A Text a Day Keeps Excess Weight at Bay?

With commentary from Ben Gerber, MD, MPH, professor of medicine, Univerity of Illinois at Chicago; Henry Fischer, MD, associate professor of medicine, University of Colorado Denver, Denver Health and Hospital Authority and others.

The average American adult sends and receives about 41 text messages a day, according to a survey by the Pew Research Center.1 If you are feeling unpopular, with a total well below that, take heart. You may soon be receiving more texts--from your health care provider.

Texting, in tandem with other programs and care, is an ideal way to help patients achieve weight loss and numerous other health goals, according to several recent studies. It's especially helpful, experts say, for those with chronic conditions such as diabetes. 2-11

texting

"It's another way to personalize our communications with people," says Ben Gerber, MD, MPH, professor of medicine in the academic internal medicine and geriatrics division at the University of Illinois at Chicago. Gerber was an early researcher on how text messaging can help doctors and other health care providers reach their patients. Since then, many others have looked at texts and how they can help your health. 7

Studies have found that texting can help you:
• lose weight and keep it off
• eat a more healthful diet
• engage in regular physical activity
• take medications such as oral diabetes medicine or insulin on schedule.

Weight Loss

In one study, Henry Fischer, MD, associate professor of medicine at the University of Colorado, Denver, assigned 163 men and women, all with prediabetes, to attend Diabetes Prevention Program classes. Then, half received text messages of support for a year, while the other half did not. At the 12-month mark, the average weight loss was 2.6 pounds in the texted group but less than a pound in the group that just went to classes. 11

That may seem like a small amount in both instances, but, as Fischer says, "Even 5 to 10 pounds can make a difference for diabetes prevention and improvement in blood pressure and cholesterol." 11

In another study, researchers sent texts to 60 obese men and women after they had finished a three-month weight loss program that focuses on changing behaviors. They assigned half to a group that got supportive text messages and emails; the other half received text messages only. 4

At the six-month mark, the men and women had lost about 7 to 10% of their weight, and the differences between the text-only group and the more intense texts and emails was not substantially different.4 So texts alone could be enough motivation.

 

Eat a Healthier Diet

Texting appeared to help people eat more fruits, vegetables and fish. Researchers assigned half of 100 women, ages 40 to 60, to receive one text a week about healthy choices, how to eat better and the benefits. The other half did not get the messages.3
At the four-month followup, those who got the texts reported that they  ate a healthier diet. 3

Exercise

In another study, researchers enrolled 65 men and women in an exercise program designed to increase their activity. Half also got twice weekly texts messages about exercising. At the four-month mark, those getting texts were exercising more than they did at the start, while those in the group not getting texts had returned to their previous sedentary levels. 5

Medication Adherence

Getting a text message about your medication schedule could double the chances that you will take it as instructed, according to an analysis that looked at 16 studies that had been published in medical journals on the topic. 2

The studies included more than 2,700 patients and the researchers looked at how well the text messages helped for about 12 weeks. The researchers say the texts might increase an adherence rate of 50% (which is found to be typical in those with long-term conditions requiring daily medication) to more than 67%, which the researchers term a promising increase. 2

Why Texting Works

Patients who get texts about health say that they feel ''more connected'' with their health care system, says Fischer, who gathered that information from focus groups.

The messages may work partly because they are brief and simple.  A patient might get this, Fischer says: "Denver Health: Breakfast idea: low-fat plain yogurt with fruit, whole grain cereal and low-fat milk, oatmeal with fruit and milk, scrambled/boiled eggs on whole-wheat toast." 6

Fischer's survey in 2013 showed that 93% of patients had access to text messaging, and many preferred texts to emails. He views texting as just one of many interventions that can help patients meet health goals.6

Texts also tell people they are not alone in their challenges, says Gerber. "When you are living your life with diabetes, or focusing on weight management, most of the time you are on your own," Gerber says. A text is a great way, he says, to prompt people to stay on course. Even though that text message is coming from a computer, he says, people have the feeling that someone is looking after them. 7
Texts can ''let them know if they took a misstep it’s OK," says Susan Weiner, RDN, a certified diabetes educator and a member of the editorial board for DiabeticLifestyle.com. She relies on motivational and inspirational texts to her patients. "It helps to keep them on track between appointments." 9

Amy Hess-Fischl, RD, a certified diabetes educator at the University of Chicago and a member of the Diabetic Lifestyle.com editorial board, texts patients. "I find that it helps them achieve their goals more readily because they have access to me when they need it and they feel and know I care so they admit they work a little harder. It helps make things more real for them--if I invest the time to be there for them, they take things more seriously." 8

Who's Sending?

Health care providers typically send the text messages. However, if your doctor or health plan hasn't embraced the technology, a ''buddy'' text message might be helpful, Gerber says. If you and a friend are determined to lose weight, for instance, or reduce blood sugar levels, agreeing to send supportive texts could help with motivation and accountability, he says. 7
 

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