Introduction: Against the background of the increasing prevalence of overweight and obesity worldwide (WHO 2017), there is an increased risk of concomitant and secondary diseases at the patient level and high direct and indirect costs at the level of global healthcare systems (John, Wolfenstetter & Wenig 2012). One of the causes of this problem is physical inactivity, which is further encouraged by increased media consumption (Banzer 2017). In contrast, there is a trend towards increasingly incorporating digital media into therapeutic concepts in a supportive manner (Raaijmakers et al. 2015). Against the background of the optimization of outpatient and inpatient obesity therapy, the question arises as to the effectiveness of digitally supported therapy approaches on the physical activity of adults.

Methods: The analysis is based on a systematic literature search in the scientific databases: Medline (via PubMed), Web of Science and Cochrane Library, according to the guidelines of the German Cochrane Center (2013). Only randomized controlled trials (RCTs) that used digital media to support obesity therapy in adults aged 18-70 years were included. The effects of the measures in terms of increasing subjectively and objectively measured physical activity were used as the outcome.

Results: Twelve RCTs with data from a total of 4377 study participants were included in the analysis. Overall, there was a positive trend in terms of increasing physical activity. The simultaneous use of various digital media with a focus on important aspects of everyday health behavior, such as diet and exercise, proved to be effective. Furthermore, positive effects were achieved through the combination of digital and personal therapeutic support. Overall, a significant time*group effect was only demonstrated in one study. The intervention consisted of a combination of a DVD, a manual and a support book, an online nutrition and activity diary and multiple individualized feedback emails.

Discussion & conclusion: The advantage of digitally supported obesity therapy measures lies, among other things, in the contemporary and everyday access and the mostly existing knowledge of how to use digital media. In addition, they facilitate and support therapy, especially in the outpatient setting and during follow-up care at home, as they can be used independently of the therapy facility. This increases the chance of implementing health-promoting behaviors into patients' everyday lives in the long term. Nevertheless, the results of the study underline the relevance of face-to-face contact and personal meetings with therapeutic staff for the success of therapy in terms of increasing physical activity. Even if the healthcare system incurs higher costs for the purchase of devices and software in the short term, digital support can save costs in the long term, especially in outpatient obesity therapy (e.g. transportation and personnel costs).

Bibliography:

Banzer, W. (2017). Physical activity and health. Berlin Heidelberg, Springer. doi: 10.1007/978-3-662-50335-5

German Cochrane Center (2013): Manual Systematic literature search for the production of guidelines. Available online at: http://www.awmf.org/fileadmin/user_upload/Leitlinien/Werkzeuge/20130523_Manual_Literaturrecherche_Final.pdf

John, J, Wolfenstetter, S.B. & Wenig, C.M. (2012). An economic perspective on childhood obesity: Recent findings on cost of illness and cost effectiveness of interventions. Nutrition, 28(9):829-39. doi: 10.1016/j.nut.2011.11.016.

Raaijmakers, L.C.H., Pouwels, S., Berghuis, K.A. & Nienhuijs, S.W. (2015). Technology-based interventions in the treatment of overweight and obesity: A systematic review. Appetite 2015, 95,138-51. doi: 10.1016/j.appet.2015.07.008.

World Health Organization (2017). Obesity and overweight-Fact sheet. Available online at: http://www.who.int/mediacentre/factsheets/fs311/en/.