© Copyright 2012 1

WHO HELPS OVERWEIGHT PATIENTS THE MOST?

TECHNOLOGY IS THE ANSWER!

Kimberly Warner

Director of Global Professional Sales

BodyMedia, Inc.

Disclosures: Employed by BodyMedia, Inc.

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The Comparison of a Technology-based System and In-Person Behavioral Weight Loss Intervention in Overweight and Obese

Adults

Study Lead: Dr. John Jakicic, PhDUniversity of Pittsburgh

Physical Activity and Weight Management Research Center

Weight Loss Outcome Study 1:

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Study design consisted of three groups

• Independently funded NIH study• 6 month intervention• Randomized into 1 of 3 groups:

1. Group Lifestyle Intervention Weekly group meetings Self-monitoring with pencil and paper for food diaries Energy intake goals of 1200-1800 kcal/day, reduce fat intake to 20-30% of total energy intake Exercise increased from 100 to 300 minutes/week

2. BodyMedia Alone (armband + display + website) with phone calls Brief (< 10min) telephone call 1x per month Weekly lessons mailed corresponding to group meetings Self-monitoring with BodyMedia system Energy intake goals of 1200-1800 kcal/day, reduce fat intake to 20-30% of total energy intake Exercise increased from 100 to 300 minutes/week

3. Group Lifestyle Intervention + BodyMedia Combination of technology + group meetings

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Study Design

Group Lifestyle Intervention

Armband Alone

Group Lifestyle Intervention+ Armband

+

6 month results show adding BodyMedia FIT alone with phone calls or with Group Weight Loss meetings produced greater weight loss.

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1420

Weight Loss at 6 months (lbs)

Wei

ght

Loss

(lb

s)

> 2X Weight Loss when adding Armband to

Weight Loss Program

5

+

$$$

Pellegrini CA, Verba SD, Otto AD, Helsel DL, Davis KK, Jakicic JM. The Comparison of a Technology-Based System and an In-Person Weight Loss Intervention. Obesity (Silver Spring). 2011 Feb 10.

Weight loss of 5 -10% of body weight will lower risks for weight-related diseases such as high BP, type 2 diabetes, and heart disease.1

1 “Facts About Healthy Weight” http://www.nhlbi.nih.gov/health/prof/heart/obesity/aim_kit/healthy_wt_facts.htm

2468

10Percent Weight Loss at 6 months (%)

We

igh

t Lo

ss (

%)

6

+

Group Lifestyle Intervention + Armband group had 100% retention throughout the 6 month study.

Group Lifestyle Intervention

BodyMedia FIT alone (phone calls +

mailings)

CompletersNon-Completers

Group Lifestyle In-tervention +

BodyMedia FIT

100%

7

+

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Electronic feedback in a diet and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial

Study Lead: Dr. Steven N. Blair, PhDUniversity of South Carolina

Department of Exercise Science, Arnold School of Public Health

Weight Loss Outcome Study 2:

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Changing behavior through the LEAN study

A lifestyle intervention study designed to examine the effectiveness of the BodyMedia system as a tool for weight loss

Lifestyle Education for Activity & Nutrition for a Leaner You: 2008-2009 (LEAN) Study

Study Population (N=197)

• Men and women• 18-65 years old• Overweight or obese• Access to a computer and the internet• Currently not in an exercise program• Currently not in a formal weight loss program

Lifestyle Intervention over 9 months197 total participants in 4 groups

Randomized studyBaseline, 4 month, and 9 month assessments

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Methods:

1. Standard Care (control)

2. Armband Alone

3. Weight Loss Program

4. Weight Loss Program + Armband

Group meetings for 4 months, then phone calls for 5 months.

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Results equal more than 3x weight loss

Standard Care (Control)

Armband Alone Group Weight Loss

Group Weight Loss + Armband

02468

10121416

4 months9 months

Wei

ght L

oss

(lbs)

> 3X

> 3X

Self-Directed Groups (No coaching)

Group Meetings + Tele-phone Calls

9 month results with BodyMedia Armband alone and BodyMedia + group weight loss program

Shuger SL, Barry VW, Sui X, McClain A, Hand GA, Wilcox S, Meriwether RA, Hardin JW, Blair SN. Electronic feedback in a diet and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial. Int J Behav Nutri Phys. 2011. May 18;8:41.

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Standard Care (Control)

Group Weight Loss Armband Alone Group Weight Loss + Armband

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39

40

41

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Change in Waist Circumference (inches)

BaselineMonth 4Month 9

Wai

st C

ircum

fere

nce

(in)

**

> 2 in.

Group Weight Loss + Armband group had significant reductions in waist circumference at both 4 and 9 months.

Very Low Density Lipoproteins (VLDL) decreased significantly from baseline for Group Weight Loss + Armband and Armband Alone Group

Standard Care (Control)

Group Weight Loss

Armband Alone Group Weight Loss + Armband

-6

-5

-4

-3

-2

-1

0

1

2Change in VLDL at 9 months

Chan

ge V

LDL

(mg/

dL)

**

13

Triglycerides changed significantly from baseline for Group Weight Loss + Armband and Armband Alone group.

Standard Care (Control)

Group Weight Loss

Armband Alone Group Weight Loss + Armband

-30

-25

-20

-15

-10

-5

0

5

10Change in Triglycerides at 9 months

Chan

ge T

rigly

cerid

es (m

g/dL

)

**

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All intervention groups had a significant decrease in fasting blood glucose compared to control.

Standard Care (control)

Group Weight Loss

Armband Alone Group Weight Loss + Armband

-15

-10

-5

0

5Change in Glucose at 9 months

Chan

ge G

luco

se (m

g/dL

)

* * *

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LEAN – Cost Effectiveness/ROI Paper

Available online: http://www.sciencedirect.com/science/article/pii/S0749379712003108

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Methods:

• Cost-effectiveness Analysis (CEA): cost related to health improvement or benefit

• LEAN CEA is from organization “payer’s” perspective• All costs are actual costs: includes overhead,

salaries, fringe benefits, phone usage, cost of armband & monthly subscription

• Presents results in 2 formats: • Cost ($)/participant/kg lost• Incremental cost-effectiveness ratio – compares cost and

effectiveness of competing interventions

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Results:

Assuming cost of Armband = $150,

Display = $99, Subscription =

$6.95/mo

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Results:

• Standard Care (SC) did not achieve significant weight loss • Group Weight Loss (GWL) is considered “Dominated” (i.e. less efficacious & more

expensive)• SWA cost $48.54 per kilogram lost• GWL + SWA cost $60.08 more per kilogram lost than SWA

For the GWL + SWA, each additional kilogram lost costs $60 more than SWA alone.

Groups Cost/Person

Weight Loss/ Person

Cost/Person/Weight Loss (kg)

Armband Alone $183 3.55 kg(7.8 lbs) $51

Group Weight Loss $240 1.86 kg(4.1 lbs) $129

Group Weight Loss + Armband $365 6.59 kg

(14.5 lbs) $55

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LEAN Study Cost Analysis

For each additional kg lost, the GWL+ Armband cost $60 more than the Armband alone.

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Discussion:

• Tech-based interventions were more cost-effective and efficacious than traditional counseling

• SWA was the most cost-effective intervention, but adding GWL increase efficacy (but also increases cost, $60 more per kg lost)

Questions?