So, once again, you resolve to lose weight for the New Year. There’s an app for that – or, rather, more apps.
But you might start out with some other gadgets first. The Nike+ FuelBand and Jawbone UP can be worn around the wrist, and the FitBit clips under clothing. These discreet digital accelerometers measure movement and calorie burn. Companion mobile apps create a log of calories consumed by simply scanning barcodes on food labels. Some even track sleep.
The new widgets may be good news for serial dieters. A Northwestern University study released Dec. 10 shows that apps such as this are effective in helping to shed pounds.
Participants who used an app created for the study along with the “Shimmer” movement tracker lost an average of 15 pounds while taking health education classes. Participants who did not attend classes lost 8.6 pounds, and the control group – which received the classes but not the mobile app ¬– lost no weight at all.
The study followed 69 overweight adults over the course of a year. Their average age was 58, and most of the subjects were men.
“They were older; they had no familiarity with the widgets,” said lead investigator and clinical psychologist Bonnie Spring. “I think it would work even more easily with younger people.”
Commercial calorie counting apps, such as Lose It! and MyFitnessPal, appeared at the dawn of smartphones. Spring said she wanted to conduct a randomized clinical study because of a gap between technology and medicine.
“(Technology) takes as evidence that (apps) are not too buggy. They perform, people like them and they provide a return on investment. But the kind of evidence we want is that it improves a health outcome,” Spring said. “The plural of anecdote is not evidence. We need real evidence that these things work. We wouldn’t introduce a drug or a surgery into that space without evidence that it is effective. ”
However, some people worry that apps such as this may be too effective.
“They stimulate people to obsess about what they’re eating and to focus intently on calorie counting and food choices in a way that for most people is not healthy or productive,” said Dr. Harry Brandt, the director of the Center for Eating Disorders at Sheppard Pratt, a psychiatric hospital in Maryland. “When there was a proliferation of these apps a while ago, we heard from our patients that there were problems.”
Spring, a clinical psychologist specializing in behavioral change, said her study focused on two-thirds of Americans who are overweight, and not the “very, very, very small population” suffering from eating disorders. Anorexia nervosa afflicts less than 1 percent of the population, while bulimia nervosa affects between 1 and 3 percent.
But Brandt said he is also concerned about the millions of Americans who engage in subclinical disordered eating without meeting strict diagnostic criteria.
This year’s National Comorbidity Survey Replication showed that nearly 5 percent of the population has been diagnosed with an unspecified eating disorder. This means a patient may meet most criteria for anorexia nervosa but still have menstrual cycles, for example, and would not be diagnosed. Brandt said disorders like this are still life threatening.
“There are high percentages of normal weight but don’t feel comfortable with their bodies,” Brandt said. “A subset of patients will be ensnared by these (apps), and it really falls right into the pathology. People are keeping complex counts of their caloric intake. It could be a real hazard and very deleterious to somebody with an eating disorder.”
Brandt said he thinks the mobile apps could serve the needs of overweight people, but the technology needs to be used with caution.
“I’m not meaning to minimize the concerns about obesity,” Brandt said. “The war on obesity encourages dieting. The two fields really need to talk to each other to really try to come up with a cohesive, comprehensive approach.”
One of the safeguards Spring adopted for her study was the use of health coaches who kept track of participants’ calorie counts and gave them personalized recommendations on a regular basis.
“I always ask that people be monitored for having too rapid a weight loss,” Spring said.