A smartphone based attentive eating intervention for energy intake and weight loss: results from a randomised controlled trial

BackgroundLaboratory studies suggest that eating more attentively' (e.g. attending to food being eaten and recalling eating episodes) can reduce food intake among participants with both healthy weight and overweight. The aim of this trial was to assess whether a smartphone application that encourages a more attentive eating style reduces energy intake and promotes weight loss.MethodsIn an open-label, single centre, parallel groups, individually randomised controlled trial, 107 adults with overweight/obesity in Merseyside, UK used an attentive eating smartphone application along with standard dietary advice (intervention group) or standard dietary advice only (control group) for 8weeks. The primary outcomes were change in body weight at 8weeks and energy intake at 4 and 8weeks. Additional outcomes included self-reported eating behaviours measured at 8weeks. Differences between groups were assessed with linear regression (adjusted) using multiple imputation for missing data. Study protocol registered prospectively at (10.17605/osf.io/btzhw).ResultsThere was no significant difference between the intervention and control group in weight lost at 8weeks, or change in self-reported 24h or objective taste-test energy intake at 4 or 8weeks. Mean weight loss in the intervention group (n=53) was 1.2kg and 1.1kg in the control group (n=54), adjusted difference of -0.10 (-1.6 to 1.3) kg. Self-reported eating behaviours at 8weeks also did not differ across groups. The intervention was largely used as intended and a per protocol analysis confined to participants in the intervention group that used the attentive eating smartphone application regularly and as intended also showed no effect on energy intake or weight loss.ConclusionsA smartphone based attentive eating intervention and standard dietary advice did not result in reduced energy intake or greater weight loss at 4 or 8week follow-up than standard dietary advice alone.Trial registrationClinicalTrials.gov, NCT03602001. Registered retrospectively on 26th July 2018.Prospectively registered on the Open Science Framework on 11th August 2017.