Digital Weight Management in Young Adults – What is Working?

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The pandemic has changed our day-to-day routines. While we are fourteen months into our new reality, many people are starting to get back to their lives as they get vaccinated. Scientific and popular news sites have pointed to weight gain as a side-effect of pandemic life to the tune of 1.5 lbs a month gained on average, month-on-month. 

Digital tools are popular in supporting lifestyle changes, and the methods to deliver intensive behavioral lifestyle therapy have been digitized in programs like the Diabetes Prevention Program. What do we know about what works in young adults? The majority of studies in weight management have been conducted in middle-aged white women, and we can’t assume that works for other segments of the population.

A new paper by Melissa Napolitano and colleagues from George Washington University published in Translational Behavioral Medicine explores the value of tailoring digital approaches to support young adults on their weight loss journey. Obesity that starts in young adulthood is likely to persist across the lifespan. Finding solutions that can help a young adult develop a healthy dietary pattern may halt the progression to later-life obesity and ensuing pound years that occur if no interventions are offered. Estimates suggest that obesity rates hover around 40%. As we come out of the pandemic, more accurate figures will be available, but the shift upwards in BMI is expected.

The study authors enrolled 459 young adults (20-29) with overweight and obesity from two University sites; the average age was 22 years old. Participants were randomly assigned to one of three study arms, those who received personalized, tailored messages on weight loss and feedback via Facebook and SMS. The second group received targeted messages, but the content was generic. The control group received general health content on topics such as sleep and body image. Participants were assessed at three different time intervals, namely 6, 12, and 18 months. 

The findings were interesting. The authors did not find any difference between the groups at the studied time intervals. One would have hypothesized that those in tailored interventions would have the highest rates of weight loss. Of note, they did report differences in the treatment groups, which showed those who had a baseline BMI less than 30 (i.e., in the overweight class) at the start of the study did lose significantly more weight than the control group at six months. Namely, the tailored and targeted groups lost 2.27 kg 1.72 kg more than the control group, respectively. 

Another interesting finding relates to engagement. At the six-month mark, those in the tailored messaging arm were very engaged (66%); regardless of starting BMI, they showed significantly more weight loss when compared to the control group. 

So what does this all mean? While the overall weight loss didn’t differ across the treatment groups compared to the control group, this study points to the potential for digital approaches to support those with overweight in their weight loss journey. Those with obesity likely need more intensive support, so a stepped care approach may be prudent given the 70% prevalence of overweight and obesity in the USA. Weight loss programs, whether in-person or online, have suffered from high dropout rates. This study sheds more light on the value of personalized approaches to keep more people engaged in their weight loss journey. 

Thanks for reading – Trina

(Opinions are my own)


Melissa A Napolitano, Jessica A Whiteley, Meghan Mavredes, Ashley Hogan Tjaden, Samuel Simmens, Laura L Hayman, Jamie Faro, Ginger Winston, Steven Malin, Loretta DiPietro, Effect of tailoring on weight loss among young adults receiving digital interventions: an 18 month randomized controlled trial, Translational Behavioral Medicine, Volume 11, Issue 4, April 2021, Pages 970–980,

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