Could technology help us tackle the obesity crisis?

Technological changes in the last century have brought about profound change in the types and amounts of foods that people consume and the amount of physical activity in which they engage. One result has been a dramatic (and continuing) increase in bodyweight; at present, 2.1 billion people are overweight (BMI ≥25 kg/m) worldwide, and 700 million are clinically obese (BMI ≥30 kg/m). Overweight and obesity are associated with severe health consequences and decreased quality of life, and have been declared an ‘epidemic’ by the WHO [1]. Unfortunately, current intervention approaches have significant shortcomings. Bariatric surgery produces the most weight loss, but has potential for severe medical complications and is often followed by weight regain [2,3]. Weight loss medications are only minimally effective (unless paired with lifestyle interventions) and also come with significant side effects. Dieting on one’s own or with the help of a professional (e.g., medical doctor, dietician, nutritionist) produces minimal weight loss and weight regain is the norm [4]. Structured, behavioral weight loss treatments involving nutritional education, behavioral change principles, and psychological strategies are considered the first line of treatment and do produce clinically significant weight loss (5–10%, on average) [5]. However, these treatments are expensive to deliver, require highly trained clinicians (of which there is a shortage), achieve unsatisfactory weight loss for many, and appear to be effective only as long as frequent clinician contact is maintained, after which most participants regain most or all of their lost weight [5]. Of note, the prescriptions that these programs utilize (involving tailored caloric intake goals that are appropriately offset by energy expenditure in the form of physical activity) reliably achieve weight control [6]. The core problem is that most people find it difficult to adhere to these strategies due to biological predispositions to consume high-calorie food and to conserve energy [7]. This difficulty with adherence is multiplied as the rate of weight loss slows or stops and motivation and accountability decrease. While past technological innovations in food production and labor-saving devices may be driving the obesity epidemic, recent and emerging technological advances also offer promise for addressing the challenges of weight loss. Below are five ways that technology may help us tackle the obesity epidemic.