Practical Pearls: Can Smartphones Help Our Patients Lose Weight?

Your 9 a.m. appointment walks in. He’s an overweight executive who tells you that he has been trying to lose weight, but he does not have the time to go to the gym or prepare healthy meals. But sitting in front of you during the office visit, he fields two phone calls, fires off three text messages to colleagues and pulls up his calendar to schedule a follow-up appointment. This type of behavior is not uncommon. Smartphones are revolutionizing the way we live our lives. The question is, can we use the smartphone to change our lifestyle?

It is estimated that, on average, users check their smartphones every six and a half minutes and each person has approximately 41 applications (apps) on their phone.¹ There are smartphone apps for absolutely everything. Whether it’s for social networking, productivity or to play games, you can be assured that out of the more than 900,000 apps available,² there is something for everyone. The medical world also has caught on with upwards of 20,000 medical apps available online.³ Since the smartphone has become an inherent part of our lives, clinicians should make use of this fact and encourage their overweight patients to use specific apps targeted at weight loss. Just remember that not every app is effective and it can be difficult to comb through the multitude of apps to find just the right one. (We suggest avoiding the application that recommends keeping your phone on vibrate to shake away your abdominal fat.)

The New York Daily News⁴ and Forbes⁵ have recently reviewed a number of weight-loss apps, coming up with what they consider to be the top apps out there. (Table 1). Topping both of their lists – and the recipient of the United States Surgeon General’s Healthy Apps Challenge – is an app called "Lose It." Lose It works by calculating the daily calorie intake needed to achieve your goal weight (Figure 1). It then helps you keep track of your daily calorie consumption and estimates the nutritional value of a given food item by scanning the barcode. It also works by connecting you with other people who are trying to lose weight, for support, encouragement and advice. Probably the best part about this app is that it’s free. Other weight-loss apps making both lists include "Fooducate." also on the Surgeon General’s best apps list⁶ (Figure 2), and "MyFitnessPal." Both count calories and allow you to scan the barcode or search for food to give you a health grade for that particular item. Whether at the grocery store or at a chain restaurant, these apps enable you to make healthy choices on the go. MyFitnessPal has the added benefit of allowing you to track calories that you have burned through exercise.

Not all apps target calorie counting as the primary method for weight loss. “Endomondo.” featured on both the New York Daily News and Forbes lists, allows you to use your smartphone as a personal trainer to keep track of your sports activities and workouts. It also incorporates a social aspect in that is enables the user to share encouraging messages with friends and invite others to participate in sport challenges with them.

The important question is whether these apps really help you lose weight. Research in this field is still in its infancy, but a recent pilot randomized control trial has looked into compliance with smartphone apps for weight loss as compared to website or paper diary-based tools.⁷ Although the number of trial participants was small, they found better adherence for smartphone apps compared to other more conventional weight-loss tools, and participants using a smartphone app lost a mean weight of 10.2 pounds over the course of the 6-month trial.

It also can be difficult to determine what makes a good app. According to a recent study in Telemedicine Journal and e-Health, there are five essential elements to a successful technology-based weight-loss tool.⁸ It must allow for selfmonitoring, have social support, have an integrated counselor feedback and communication tool, incorporate the use of a structured program and allow for the tailoring of the program to the individual. As clinicians, it’s important to stay up to date on new resources available to our patients. Admittedly, given the wide variety of weight-loss apps available, it can be difficult to determine the best app to recommend, and what works for one patient may not work for another. There are, however, excellent options available and patients should be encouraged to try a few weight-loss apps to find the one that works best for them. Perhaps, the next time your patient picks up his smartphone, it will be to help lose weight and stay healthy.

Disclosure statement: Dr. Karalis has received speaker honoraria from GlaxoSmithKline. Dr. Prasad has no disclosures to report.