Technology cannot replace human coaches in obesity treatment – study

Technology alone is not enough to replace human coaches when it comes to successfully losing weight, new research suggests.

There is a need for low-cost but effective obesity treatments delivered by technology as obesity continues to be an issue and put a strain on health services, experts say.

Current technology is not advanced enough to replace human coaches, but an AI chatbot may one day be able to do the job, they add.

Bonnie Spring, director of the Centre for Behaviour and Health and professor of preventive medicine at Northwestern University Feinberg School of Medicine in the United States, said: “Giving people technology alone for the initial phase of obesity treatment produces unacceptably worse weight loss than giving them treatment that combines technology with a human coach.”

Prof Spring, corresponding study author, added: “At this stage, the average person still needs a human coach to achieve clinically meaningful weight loss goals because the tech isn’t sufficiently developed yet.

“We may not be so far away from having an AI chatbot that can sub for a human, but we are not quite there yet. It’s within reach. The tech is developing really fast.”

The study found that people who initially only received technology, which included weight loss lessons, without coach support were less likely to have a meaningful weight loss – considered to be at least 5% of body weight – compared to those who had a human coach at the start.

Researchers quickly intensified treatment if someone showed less than optimal weight loss, but the weight loss disadvantage for those who started without coach support persisted for six months, the study found.

Previous research suggested that mobile health tools for tracking diet, exercise and weight, increase engagement in behaviour that addresses obesity, but it has not been clear whether they produced clinically acceptable weight loss in the absence of support from a human coach.

Half of the people in the new study, published in Jama, started their weight loss treatment with technology alone. The other half began with gold-standard treatment involving both technology and a human coach.

The technology used in the trial was a Wireless Feedback System (an integrated app, Wi-Fi scale and Fitbit) that people used to track and receive feedback about their diet, activity and weight.

Some 400 adults between the ages of 18 and 60 with obesity were randomly assigned to begin three months of treatment beginning with either the Wireless Feedback System (WFS) alone or the WFS plus remote coaching.

Weight loss was measured after two, four and eight weeks of treatment, and treatment was intensified at the first sign of suboptimal weight loss.

Treatment for both groups started with the same WFS tracking technology, but standard-of-care treatment also transmitted the digital data to a coach, who used it to provide behavioural coaching.