Features Predicting Weight Loss in Overweight or Obese Participants in a Web-Based Intervention: Randomized Trial

BackgroundThe Internet is widely available and commonly used for health information; therefore, Web-based weight loss programs could provide support to large parts of the population in self-guided weight loss. Previous studies showed that Web-based weight loss interventions can be effective, depending on the quality of the program. The most effective program tools are visual progress charts or tools for the self-monitoring of weight, diet, and exercises. KiloCoach, a commercial program currently available in German-speaking countries, incorporates these features. A previous investigation showed that the program effectively supports users in losing weight.ObjectiveWe investigated weight loss dynamics stratified by weight loss success after 6-month use of KiloCoach. Furthermore, we analyzed possible associations between intensity of program use and weight loss. The results are intended for tailoring user recommendations for weight-loss Internet platforms.MethodsDatasets of KiloCoach users (January 1, 2008 to December 31, 2011) who actively used the platform for 6 months or more were assigned to this retrospective analysis. Users (N=479) were 42.2% men, mean age of 44.0 years (SD 11.7), with a mean body mass index (BMI) of 31.7 kg/m2 (SD 3.2). Based on the weight loss achieved after 6 months, 3 success groups were generated. The unsuccessful group lost <5%, the moderate success group lost 5%-9.9%, and the high success group lost ≥10% of their baseline body weight. At baseline, the unsuccessful (n=261, 54.5%), moderate success (n=133, 27.8%), and high success (n=85, 17.8%) groups were similar in age, weight, BMI, and gender distribution.ResultsAfter 6 months, the unsuccessful group lost 1.2% (SD 2.4), the moderate success group lost 7.4% (SD 1.5), and the high success group lost 14.2% (SD 3.8) of their initial weight (P<.001). Multivariate regression showed that early weight loss (weeks 3-4), the total number of dietary protocols, and the total number of weight entries were independent predictors for 6-month weight reduction (all P<.001) explaining 52% of the variance in weight reduction. Sensitivity analysis by baseline carried forward method confirmed all independent predictors of 6-month weight loss and reduced the model fit by only 11%. The high success group lost weight faster and maintained weight loss more efficiently than the other groups (P<.001). Early weight loss was associated with weight maintenance after 1 year and 2 years (both P<.001). Weight dynamics did not differ between men and women over 6 months when adjusted for baseline and usage parameters (P=.91). The percentage of male long-term users was unusually high (42.2%).ConclusionsOur results suggest that early weight loss and close program adherence (ie, 5 dietary protocols per week and weekly entering of current weight), especially in the early phase of program usage, can improve weight loss outcome.

BackgroundObesity rates in adults continue to rise and effective treatment programs with a broad reach are urgently required. This paper describes the study protocol for a web-based randomized controlled trial (RCT) of a commercially available program for overweight and obese adult males and females. The aim of this RCT was to determine and compare the efficacy of two web-based interventions for weight loss and maintenance of lost weight.Methods/DesignOverweight and obese adult males and females were stratified by gender and BMI and randomly assigned to one of three groups for 12-weeks: waitlist control, or basic or enhanced online weight-loss. Control participants were re-randomized to the two weight loss groups at the end of the 12-week period. The basic and enhanced group participants had an option to continue or repeat the 12-week program. If the weight loss goal was achieved at the end of 12, otherwise on completion of 24 weeks of weight loss, participants were re-randomized to one of two online maintenance programs (maintenance basic or maintenance enhanced), until 18 months from commencing the weight loss program. Assessments took place at baseline, three, six, and 18 months after commencing the initial weight loss intervention with control participants repeating the initial assessment after three month of waiting. The primary outcome is body mass index (BMI). Other outcomes include weight, waist circumference, blood pressure, plasma markers of cardiovascular disease risk, dietary intake, eating behaviours, physical activity and quality of life.Both the weight loss and maintenance of lost weight programs were based on social cognitive theory with participants advised to set goals, self-monitor weight, dietary intake and physical activity levels. The enhanced weight loss and maintenance programs provided additional personalized, system-generated feedback on progress and use of the program. Details of the methodological aspects of recruitment, inclusion criteria, randomization, intervention programs, assessments and statistical analyses are described.DiscussionImportantly, this paper describes how an RCT of a currently available commercial online program in Australia addresses some of the short falls in the current literature pertaining to the efficacy of web-based weight loss programs.Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12610000197033

Review Question/Objective The primary objective of this review is to identify the effectiveness of web-based interventions on weight loss and maintenance. The second objective is to identify the effectiveness of web-based interventions on behaviours associated with weight loss (eating and physical activity). The third objective is to identify what components of web-based interventions are associated with greater weight loss and maintenance, as well as lower attrition rates. Criteria for Inclusion Types of participants The quantitative component of this review will consider studies that include overweight and/or obese adults, aged greater than 18 years. Overweight and obesity will be defined as a body mass index (BMI) greater than or equal to 25(kg/m2). Types of intervention(s) The quantitative component of the review will consider studies that evaluate web-based interventions with the primary aim of achieving weight loss or weight maintenance following weight loss. This includes studies with the aim of achieving positive dietary and physical activity behaviour change for participants that include overweight/obesity outcome measures. However, if the stated aim is to achieve positive dietary and physical activity behaviour change for participants, and they do not include overweight/obesity outcome measures they will be excluded. At least one arm of the study must include a web-based intervention. A web-based intervention will be based around a website that participants receive information from and directly interface with. They are not required to input information into the website for the intervention to be included. Types of outcomes This review will consider studies that include the following outcome measures: Primary Outcome: Overweight/obesity related outcomes: weight (kg), % body weight lost, BMI, waist measurements, % body fat, % lost 5% of body weight. Secondary Outcomes: Dietary behaviours: energy intake, core food group intake (e.g. number of serves of fruit per day), macronutrient composition of diet (e.g. fat intake per day) Physical activity behaviours: energy expenditure, time spent in activity, steps per day. Effect modifiers/confounders: Compliance/engagement with website: website logins, completion of self-monitoring diaries, attendance at meetings/group discussions, retention etc Adjuncts to web-based intervention (e.g. contact with professional/face to face contact, other eHealth technology such as SMS, email, CD-Rom, Personal Digital Assistant (PDA) and use of rewards/prizes) Intervention based on theoretical models Intensity of web-based intervention: type and number of features included (e.g. self-monitoring diary, chat room, discussion board)

The presented article is devoted to the study of the spatio-temporal distribution of the average number of days with snow cover (the number of days when the snow cover of the territory was 60% or more (6 or more points)) for certain months of the cold and certain transitional seasons of the year during certain decades 1991-2020. For the analysis, the materials of observations of the snow cover, which are placed in the Meteorological monthlies in the tables containing the relevant information about the state of the snow cover, were included. The spatio-temporal distribution of the average number of days with snow cover on the territory of Ukraine during individual decades of the specified period is shown, and the centers of their largest and smallest number, as well as the general directions of changes in their distribution from decade to decade, are determined. For each of the studied months, based on the data on the average number of days with snow cover at the meteorological stations of the regions, appropriate maps were constructed showing the spatial distribution of the number of days with snow cover. Changes in the spatio-temporal distribution of the average number of days with snow cover on the territory of Ukraine in some of the studied months were revealed. Thus, for the winter months, especially for January and February, the biggest changes in the average number of days with snow cover are noticeable in the central and southern parts of the country, which are associated with a decrease in their number. In December, these changes are more pronounced. However, the most noticeable downward changes in the average number of days with snow cover from decade to decade occurred in March and November. For April, given the small number of days with snow during this month, it is difficult to make a final conclusion. However, the obtained empirical material indicates a certain decrease in the average number of days with snow cover for most of the country from decade to decade, even for mountainous areas. In general, a general trend towards a decrease in the average number of days with snow cover for the territory of Ukraine was established for the studied months. This is especially true for the second and third decades, which points to continued warming.

In the past 50 years, Southwestern China has suffered from frequent, intense droughts. MCI (meteorological drought composite index) was calculated, and ArcGIS Spatial Analyst was run in the present study. The simulation performance was compared between different CMIP5 models. Then we projected the temporal and spatial distributions of drought in the intermediate path (RCP4.5 scenario) in the two time periods (2018-2058 and 2059-2099) between 2018 and 2099. The results showed that (1) the number of days with moderate drought and above increased in Southwestern China in both two time periods. The high-value regions were mainly found at the borders between Sichuan and Yunnan Province from 2018 to 2099. The annual number of drought days was generally above 150d. The low-value regions were mainly found in some parts of southeastern Sichuan, Chongqing, and the large parts of Guizhou. The annual average number of drought days was generally below 100d; (2) At phase P1 (from 2018 to 2058), the projected spatial distribution of drought severity was generally consistent with that of the annual average number of days with moderate drought and above. At phase P2 (from 2059 to 2099), the high-value regions of drought severity were still primarily found at the borders between Sichuan and Yunnan Province. The low-value regions were mainly found in the large parts of Chongqing and Guizhou. As time progressed, the high-value regions of drought severity expanded, and the drought was aggravated; (3) At phase P1, the high-value regions of drought frequency were mainly found at the borders between Sichuan and Yunnan. In these regions, the drought frequency was above 80%. The low-value regions of drought frequency were mainly found in parts of western Guizhou and central and eastern Sichuan. In these regions, the drought frequency was below 20%. At phase P2, the high-value regions of drought frequency were generally found in Yunnan Province and southwestern Sichuan. In these regions, the drought frequency was above 60%. The low-value regions of drought frequency were mainly found in Chongqing and northern Guizhou. In these regions, the drought frequency was below 20%. From phase P1 to P2, the high-value regions of drought frequency expanded, and the drought frequency increased. The low-value regions of drought frequency shrank in size. The drought frequency also decreased. Taken together, the drought in Southwestern China was aggravated and occurred more frequently according to the projections from 2018 to 2099. Our research findings offered important guidance for drought early warning and prevention in Southwestern China.

BackgroundMobile health (mHealth) and web-based technological advances allow for new approaches to deliver behavioral interventions for chronic diseases such as obesity and diabetes. African American and Hispanic adults experience a disproportionate burden of major chronic diseases.ObjectiveThis paper reviews the evidence for mHealth and web-based interventions for diabetes and obesity in African American and Hispanic adults.MethodsLiterature searches of PubMed/Medline, The Cochrane Library, EMBASE, CINAHL Plus, Global Health, Scopus, and Library & Information Science Source were conducted for relevant English-language articles. Articles identified through searches were reviewed by 2 investigators and, if they met the inclusion criteria, were extracted and assessed for risk of bias. Findings were summarized in tabular and narrative format. The overall strength of the evidence was assessed as high, moderate, low, or insufficient on the basis of risk of bias, consistency of findings, directness, precision, and other limitations.ResultsSearches yielded 2358 electronic publications, 196 reports were found to be eligible for inclusion, and 7 studies met the eligibility criteria. All 7 included studies were randomized control trials. Five studies evaluated the effectiveness of an mHealth intervention for weight loss, including one that evaluated the effectiveness for diabetes and two studies focused on diabetes. Of all the studies that focused on weight loss, 3 reported significant differences in weight loss in participants in the intervention group compared with those in the usual care group. Although all studies on diabetes control showed greater improvement in glycemic control for the intervention group compared to that in the control group, only one study showed a significant difference between the 2 groups.ConclusionsThis analysis indicates that there are few published studies that assessed mHealth interventions among minority populations and focused on weight or diabetes. Although the overall strength of evidence was low for diabetes control, it was moderate for weight loss, and our findings suggest that mHealth and web-based interventions may provide a promising approach for interventions among African American and Hispanic adults who have obesity or diabetes.

The prevalence of overweight and obesity in the United States remains high. Commercial weight loss programs may contribute to efforts to reduce the prevalence of overweight and obesity, although few studies have examined their efficacy in controlled trials. To test whether a free prepared meal and incentivized structured weight loss program promotes greater weight loss and weight loss maintenance at 2 years compared with usual care. A randomized controlled trial of weight loss and weight loss maintenance in 442 overweight or obese women (body mass index, 25-40) aged 18 to 69 years (mean age, 44 years) conducted at US institutions over 2 years with follow-up between November 2007 and April 2010. The program, which involves in-person center-based or telephone-based one-to-one weight loss counseling, was available over a 2-year period. Behavioral goals were an energy-reduced, nutritionally adequate diet, facilitated by the inclusion of prepackaged food items in a planned menu during the initial weight loss phase, and increased physical activity. Participants assigned to usual care received 2 individualized weight loss counseling sessions with a dietetics professional and monthly contacts. Weight loss and weight loss maintenance. Weight data were available at 24 months for 407 women (92.1% of the study sample). In an intent-to-treat analysis with baseline value substitution, mean weight loss was 7.4 kg (95% confidence interval [CI], 6.1-8.7 kg) or 7.9% (95% CI, 6.5%-9.3%) of initial weight at 24 months for the center-based group, 6.2 kg (95% CI, 4.9-7.6 kg) or 6.8% (95% CI, 5.2%-8.4%) for the telephone-based group, and 2.0 kg (95% CI, 0.6-3.3 kg) or 2.1% (95% CI, 0.7%-3.5%) for the usual care control group after 24 months (P < .001 for intervention effect). Compared with usual care, this structured weight loss program resulted in greater weight loss over 2 years. clinicaltrials.gov Identifier: NCT00640900.

BackgroundThe Internet holds promise for the delivery of evidence-based weight loss treatment to underserved populations. However, most studies do not reflect the more naturalistic and common ad libitum, or freely at will, use of the Internet. Randomized clinical trials, for example, typically include at least some direct contact with participants and often have restrictive selection criteria. There is a paucity of research examining utilization patterns of online weight loss programs, particularly in the rapidly expanding direct-to-consumer arena.ObjectivesTo examine self-reported characteristics (age, body mass index [BMI], gender), behaviors, and Internet site utilization patterns of a sample of users of a direct-to-consumer ad libitum Internet weight loss program.MethodsThis study is based on analysis of archival data from the initial 15 weeks of an ongoing, free, evidence-based, direct-to-consumer Internet weight loss program, the Healthy Weight Center, which included standard information about nutrition, fitness, and behavioral strategies; monitoring tools; and moderated support group message boards. Participants encountered the program through self-directed Internet searches and anonymously registered to utilize the site. Self-reported user characteristics and electronically tracked utilization data were extracted from existing program data, compiled, and examined. Pearson correlations were computed to examine the association of program utilization with age and BMI. One-way analysis of variance (ANOVA) was used for gender comparisons.ResultsWe examined data from the first 204 adult users of the program who were classified as either overweight (BMI 25 to < 30 kg/m2) or obese (BMI ≥ 30 kg/m2). The mean age of participants was 42.0 years (SD 11.7), 81.9% (167/204) were women, and mean BMI was 32.01 kg/m2 (SD 6.26). The percent of participants who used program tools was as follows: 13.7%, meal planner; 10.8%, nutrition lookup: 17.6%, activity log; 14.2%, journal; and 22.1%, weight tracker. Participants also used the following educational resources: nutrition, 13.2%; fitness, 6.4%; and behavioral, 7.4%. Of the personal self-assessments available through the program, 57.8% of participants assessed personal barriers, and 50.5% assessed relationship with food. Only 7.8% used the support group message boards. No significant associations between site utilization and age, gender, or BMI were found. Reasons for wanting to lose weight were: health, 87%; appearance, 74%; mobility, 44%; doctor recommendation, 23%; and spouse/friend suggested, 12%. The age participants reported first becoming overweight was young adulthood, 31%; late adulthood, 28%; childhood, 22%; adolescence, 17%; and as a toddler, 3%. Self-perceived factors contributing to weight gain were lack of exercise for 70% of participants, emotions for 62%, overeating for 61%, and slow metabolism for 33%.ConclusionsInternet weight loss programs reach many people who cannot access traditional treatment. However, users appear not to be optimally utilizing key aspects of the weight loss intervention, such as education, monitoring, and support. This study provides insight into the patterns of ad libitum use of an online weight loss program across multiple treatment-related domains in a naturalistic Internet environment.

Background: Despite evidence for the beneficial effects of probiotics and low-fat dairy products, to our knowledge, no study has compared the beneficial effect on weight loss of consuming a probiotic yogurt (PY) compared with a standard low-fat yogurt (LF) during a hypoenergetic program.Objective: We compared the effect of the PY with LF yogurt consumption on body weight and cardiometabolic risk factors in women during a weight-loss program.Design: Overweight and obese women [body mass index (in kg/m2): 27–40; age: 18–50 y) who usually consumed standard LFs were asked to consume either PY or LF every day with their main meals for 12 wk while following a weight-loss program.Results: A total of 89 participants were randomly assigned to one of the 2 intervention groups. Baseline variables were not significantly different between groups. A statistically significant reduction in anthropometric measurements and significant improvements in cardiometabolic risk characteristics were observed over the 12 wk in both groups. However, no significant differences in weight loss and anthropometric measurements were seen between groups after the intervention. Compared with the LF group, the PY group had a greater (mean ± SD) decrease in total cholesterol (PY = −0.36 ± 0.10 mmol/L, LF = −0.31 ± 0.10 mmol/L; P = 0.024), low-density lipoprotein cholesterol (PY = −0.35 ± 0.10 mmol/L, LF = −0.31 ± 0.11 mmol/L; P = 0.018), homeostasis model assessment of insulin resistance (PY = −0.55 ± 0.32, LF = −0.42 ± 0.20; P = 0.002), 2-h postprandial glucose (PY = −0.61 ± 0.24 mmol/L, LF = –0.44 ± 0.19 mmol/L; P < 0.001), and fasting insulin concentration (PY = −1.76 ± 1.01 mU/mL, LF = −1.32 ± 0.62 mU/mL; P = 0.002), as secondary endpoints after the study. No significant differences were found for fasting plasma glucose, high-density lipoprotein cholesterol, or triglycerides within both groups after the 12 wk.Conclusion: Consumption of PY compared with LF with main meals showed no significant effects on weight loss. However, it may have positive effects on lipid profiles and insulin sensitivity during a weight-loss program. This trial was registered at http://www.irct.ir/ as IRCT201402177754N8.

Losing weight online with POWeR: a randomised controlled trial of a web-based behavioural intervention in a community setting

Background Hemodynamic-guided therapy using the CardioMEMS™ system has been shown to reduce heart failure hospitalization (HFH) in both clinical trials and real-world settings. However, the CardioMEMS system requires input from multiple independent elements to achieve its effect, and no studies have been done to investigate those elements. Consistent patient participation and health care provider participation are two of those key elements, and this study sought to assess how they affect HFHs. Methods This was a single-center, retrospective cohort study of patients with the CardioMEMS sensor. The primary outcome was the number of HFH days patients experienced in the 1 year following CardioMEMS sensor implant. The primary independent variables were the average number of days between patient transmissions of data and the average number of days between health care provider reviews of those data. Covariates included patient demographics, medical comorbidities, history of HFHs, and initial pressure response to hemodynamic-guided therapy at 28 days after implant. Data were fit to a zero-inflated negative binomial regression. Results Seventy-eight patients were included in the study. The mean age was 64 ± 15 years, 52 (67%) were male, and 58 (76%) had heart failure with reduced ejection fraction. During the study period, there were 538 cumulative HFH patient-days. Based on the regression model, there was an exponential relationship between HFH days and the mean number of days between patient transmissions (IRR = 1.74, 95% CI: 1.09–2.75, p=0.019). There was also an exponential relationship between HFH days and the mean number of days between health care provider reviews (IRR = 1.03, 95% CI: 1.01–1.05, p=0.013). Conclusions This single-center study suggests that more frequent patient transmissions and health care provider reviews of the CardioMEMS system are associated with a decreased number of HFH days, but larger multicentered studies are required. Further systems-based analyses of the CardioMEMS system may be a useful approach to guiding effective use of the CardioMEMS device.

Utility of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Equations in Obese Diabetic Individuals Before and After Weight Loss

0697 PURPOSE: To examine the relationship between macronutrient composition (dietary carbohydrate and protein) on 12-month weight loss in overweight women. METHODS: Data from 164 women (age = 37.62 ± 5.42 years; body mass index = 32.53 ± 4.09 kg/m2) who completed a 12-month behavioral weight loss program were analyzed. Participants were prescribed a reduced energy (1,200 to 1,500 kcal/d) and dietary fat (20 to 30%) diet and 150 to 300 min/wk of moderate to vigorous intensity exercise. Subjects attended group behavioral sessions and received intervention telephone calls throughout the study. Total energy and macronutrient content were measured using the Block Food Frequency Questionnaire with physical activity assessed using a 7-day physical activity recall (7-day PAR). Participants were separated into higher and lower intakes of percent carbohydrate and protein. Participants in the highest tertile of carbohydrate intake (>56% intake) and lowest tertile of protein intake (<16% intake) were classified as HC/LP (N = 25). Participants in the lowest tertile of carbohydrate intake (<50% intake) and highest tertile of protein intake (>17% intake) were classified as LC/HP (N = 26). RESULTS: The HC/LP group reported 60.82 ± 3.02 % carbohydrate intake and 13.27 ± 1.31% protein intake. The LC/HP group reported 44.61 ± 6.62 % carbohydrate intake and 20.32 ± 2.63% protein intake. Weight loss at 12-months was significantly greater in HC/LP (10.38 ± 7.74 kg) compared to LC/HP (6.16 ± 6.06 kg) (P <0.04). There was no statistical difference in total energy intake between the HC/LP (1305.80 ± 604.44 kcal/d) and LC/HP (1437.23 ± 583.65 kcal/d) groups. Physical activity did not differ statistically between HC/LP (220.83 ± 100.25 min/wk) and LC/HP (160.00 ± 116.08 min/wk). CONCLUSION: Within the confines of this study, it appears that 12-month weight loss was enhanced in participants consuming a higher carbohydrate and lower protein diet compared to those consuming a lower carbohydrate and higher protein diet. Additional research is necessary to understand the impact of macronutrient composition on long-term weight loss in overweight and obese individuals. Supported by National Institutes of Health (HL64991)

Background and AimsmicroRNAs (miRNAs) are small, endogenous non-coding RNAs that regulate metabolic processes, including obesity. The levels of circulating miRNAs are affected by metabolic changes in obesity, as well as in diet-induced weight loss. Circulating miRNAs are transported by high-density lipoproteins (HDL) but the regulation of HDL-associated miRNAs after diet-induced weight loss has not been studied. We aim to determine if HDL-associated miR-16, miR-17, miR-126, miR-222 and miR-223 levels are altered by diet-induced weight loss in overweight and obese males.MethodsHDL were isolated from 47 subjects following 12 weeks weight loss comparing a high protein diet (HP, 30% of energy) with a normal protein diet (NP, 20% of energy). HDL-associated miRNAs (miR-16, miR-17, miR-126, miR-222 and miR-223) at baseline and after 12 weeks of weight loss were quantified by TaqMan miRNA assays. HDL particle sizes were determined by non-denaturing polyacrylamide gradient gel electrophoresis. Serum concentrations of human HDL constituents were measured immunoturbidometrically or enzymatically.ResultsmiR-16, miR-17, miR-126, miR-222 and miR-223 were present on HDL from overweight and obese subjects at baseline and after 12 weeks of the HP and NP weight loss diets. The HP diet induced a significant decrease in HDL-associated miR-223 levels (p = 0.015), which positively correlated with changes in body weight (r = 0.488, p = 0.032). Changes in miR-223 levels were not associated to changes in HDL composition or size.ConclusionHDL-associated miR-223 levels are significantly decreased after HP diet-induced weight loss in overweight and obese males. This is the first study reporting changes in HDL-associated miRNA levels with diet-induced weight loss.

There are inconsistent results for the effectiveness of using smartphone applications (apps) or websites on weight loss. We investigated the efficacy of a smartphone intervention using a designated app that utilizes a lifestyle intervention-focused approach, including a human coaching element, toward weight loss in overweight or obese Korean adults. One hundred four adults aged 20-60 years with a body mass index ≥23 kg/m2, who signed up for a smartphone program for weight loss (using the Noom app), were recruited. Participants received an in-person orientation about the study and app use, and a baseline blood sample was obtained. The in-app intervention with daily behavior and nutrition education content and coaching lasted 15 weeks. The primary endpoint of the study was a change in weight. The secondary endpoints were changes in metabolic risk factors such as blood pressure, waist circumference, and glucose and lipid profiles. Body composition changes were also assessed, and body weight at 52 weeks was measured to ascertain long-term effects. Participants showed a clinically significant weight loss effect of -7.5% at the end of the 15-week program (P < 0.001), and at a 52-week follow-up, a weight loss effect of -5.2% was maintained. At 15 weeks, percent body fat and visceral fat decreased by -6.0 ± 5.4% and -3.4 ± 2.7 kg, respectively (both P < 0.001). Fasting glucose level also decreased significantly by -5.7 ± 14.6 mg/dL at 15 weeks. Lipid parameters showed significant improvements, except for high-density lipoprotein cholesterol. The frequency of logging meals and exercise was associated with body fat loss. This advanced smartphone app was a useful tool to maintain weight loss in overweight or obese people.