Tailored Advice Tool for Weight Loss

Overseen By Nisha O'Shea, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: UNC Lineberger Comprehensive Cancer Center

Must not be taking: Oral steroids, Weight loss medications

Disqualifiers: Diabetes, Heart condition, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new weight loss approach using a smart scale and activity tracker. The goal is to determine if personalized text messages, part of the ADAPT program, can help individuals achieve daily health goals, such as staying active and managing calories, for improved weight loss results. It targets English-speaking adults with a smartphone and a BMI (body mass index) between 25 and 40, who are not currently on certain medications or programs affecting weight. Participants receive daily and weekly feedback on their progress to help them stay on track. As an unphased trial, participants contribute to innovative research that may lead to new weight loss strategies.

Will I have to stop taking my current medications?

If you are currently using prescription medications that affect appetite or weight, you may not be eligible to participate, unless you have been on a stable dose of SSRIs (a type of antidepressant) for at least 3 months. The trial does not specify a need to stop other medications.

What prior data suggests that this reinforcement learning model is safe for weight loss interventions?

Research shows that short-term programs combining exercise and healthy eating can help adults lose weight safely. Similar weight loss efforts have generally received positive feedback. Studies on flexible behavior changes for managing weight usually report positive results without major safety concerns.

Although specific side effects aren't detailed, the program employs tools like smart scales and activity trackers, along with personalized messages, to encourage behavior change rather than medication. This approach suggests a lower risk of side effects compared to drug-based treatments. Overall, previous studies indicate that this type of behavior-focused program is safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the ADAPT intervention for weight loss because it integrates technology to create a personalized and engaging approach. Unlike traditional weight loss methods that might rely heavily on diet plans or exercise programs alone, ADAPT leverages a smart scale and activity tracker to give real-time feedback and set daily personalized goals for weight, activity, and calorie intake. This approach encourages consistent monitoring and motivation through daily text messages and weekly progress updates, aiming to make behavior change more sustainable and effective. By combining these elements, ADAPT offers a dynamic and tailored alternative to standard weight loss strategies.

What evidence suggests that the ADAPT intervention is effective for weight loss?

Research shows that the ADAPT program, which participants in this trial will receive, might aid weight loss by providing personalized feedback and setting goals. Studies on customized online health programs have successfully helped people lose weight by tailoring messages and methods to individual needs. In the ADAPT study, participants use a smart scale and activity tracker to meet daily targets for weight, exercise, and calorie intake. They receive daily text messages and weekly feedback, which previous research found useful for achieving weight loss goals. This method employs reinforcement learning, adjusting advice based on individual progress to enhance motivation and success. ^{1 6 7 8 9}

Who Is on the Research Team?

Brooke Nezami, PhD, MA

Principal Investigator

University of North Carolina, Chapel Hill

Are You a Good Fit for This Trial?

This trial is for adults aged 18-55 with a BMI of 25-40 who are not meeting US physical activity guidelines, can speak and write English, have no major health issues that limit exercise, and own a smartphone. Excluded are those on weight loss meds, pregnant or planning pregnancy soon, with certain medical conditions like diabetes requiring insulin treatment or recent cancer treatment.

Inclusion Criteria

Has a smartphone with a data and text messaging plan

Body Mass Index of 25-40 kg/m2

Not adhering to the US physical activity guidelines of at least 150 moderate-to-vigorous intensity activity minutes/week

Exclusion Criteria

Another member of the household is a participant or staff member in this trial

I have heart or bone issues, or take medicine for blood pressure or heart conditions.

I have Type 1 diabetes or am being treated for Type 2 diabetes.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a smart scale and a physical activity tracker, with daily goals and personalized messages for 12 weeks

12 weeks

0-3 virtual interactions per day

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• ADAPT

Trial Overview The ADAPT study is testing the AdaptRL tool over 12 weeks to see if it helps people lose weight by suggesting personalized behavior change techniques. It builds on an existing approach that adjusts support based on how individuals respond to different contexts in real-time.

How Is the Trial Designed?

Group I: ADAPT intervention Experimental Treatment 1 Intervention

Participants will receive a smart scale and a physical activity tracker and will have three daily goals: weigh daily, a daily personalized active minutes goal, and a daily calorie goal. For 12 weeks, participants will receive 0-3 text messages per day about their behaviors and progress towards their goals, along with weekly personalized feedback, progress graphs, and lessons and resources available on the website.

Who Is Running the Clinical Trial?

UNC Lineberger Comprehensive Cancer Center

Lead Sponsor

Trials

377

Recruited

95,900+

RTI International

Collaborator

Trials

201

Recruited

942,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Duke University

Collaborator

Trials

2,495

Recruited

5,912,000+

Published Research Related to This Trial

The OnTrack smartphone app, designed to predict and prevent dietary lapses using machine learning, was found to be feasible and acceptable among 43 participants in an 8-week weight loss program, with high user satisfaction reported.

Participants using OnTrack experienced an average weight loss of 3.13% and a reduction in unplanned dietary lapses, indicating the app's potential effectiveness in supporting weight management efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

OnTrack: development and feasibility of a smartphone app designed to predict and prevent dietary lapses. Forman, EM., Goldstein, SP., Zhang, F., et al.[2023]

A study involving 22 participants from a weight management clinic in Singapore identified key features that weight loss apps should include for a multi-ethnic population with overweight and obesity, such as comprehensive calorie counters and individualized behavior change recommendations.

Participants emphasized the importance of flexibility in food logging and the need for apps to provide just-in-time reminders about the consequences of their choices, suggesting that future apps could benefit from artificial intelligence to offer personalized support for weight management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Essential elements of weight loss apps for a multi-ethnic population with high BMI: a qualitative study with practical recommendations. Chew, HSJ., Lim, SL., Kim, G., et al.[2023]

In a review of 28 trials involving orlistat, sibutramine, and rimonabant, rimonabant and orlistat were associated with a significantly higher risk of discontinuation due to adverse events, with rimonabant having the highest risk ratio of 2.00.

The most common reasons for discontinuation were gastrointestinal issues for orlistat (40%) and psychiatric issues for rimonabant (47%), highlighting the importance of monitoring side effects in patients using these medications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Discontinuation due to adverse events in randomized trials of orlistat, sibutramine and rimonabant: a meta-analysis. Johansson, K., Neovius, K., DeSantis, SM., et al.[2018]

Diet and exercise alone have not proven effective for sustained weight loss in most obese individuals, while surgical interventions can lead to prolonged weight loss but may result in rebound weight gain over time.

The authors propose a new framework for evaluating medical devices aimed at treating obesity, focusing on a benefit-risk assessment to guide the development and approval of these devices, which was discussed at an FDA workshop and advisory panel.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Benefit-risk paradigm for clinical trial design of obesity devices: FDA proposal. Lerner, H., Whang, J., Nipper, R.[2021]

A total of 4941 adverse event (AE) reports were identified for antiobesity medicines in Europe from 2007 to 2014, with over 90% classified as serious, including 159 deaths, highlighting significant safety concerns associated with these medications.

The most commonly reported serious AEs were cardiac (19%) and psychiatric disorders (18%), particularly linked to orlistat and rimonabant, indicating a need for ongoing safety monitoring despite the withdrawal of some products from the market.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Serious adverse events reported for antiobesity medicines: postmarketing experiences from the EU adverse event reporting system EudraVigilance. Aagaard, L., Hallgreen, CE., Hansen, EH.[2018]

Patient-reported outcome measure (PROM) feedback interventions in oncology showed a positive impact on health-related quality of life (HRQL) and patient-healthcare provider communication, with a moderate effect size based on a meta-analysis of 29 studies involving 7071 cancer patients.

The intervention also demonstrated a significant improvement in 1-year overall survival rates, suggesting that providing feedback can enhance care processes and outcomes for cancer patients, although the findings are limited by a high risk of bias in the studies reviewed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of routine provision of feedback from patient-reported outcome measurements for cancer care improvement: a systematic review and meta-analysis. Lu, SC., Porter, I., Valderas, JM., et al.[2023]

Users prefer mHealth weight loss apps that are simple, attractive, and allow for self-monitoring with feedback, emphasizing the importance of personalization and engaging content.

Key barriers to using these apps include technological issues and message overload, highlighting the need for careful consideration of message tone, structure, and delivery frequency to enhance user experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Consumer perspectives on mHealth for weight loss: a review of qualitative studies. Lyzwinski, LN., Caffery, LJ., Bambling, M., et al.[2018]

Integrating patient-reported outcomes data into the management of chronic, non-cancer pain can significantly guide improvements in patient care and outcomes.

Standardizing care processes and using valid outcome measurement tools can enhance the effectiveness of treatment while minimizing the burden on patients and healthcare providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can assessing chronic pain outcomes data improve outcomes? Witkin, LR., Farrar, JT., Ashburn, MA.[2019]

In a 12-week study involving 112 overweight Japanese adults, those receiving professional dietary coaching via a smartphone app lost significantly more weight (average -1.4 kg) compared to the control group (-0.1 kg).

Participants who frequently uploaded meal photos to the group chat not only lost more weight but also showed significant improvements in cardiometabolic risk factors, indicating that active engagement in the program enhances health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Professional dietary coaching within a group chat using a smartphone application for weight loss: a randomized controlled trial. Tanaka, K., Sasai, H., Wakaba, K., et al.[2022]

Patient-reported outcome measures (PROMs) are crucial for accurately capturing patient symptoms and quality of life, which can enhance the robustness of clinical research and improve patient outcomes.

Incorporating PROMs in clinical trials helps reduce observer bias and actively engages patients in the research process, while also providing valuable insights for health service planning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How to Include Patient-Reported Outcome Measures in Clinical Trials. McGee, RG.[2021]

A study analyzing adverse drug events (ADEs) related to anti-obesity medications found that phentermine and liraglutide were the most commonly reported drugs, with serious ADEs linked to psychiatric, liver, cardiovascular, and respiratory disorders.

Men were found to be at a higher risk for serious adverse events, especially when using multiple anti-obesity medications or when taking fluoxetine alongside them, indicating the need for careful monitoring and further research on the safety of these treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A nationwide pharmacovigilance investigation on trends and seriousness of adverse events induced by anti-obesity medication. Choi, YJ., Choi, CY., Kim, CU., et al.[2023]

Citations

1. sciencedirect.com sciencedirect.com/science/article/pii/S0002916525004514

Adaptive dietary and exercise strategies for weight loss in ... All study data were collected and managed using REDCap electronic data capture tools hosted at UAB [25,26]. REDCap is a secure, web-based software platform ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11094642/

An Adaptive Behavioral Intervention for Weight Loss ... Delineation of a feature that preidentifies what individuals are likely to succeed with digital tools alone before launching obesity treatment ...

3. withpower.com withpower.com/trial/tailored-advice-tool-for-weight-loss-c28d2

Tailored Advice Tool for Weight Loss · Info for Participants This suggests that the tailored advice tool in ADAPT, which likely uses similar feedback mechanisms, could be effective in supporting weight loss.

4. bmj.com bmj.com/content/374/bmj.n1679

Adapting interventions to new contexts—the ADAPT ... ADAPT systematic review and more recent emerging tools and frameworks. Systematic review conducted as part of the ADAPT study. Our systematic ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6366004/

A systematic review of tailored eHealth interventions for ... Summary table of results of included studies on weight loss. ... The use of tailored eHealth tools in weight-gain prevention and weight-loss ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11996779/

Tackling the complexity of obesity in the US through ... Obesity prevalence continues to rise in the US despite more than two decades of recommendations and guidelines for its prevention and management.

7. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1551714414000895

Adaptation and dissemination of an evidence-based ... Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized ...

8. cdc.gov cdc.gov/pcd/issues/2024/23_0347.htm

Weight Loss in Short-Term Interventions for Physical ... Short-term multicomponent interventions involving physical activity and nutrition can achieve weight loss for adults with overweight or obesity.

9. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2774318

Effect of a Culturally Adapted Behavioral Intervention for ... These findings suggest that among Latino adults with high diabetes risk, a culturally adapted behavioral lifestyle intervention was effective for weight loss ...