Efficacy of in-person versus digital enhanced lifestyle interventions in adults with overweight and obesity

Abstract

Background

Lifestyle interventions (LIs) are the cornerstone for obesity management. The Mayo Clinic Diet (MCD) offers two approaches for LIs: the In-Person LI (IPLI) and the Digital Enhanced LI (DELI). The IPLI includes a 2-day in-person program with monthly follow-ups, whereas the DELI provides on-demand digital tools. The comparative efficacy of these approaches is currently unknown.

Methods

This retrospective study included two cohorts of adults with a body mass index (BMI) of ≥25 kg/m² and weight metrics at least 3 months after starting either the IPLI or DELI program. The primary endpoint was the total body weight loss percentage (TBWL%) at 6 months.

Results

The study included 133 participants in the IPLI cohort (mean age 46.3 years, 65.4 % female, BMI 36.4) and 9603 in the DELI cohort (mean age 60.1 years, 85.0 % female, BMI 33.1). The DELI group achieved superior TBWL% at 1, 3, and 6 months compared to the IPLI group (3.4 % vs. 1.5 %, 4.7 % vs. 2.4 %, 5.3 % vs. 2.9 %, respectively; p < 0.001). After adjusting for age, gender, and starting weight, the DELI group maintained a higher TBWL% (difference 2.0 %; 95 % CI [1.0, 3.0], p < 0.001) and a greater proportion of participants achieved >5 % TBWL at 6 months (OR 1.66; 95 % CI [1.08, 2.55], p < 0.023).

Conclusion

The DELI approach resulted in superior weight loss outcomes compared to the IPLI. Further research is needed to explore how digital tools can improve weight loss effectiveness.