who helps overweight patients the most? technology is the answer! kimberly warner director of global...
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© Copyright 2012 1
WHO HELPS OVERWEIGHT PATIENTS THE MOST?
TECHNOLOGY IS THE ANSWER!
Kimberly Warner
Director of Global Professional Sales
BodyMedia, Inc.
Disclosures: Employed by BodyMedia, Inc.
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The Comparison of a Technology-based System and In-Person Behavioral Weight Loss Intervention in Overweight and Obese
Adults
Study Lead: Dr. John Jakicic, PhDUniversity of Pittsburgh
Physical Activity and Weight Management Research Center
Weight Loss Outcome Study 1:
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Study design consisted of three groups
• Independently funded NIH study• 6 month intervention• Randomized into 1 of 3 groups:
1. Group Lifestyle Intervention Weekly group meetings Self-monitoring with pencil and paper for food diaries Energy intake goals of 1200-1800 kcal/day, reduce fat intake to 20-30% of total energy intake Exercise increased from 100 to 300 minutes/week
2. BodyMedia Alone (armband + display + website) with phone calls Brief (< 10min) telephone call 1x per month Weekly lessons mailed corresponding to group meetings Self-monitoring with BodyMedia system Energy intake goals of 1200-1800 kcal/day, reduce fat intake to 20-30% of total energy intake Exercise increased from 100 to 300 minutes/week
3. Group Lifestyle Intervention + BodyMedia Combination of technology + group meetings
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Study Design
Group Lifestyle Intervention
Armband Alone
Group Lifestyle Intervention+ Armband
+
6 month results show adding BodyMedia FIT alone with phone calls or with Group Weight Loss meetings produced greater weight loss.
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1420
Weight Loss at 6 months (lbs)
Wei
ght
Loss
(lb
s)
> 2X Weight Loss when adding Armband to
Weight Loss Program
5
+
$$$
Pellegrini CA, Verba SD, Otto AD, Helsel DL, Davis KK, Jakicic JM. The Comparison of a Technology-Based System and an In-Person Weight Loss Intervention. Obesity (Silver Spring). 2011 Feb 10.
Weight loss of 5 -10% of body weight will lower risks for weight-related diseases such as high BP, type 2 diabetes, and heart disease.1
1 “Facts About Healthy Weight” http://www.nhlbi.nih.gov/health/prof/heart/obesity/aim_kit/healthy_wt_facts.htm
2468
10Percent Weight Loss at 6 months (%)
We
igh
t Lo
ss (
%)
6
+
Group Lifestyle Intervention + Armband group had 100% retention throughout the 6 month study.
Group Lifestyle Intervention
BodyMedia FIT alone (phone calls +
mailings)
CompletersNon-Completers
Group Lifestyle In-tervention +
BodyMedia FIT
100%
7
+
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Electronic feedback in a diet and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial
Study Lead: Dr. Steven N. Blair, PhDUniversity of South Carolina
Department of Exercise Science, Arnold School of Public Health
Weight Loss Outcome Study 2:
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Changing behavior through the LEAN study
A lifestyle intervention study designed to examine the effectiveness of the BodyMedia system as a tool for weight loss
Lifestyle Education for Activity & Nutrition for a Leaner You: 2008-2009 (LEAN) Study
Study Population (N=197)
• Men and women• 18-65 years old• Overweight or obese• Access to a computer and the internet• Currently not in an exercise program• Currently not in a formal weight loss program
Lifestyle Intervention over 9 months197 total participants in 4 groups
Randomized studyBaseline, 4 month, and 9 month assessments
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Methods:
1. Standard Care (control)
2. Armband Alone
3. Weight Loss Program
4. Weight Loss Program + Armband
Group meetings for 4 months, then phone calls for 5 months.
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Results equal more than 3x weight loss
Standard Care (Control)
Armband Alone Group Weight Loss
Group Weight Loss + Armband
02468
10121416
4 months9 months
Wei
ght L
oss
(lbs)
> 3X
> 3X
Self-Directed Groups (No coaching)
Group Meetings + Tele-phone Calls
9 month results with BodyMedia Armband alone and BodyMedia + group weight loss program
Shuger SL, Barry VW, Sui X, McClain A, Hand GA, Wilcox S, Meriwether RA, Hardin JW, Blair SN. Electronic feedback in a diet and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial. Int J Behav Nutri Phys. 2011. May 18;8:41.
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Standard Care (Control)
Group Weight Loss Armband Alone Group Weight Loss + Armband
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40
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Change in Waist Circumference (inches)
BaselineMonth 4Month 9
Wai
st C
ircum
fere
nce
(in)
**
> 2 in.
Group Weight Loss + Armband group had significant reductions in waist circumference at both 4 and 9 months.
Very Low Density Lipoproteins (VLDL) decreased significantly from baseline for Group Weight Loss + Armband and Armband Alone Group
Standard Care (Control)
Group Weight Loss
Armband Alone Group Weight Loss + Armband
-6
-5
-4
-3
-2
-1
0
1
2Change in VLDL at 9 months
Chan
ge V
LDL
(mg/
dL)
**
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Triglycerides changed significantly from baseline for Group Weight Loss + Armband and Armband Alone group.
Standard Care (Control)
Group Weight Loss
Armband Alone Group Weight Loss + Armband
-30
-25
-20
-15
-10
-5
0
5
10Change in Triglycerides at 9 months
Chan
ge T
rigly
cerid
es (m
g/dL
)
**
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All intervention groups had a significant decrease in fasting blood glucose compared to control.
Standard Care (control)
Group Weight Loss
Armband Alone Group Weight Loss + Armband
-15
-10
-5
0
5Change in Glucose at 9 months
Chan
ge G
luco
se (m
g/dL
)
* * *
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LEAN – Cost Effectiveness/ROI Paper
Available online: http://www.sciencedirect.com/science/article/pii/S0749379712003108
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Methods:
• Cost-effectiveness Analysis (CEA): cost related to health improvement or benefit
• LEAN CEA is from organization “payer’s” perspective• All costs are actual costs: includes overhead,
salaries, fringe benefits, phone usage, cost of armband & monthly subscription
• Presents results in 2 formats: • Cost ($)/participant/kg lost• Incremental cost-effectiveness ratio – compares cost and
effectiveness of competing interventions
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Results:
Assuming cost of Armband = $150,
Display = $99, Subscription =
$6.95/mo
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Results:
• Standard Care (SC) did not achieve significant weight loss • Group Weight Loss (GWL) is considered “Dominated” (i.e. less efficacious & more
expensive)• SWA cost $48.54 per kilogram lost• GWL + SWA cost $60.08 more per kilogram lost than SWA
For the GWL + SWA, each additional kilogram lost costs $60 more than SWA alone.
Groups Cost/Person
Weight Loss/ Person
Cost/Person/Weight Loss (kg)
Armband Alone $183 3.55 kg(7.8 lbs) $51
Group Weight Loss $240 1.86 kg(4.1 lbs) $129
Group Weight Loss + Armband $365 6.59 kg
(14.5 lbs) $55
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LEAN Study Cost Analysis
For each additional kg lost, the GWL+ Armband cost $60 more than the Armband alone.
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Discussion:
• Tech-based interventions were more cost-effective and efficacious than traditional counseling
• SWA was the most cost-effective intervention, but adding GWL increase efficacy (but also increases cost, $60 more per kg lost)
Questions?