Effectiveness of Mobile Application-Based Multimodal Behavioral Interventions on Weight Loss in Obesity: A Systematic Review and Meta-Analysis.

BACKGROUND: Healthcare systems face increasing demands in chronic disease management such as obesity. Mobile applications offer scalable tools for weight management, ranging from simple trackers to prescribable digital therapeutics. OBJECTIVE: This review evaluates the effectiveness of fully remote, app-based interventions using a multimodal approach for weight loss in adults with obesity. Complying with international guidelines, these interventions combine behavior change strategies for diet, physical activity, and/or psychosocial education. METHODS: A systematic literature search was performed. Eligible studies were assessed using the Cochrane Risk of Bias Tool 2 and the Grading of Recommendations, Assessment, Development and Evaluation approach for certainty of evidence. A meta-analysis was performed for body weight outcomes. RESULTS: Twelve randomized controlled trials and five systematic reviews were included, reporting changes in body weight or body mass index. The standardized mean difference of body weight changes at the end of intervention was -0.50 (95% confidence interval: -0.77, -0.22), corresponding to a mean difference of -2.61 kg (-4.45, -0.78). Heterogeneity was substantial (I2 = 79.2%; p < 0.0001). CONCLUSION: Fully remote, app-based interventions show moderate weight loss with promising potential in obesity management. However, heterogeneity between studies highlights the need for further research into potential factors with a significant influence on the results.