Dieting? There's an app for fat

Virtual coaching and other online services can help people lose weight

Essdras M Suarez/Globe staff
Sara Noonan uses an application called MyFitnessPal to track her fitness and calories. The Cambridge resident lost 14 pounds between April and August last year.

It’s Julia Child’s fault. That’s how Sara Noonan explained the extra pounds she acquired during 2010 and into 2011.

“I started doing a lot of French cooking at home and using butter,’’ she said. “Before I knew it, my pants didn’t fit.’’

Friends had been successful tracking their food consumption and exercise using a website and free mobile application called MyFitnessPal. Noonan, 24, of Cambridge, signed up, too. It helped her understand what that butter meant for her calorie count, and see the benefit of a few extra minutes on the elliptical machine. And, she said, it kept her focused.


“I felt very dedicated,’’ Noonan said. “You sort of develop a relationship with it. It’s also about developing that relationship with yourself.’’

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Between April and August last year, Noonan lost 14 pounds. Now she uses the application to track her fitness and calories when she falls out of her normal routine - around the holidays, for example.

The market for food and fitness-tracking websites and mobile applications has exploded in recent years, with many products tapping into the hallmarks on which weight-loss powerhouses like Weight Watchers and Jenny Craig have built their empires: self-tracking and accountability.

A review published in September, of 204 applications that were available on iTunes in 2009, found that few applications did more than offer a way to keep a food and activity journal or track weigh-ins. But weight-loss and technology experts say the potential for mobile products is huge, and the market is changing quickly.

Many popular products today can be linked to hardware - pedometers or other devices that track activity. Some companies, with the help of social media, have developed expansive communities of users who act as a support group. Other websites and mobile applications offer contests in which people compete for points or financial incentives for meeting exercise goals. And there are also products that provide automated feedback, in which a virtual coach counsels users depending on their specific needs and whether they are hitting their food and exercise targets.


The programs have been developed and marketed largely in the commercial sector, but weight-loss counselors and other clinicians increasingly see them as an important tool for their patients.

The online and mobile applications, paired with social media networks, are “the wave of the future, in terms of changing behavior,’’ said Sherry Pagoto, a clinical psychologist in the Weight Center at UMass Memorial Medical Center and associate professor of medicine at UMass Medical School.

In many cases, weight-loss counseling is not covered by health insurance unless it is recommended for treatment of another condition, such as diabetes. This is changing some, with Medicare announcing last year that it would begin covering limited wellness coaching for people who are obese. Still, Pagoto said, there is huge demand for affordable counseling options. Even for many of the patients she sees in the clinics, the applications are a good tool, Pagoto said.

But, she said, more research is needed into what works, and for whom. She studies the role social networks play in weight loss, tracking people’s activity in forums like Twitter and its effect on their behavior.

“Once the partnerships start developing [between] the experts and the technology people, that’s when some really interesting things are going to start to happen,’’ she said.


Some collaborations are already happening. The Center for Connected Health, part of Partners HealthCare, tripled the number of studies it did on a variety of products in the mobile health market last year - though not all related to weight - and Dr. Joseph Kvedar, the director, expects the number to triple again in the coming year.

Kvedar said the proliferation of weight-loss products is not surprising.

“It’s a hard problem to solve,’’ he said. “When you see so many of anything, that probably means no one’s got it quite right.’’

Kyle T. Webster for the Boston Globe

Kvedar and others at the center, along with Timothy Bickmore of the Northeastern University College of Computer and Information Science, published a study in the Journal of Medical Internet Research last month that found that a virtual coach, simulating one-on-one counseling, can help people to stick with their weight-loss program.

The team studied the progress of 62 people from the Boston area over 12 weeks. Each was given a pedometer and a website to track activity. About half also were given access to an automated coach, which reviewed their step counts, and offered feedback and goals they should strive for. The coach also gave words of encouragement, with messages tailored to whether the participant had hit specific targets, and provided tips on exercise and diet.

Those with the virtual coach were better able to sustain their activity level throughout the 12 weeks, maintaining an average daily step count within each three-week period of about 6,943. The average count for the group without a coach fell from 7,174 in the first quarter to 6,149 in the last quarter. Among those with the automated coach, 58 percent said the coach made them feel more motivated and 87 percent said they felt guilty if they skipped an appointment with the virtual coach.

Many of the weight-loss applications available today use social networking as a motivator. Users get encouragement and empathy from people within their online support system, and often feel accountable to those who are cheering them on.

One such system is Lose It!, a Boston-based company similar to MyFitnessPal that offers a website and mobile application for tracking calories consumed and burned through exercise. The company is involved in several clinical studies, though none published yet, and has plans in the coming months to introduce tools partly aimed at helping health professionals use the program with patients, said Kevin McCoy, vice president for business development.

McCoy said there are about 1 million people engaged in the Lose It! social network.

“It’s almost like an all-day weight-loss support meeting,’’ he said.

While that kind of support works for many, it’s not the solution for everyone, Kvedar said. For someone who is more likely to respond to authority - rather than peers - the coaching model may be more helpful. Those who are motivated by competition may do better in a program set up as a contest.

The next generation of applications will help people evaluate what motivates them, Kvedar said, perhaps using brief questionnaires to assess personality and tailor weight-loss strategies to the individual.

Of course, there are limits to these websites and mobile applications. Obstacles to weight loss can be complicated, including chronic pain, stress, or family and work schedules.

“What [the applications] don’t do is help you to solve problems, help you with planning, necessarily, and anything that might be tailored to you and your challenges,’’ UMass Memorial’s Pagoto said.

Not yet, at least.

Chelsea Conaboy can be reached at Follow her on Twitter @cconaboy.