"Apps do include evidence-based behavioral strategies, but only a narrow range," said Dr. Pagoto, associate professor of medicine at UMass Medical School. "Strategies that often were missing are ones that help patients with adherence and motivation." In the study "Evidence-based strategies in weight-loss mobile apps," published online Oct. 8, Pagoto and colleagues rated 30 of the most popular mobile weight-loss apps on the market for inclusion of 20 evidence-based behavioral strategies. Most of the apps evaluated include few or no behavioral weight-loss strategies—28 out of 30 included only 25 percent of the strategies or less.
Even the top two apps include only 65 percent of the 20 strategies. Behavioral weight-loss strategies that are evidence-based—meaning they have been scientifically researched and found to be effective—include stimulus willpower control, problem solving, stress reduction and relapse prevention. The 20 strategies that the study rated are those in the Centers for Disease Control's evidence-based Diabetes Prevention Plan, designed to help participants make modest behavior changes in order to lose 5 to 7 percent of their body weight. Pagoto's team was also interested in determining whether apps incorporate technology features to enhance behavioral strategies.
"On the bright side, in terms of how apps are using technology, they're doing some really interesting things," Pagoto noted. Enhancements include barcode scanners that can be used in a supermarket to instantly get products' nutritional information; social networks where users can encourage and support each other; email and text reminders; and calendars for scheduling exercise and tracking food intake. The researchers' final question was "Do you get what you pay for?" "The answer is no," said Pagoto. "Free apps were just as likely as paid apps to include evidence-based strategies. That's the good news for the consumer." The two top-rated apps, according to the study, are MyNetDiary PRO ($3.99,) and MyNetDiary (free.) "Where we're hoping the next generation of apps can do better is in incorporating some of those strategies that help the user who might not be so good about entering their diet every day and staying on track with their goals," Pagoto concluded.