Improving weight loss among young adults with excess body weight using a theory-driven digital self-regulation program: a randomized controlled trial

Abstract Background Lifestyle modification is fundamental for obesity management but remains challenging. Purpose To test the effectiveness of a 12-week digital self-regulation program on improving weight loss and self-regulation among young adults. Methods A 2-arm parallel 1:1 randomized controlled trial was conducted. Participants were randomly assigned to either the intervention or the control group. The primary outcomes were weight and self-regulation, while the secondary outcomes were nutrition knowledge, eating phenotypes, overeating habits, anxiety, and depression. All data were collected at weeks 0, 12, and 24. Results We showed the effectiveness of a digital commitment device on body weight (−1.90 ± 6.4 kg, P = .002), body mass index (−0.45 ± 2.0 kg/m2, P = .002), waist circumference (−2.10 ± 12.1 cm, P = .01), basal metabolic rate (−20.30 ± 118.6 kcal, P = .04) and body roundness index (−0.17 ± 0.6, P = .014). Interventional effects were sustained for waist circumference (−0.8 ± 2.8 cm, P = .05) and body roundness index (−0.07 ± 0.36, P = .047) 3 months beyond removing access to the commitment device. General improvements in nutrition knowledge, psychological flexibility, uncontrolled eating, and anxiety were found among both groups, but differences were only significant for depression scores (−0.06 ± 1.5, P = .032) and eating self-regulation (0.16 ± 0.54, P = .003). Conclusion This study showed the potential of a digital commitment device in improving eating self-regulation, anthropometry, and mental wellness for scalable implementation in the community setting. Trial Registration Clinicaltrials.gov (NCT05969639).