A systematic review with meta-analyses of text message-delivered behaviour change interventions for weight loss and weight loss maintenance

Short Message Service (SMS)-delivered behaviour change interventions are frequently used to support weight management. This systematic review examines the effectiveness of SMS-delivered behaviour change interventions for weight management. Electronic databases were searched for randomised controlled trials (RCTs) comparing SMS-delivered adult weight management interventions to control groups, published between 1990 and 2018. Weight change was examined using random effects meta-analyses at intervention cessation and post intervention follow-up. Subgroup analyses examined intervention duration, SMS frequency, theory use, SMS interactivity, and SMS tailoring. Fifteen studies met inclusion criteria (2,705 participants). For weight loss interventions (n=12, 1,977 participants), the mean differences in weight change was -2.28kg (95% confidence interval [CI] -3.17 to -1.36kg). No studies reported post intervention follow-up. For weight loss maintenance interventions (n=3, 728 participants) the mean differences in weight change was -0.68kg (95% CI, -1.31 to -0.05kg) and post intervention follow-up (n=2, 498 participants) effects were -0.57kg (95% CI, -1.67 to 0.53kg). No subgroup differences were found. SMS-delivered behaviour change interventions for weight loss led to significant small to moderate weight loss and weight loss maintenance compared to control groups. Evidence on long-term effects is limited. SMS-delivered behaviour change interventions are a potentially effective and scalable intervention option for obesity treatmen