Recently in the journal Obesity, researchers including those from the National Institutes of Health published a gripping study that examined 14 participants from season 8 of “The Biggest Loser,” the televised weight-loss competition. The study found that six years after the competition concluded, a mean amount of nearly 90 pounds (with a standard deviation of about 68 pounds) of the lost weight was regained among the study participants.
Healthcare wellness and app executives note that the results highlight the discussion around behavioral changes so individuals can maintain weight loss. Yoni Freedhoff, an obesity medicine doctor, wrote in The Atlantic, “Perhaps the constructs we’ve set up around weight loss…doom those who buy into them to failure.”
The study received significant media attention. It has the makings of a great media story: sensational results, reality television, supported by the National Institutes of Health, relatable to anyone struggling to lose weight.
As Freedhoff notes, only one of the 14 study participants weighs less than when the weight-loss competition ended. With a slowed-down metabolic rate, the researchers found many contestants were struggling to maintain their weight loss. While it is not unusual for those who lose weight to experience a slower metabolism, the contestants experienced an average metabolic deficit at 499 calories per day (with a standard deviation of 207 calories), about two regular Snickers bars.
What the execs are saying
Some companies are excited about the conversation the study’s results have created. PricewaterhouseCooper’s Paul D'Alessandro, sales, marketing and customer experience partner lead, told Healthcare Dive the results highlight discussions around a body’s set weight point and resting metabolic rate.
“People should be anchored on this more today with all this work on wearables and data science but it hasn’t gotten enough attention because of macro healthcare issues,” D’Alessandro says.
PwC’s Bodylogical uses an individual’s health data to create a predictive model to simulate the onset, progression and impact of chronic lifestyle diseases. What PwC has found, D’Alessandro notes, is that short-term interventions are not lasting. Rather, he says weight and chronic disease management interventions require reinforcement. One reinforcement example he gives could be switching up an employer’s cafeteria menu.
Focus on quick weight loss can be a concern, Dr. Jason Langheier, CEO and founder of Zipongo, told Healthcare Dive. Zipongo provides personalized recommendations tied to digital tools such as nutrition coaching, meal planning and ordering, recipes, and loyalty-card linked rewards to help make finding, buying and eating healthier food easier.
“That is a problem that permeates both our personal and business lives -- short-term planning on weight loss, agricultural subsidies, or [a] traditional lack of health system budgeting for prevention that leads to savings in health costs are all large drivers of our current problems,” Langheier said.
Charles Teague, CEO and founder of the weight-loss app Lose It!, notes the results of 14 individuals in a very extreme weight-loss intervention, while important research, can be hard to generalize to the rest of the world. “The biggest, overwhelming challenge in someone losing weight is a behavioral challenge,” Teague told Healthcare Dive.
The app, downloaded more than 25 million times, takes gender, current weight, height, age, desired weight loss and gives the user a daily caloric budget. Users enter exercise and food items they eat throughout the day.
As Teague notes, the app is meant to highlight food and beverage behaviors so users make a sustainable change to their dietary habits. Teague told Healthcare Dive that Lose It’s most entered item is a McDonald’s small fries (230 calories). But, as he notes, at least it’s a small serving. “The big point is we’re trying to help people make incremental, sustainable changes,” Teague says. “The best user is someone who makes changes, achieves their goals, and doesn’t need the app anymore.”
The study’s results do give some directions for weight-loss and wellness apps such as Lose It!
“We’re definitely thinking about how to get smarter and more personal,” Teague says. “That’s the meta point the study makes that we’re on board with.”
Teague says some future efforts could include integration with implantables, wearables, DNA and/or blood-testing. Such initiatives could serve to receive better, more trustworthy data. He admits one of the larger problems for an app like Lose It! is imprecise data. A person fasting for a day is very different from a person not reporting what they ate but the company, in those instances, still receives no data.
Everything Zipongo does is predicated on the notion people who want to change nutrition and health status can be helped by changing their food environment and behavioral economics, “not just go on a diet, or track their food intake,” Langheier says. “Now that we understand what does and does not work better, things are starting to look up.”
He points to data that show high adult obesity rates; about 38% of American adults qualified as obese in 2013 and 2014, a 3% increase from 2011 and 2012. At the same time, while approximately 17% (or 12.7 million) American children are obese, the pervasiveness of childhood obesity aged 2 to 5 years old decreased from 13.9% in 2003-2004 to 8.4% in 2011-2012. “Why? Mostly because of dramatic changes made to the environmental display of fruits, veggies and water versus foods with added sugars and other foods that have been shown to promote weight gain, in schools,” Langheier posits.
D'Alessandro says if you know an individual’s baseline metabolic rate, their weight and their activity level, you can begin to understand how to break an individual’s current way of living and how to get them to a new, healthier stasis.
“Everyone is doing a good job of collecting data,” he says, adding, “Now that we have the data, let's do something with it.”