Could small amounts of weight loss make a big difference to your health?

An app developed in Aneurin Bevan University Health Board for the Bevan Exemplar programme aims to promote the health benefits of steady, incremental weight loss.

It can be difficult to maintain weight loss motivation when the scales and the mirror don’t show us the radical improvements we want to see. But a team at Aneurin Bevan University Health Board, supported by the Bevan Commission, wants to celebrate the health benefits of even small steps in weight loss.

They have been working with dietitians, mathematicians, hospital staff and patients to develop a smartphone app to demonstrate some of the health gains that people achieve from relatively small amounts of weight loss (even when they are hardly noticeable to the naked eye).

Unrealistic expectations

Aneurin Bevan University Health Board (ABUHB) established the Adult Management Service (AWMS) in 2014 in Gwent, an area that has some of the highest obesity rates in Wales (approx. 29%).

The service aimed to support patients to achieve clinically meaningful weight-loss (i.e. above 5%). However many people have more immediate and unrealistic weight-loss expectations, and these expectations can hinder motivation. The Adult Weight Management Service found that if patients did not achieve the weight-loss they desire, they became frustrated and dropped out from the service.

A key challenge for the Adult Weight Management Service is to keep patients engaged and motivated in taking steady, incremental steps in weight loss. If they do, they can experience improved health benefits, such as reducing their risk of type 2 diabetes. For example, if you are in your 40s, of average height, weigh 122kg (i.e. 19 stone and 4 lbs) and lose 2kg (i.e. 4.4 lbs), you would be almost 60% less likely to develop type 2 diabetes over the next 10 years.

This focus towards health gains, rather than the visible changes we can see in the mirror, has been reported to enhance ‘intrinsic motivation’ and supports long-term weight maintenance.

Mobile phone showing weight loss app welcome page

Positive messages

The NHS team worked with patients to develop a prototype app which could be rolled out on iOS, Android or Windows devices. They worked with Cardiff University School of Mathematics to translate the mathematical model (which tells a patient who weighs x stone, what their health benefits of x pounds weight loss would be) into a digital application.

Healthcare staff are working with patients and community members to provide feedback on the app, so it provides the most motivating messages possible based on people’s responses. Patients involved in designing the app have reported that it has improved their understanding of how relatively small amounts of weight loss (i.e. 2-11 lbs) can improve their health.

One patient said: “I would have never believed that such a tiny weight loss has such a huge impact on my health!”

Mobile phone showing impact of weight change page in weight loss app

Enhanced motivation and cost savings

Initial findings suggest that the app has enhanced motivation, and further evaluation will assess whether the app could improve patients’ weight-loss related health improvements and reduce early ‘drop-out’ or missed appointments.

The app also computes the cost savings associated with the health benefits of small amounts of weight loss. For a pre-diabetes patient who loses 2 kg (i.e. 4.4 lbs) over two years without instantly regaining it, this generates approx. £5,000 treatment cost saved over the next 25 years – and this is just the cost of treating type 2 diabetes and diabetes-related conditions, ignoring the cost of any other condition like cancer, hypertension, gynaecological and obstetric complications, peripheral arterial disease, dyslipidaemia, gastrointestinal and liver disease, musculoskeletal problems, respiratory problems and psychological and emotional problems.

The NHS team behind the app now plan to launch it in the App Store and on Google Play so that people with smartphones around the world can access it and benefit from improved health benefits of small, sustained weight losses.