693250? term=Adolescent+ obesity+AND+mhealth&rank=5 (Archived by WebCite at )

Globally, childhood overweight and obesity are increasing, resulting in several comorbidities. While different interventions to manage childhood obesity exist, their effectiveness is still a subject of debate among scholars. Therefore, this systematic review evaluated the effectiveness of interventions for preventing and managing childhood obesity reported in the literature. The findings showed that community-based, school-based, family-focused, and technology-driven approaches have various positive outcomes. Community-based interventions showed significant decreases in Body Mass Index (BMI), especially in population groups with limited resources, whereas school-based programs effectively reduced both BMI and waist circumference among children with obesity. On the other hand, family-based interventions were shown to be effective in promoting long-term behavioral changes, resulting in sustained BMI reduction. However, the effectiveness of technology-based interventions varied, but their effectiveness was enhanced when paired with human engagement. The review's findings underscored the need for culture-tailored interventions, citing disparities in the effectiveness of different interventions influenced by culture and ethnicity in addition to baseline weight status. Furthermore, to sustain the benefits of interventions, long-term follow-up and support were essential. The findings indicated that multi-component programs involving community, family, digital tools, and cultural context-relevant interventions are essential for long-term success in childhood obesity management.