The Twazon Arabic Weight Loss App: App-Based Intervention for Saudi Women With Obesity

Abstract

Background By 2022, it is estimated that the rate of female obesity (78%) in Saudi Arabia will almost double that of males (41%). Despite being mainly attributed to poor diet, sedentary lifestyle, and a lack of health awareness, behavioral modification interventions are relatively new to the population; bariatric surgery continues to be the treatment of choice for comorbidities. However, neither pre nor postoperative diet and exercise are promoted. Evidence-informed mobile health (mHealth) weight loss apps and interventions may be an effective tool for delivering a culturally relevant intervention. Objective This study aimed to determine the feasibility of a weight loss intervention that tests the effectiveness of Twazon, an originally designed Arabic weight-loss app that promotes lifestyle modification specific to Arab populations. Methods A pre-post single‐arm pilot study was carried out among a sample of 240 overweight volunteer Saudi women residing in Riyadh, Saudi Arabia who used the Twazon app over a 4-month period. Anthropometric, diet, and physical activity measures were assessed 3 times: baseline, 2-months and 4-months; frequency of app use and system usability were evaluated during the 2 latter data collection periods. Repeated measures analysis of variance was used to identify changes over time. Results A total of 40 participants completed the 4-month intervention with an attrition rate of 83%. An evaluation of the frequency of app use fostered 2 groups: engaged users (65%) and unengaged users (35%). At 4 months, the engaged users experienced more successful outcomes; body weight was lowered on average by 1.3 (SD 0.6) kg ( P =.18), waist circumference (WC) was reduced by 4.9 (SD 1.1) cm ( P <.001), and daily energy consumption was decreased by >600 calories ( P =.002). Unengaged users experienced minor changes in body weight, WC, and reduced energy intake. Conclusions The findings have demonstrated that engagement with the Twazon app renders positive changes in body weight, WC, and energy intake. mHealth weight loss apps and interventions have the potential to be effective in promoting weight loss and healthy lifestyle modification in Saudi Arabia and similar populations.

Effectiveness of Integrated Technology Apps for Supporting Healthy Food Purchasing and Consumption: A Systematic Review

“…Among the included studies in this review, since 2006, when the integrated applications were launched, hand-held computers were utilised to improve and monitor the dietary intakes of the consumers [25,52]. Only until recently, smartphone applications were utilised in obesity treatment to achieve weight loss among smartphone users [24,26,57,60]; as well as in salt reduction movements, through buying low salt content food purchase behaviours [29]. Western countries were still the leading countries for the technology app penetration when compared to Asian countries.…”

“…In general, most of the studies were conducted in the United States (n = 9, 45%) [24][25][26]30,32,[52][53][54][55], followed by Australia (n = 2, 10%) [56,57] and Korea (n = 2, 10%) [28,33]. The majority of studies were from developed Western countries (n = 16, 80%) [19,[24][25][26][27][29][30][31][32][52][53][54][55][56][57][58], followed by three Asian countries (Korea and India) [28,33,59] and one Western Asian country (Saudi Arabia) [60]. Most of the technology app devices were smartphones, and only two early studies used a personal digital assistant (PDA).…”

What Works Best to Engage Participants in Mobile App Interventions and e-Health: A Scoping Review

“…Through app usage logs, researchers were able to track app engagement and assess drop-off in participation (Table 1). This pattern was not reported in studies that only relied on subjective measures of engagement, demonstrating that measurable methods to track app engagement provide a fuller picture Diet and weight loss (n = 12) Feedback about calorie intake and consumption 57,72,73 Redundant surveys 71 Calorie counter 66 Peer support 30 Step counter 66 Mobile-based visual diary 30 Contributing posts on a group 67 Difficulty logging in 72 Information/reading articles 67,73 A hard to navigate app 72 Customized recipes 68 Diet, fluid, and/or protein tracking 70 Push notification reminders (i.e., of goals, to drink and walk frequently) 71,73 Nutritional information 71 Image-based dietician support 30 Personalized text messaging 31,72 Personal data entry (i.e., fluid intake logging) [71][72][73] Goal-setting 73 Food lists 73 of app usage. The analysis suggests that app engagement plays an important role in study retention.…”

Aplicativos móveis desenvolvidos para Educação em Saúde no mundo: revisão integrativa da literatura

“…Desenvolvemos um aplicativo móvel (RECOVER-E) para iOS e Android smartphones que fornecem informações importantes sobre a fase pré-operatória, cirurgia e recuperação Despecho primário: será a função física autorreferidamedido nas subescalas de atividades da vida diária (AVD) da lesão no joelho e no escore de resultado da osteoartrite(KOOS) eo escore de resultado de deficiência de quadril e osteoartrite (HOOS) para pacientes com joelho e quadrilosteoartrite, respectivamente.Desfecho secundário: incluem as subescalas de dor, sintomas, função no esporte e recreação e joelho / quadril.qualidade de vida relacionada ao HOOS e KOOS, ansiedade préoperatório O estudo deve fornecer evidências que apóiem o uso da saúde móvel para facilitar a recuperação e abrir novas possibilidades para atendimento ao paciente em substituição do joelho ou quadril Scopus (Alnasser, et al, 2019) Arábia Saudita…”