Mobile App May Help Prevent Excess Weight Gain in Pregnancy
Key Takeaways:
- A digital intervention combining self-monitoring and personalised feedback helped reduce excess weight gain during pregnancy among women with overweight or obesity
- Participants using the programme gained weight more slowly and were less likely to exceed recommended guidelines compared with standard care
- Greater engagement, particularly consistent self-weighing, was linked to better outcomes
Addressing a common challenge in pregnancy
Weight gain during pregnancy is both expected and necessary. However, gaining more than recommended levels is associated with increased health risks for both the pregnant person and the baby. These risks are particularly pronounced among individuals who are already living with overweight or obesity at the start of pregnancy.
Excess gestational weight gain has been linked to complications such as gestational diabetes and preeclampsia. It also increases the likelihood of pre-term birth and larger birthweight, both of which can complicate delivery and raise the child’s long-term risk of obesity.
In the United States, around half of pregnant individuals with overweight or obesity exceed national guidelines for weight gain, highlighting a persistent challenge in routine prenatal care.
The LEAP programme – a technology-enabled approach
To address this issue, researchers at Kaiser Permanente developed the Lifestyle, Eating, and Activity in Pregnancy (LEAP) programme. The intervention was designed to provide scalable, technology-driven support integrated into everyday clinical care.
The study, published in JAMA Network Open on 20 April, evaluated whether this digital approach could help individuals maintain healthier weight gain trajectories during pregnancy.
“Our results are especially exciting because we intentionally designed the LEAP program to be feasible for widespread implementation,” said first author Monique Hedderson, PhD, principal investigator with the Kaiser Permanente Division of Research (DOR). “This study represents the culmination of years of research on what works well for this high-risk population and how to leverage technology to make those benefits achievable across a health system.”
How the intervention worked
Participants in the LEAP group were provided with a digital scale for home use and a wearable activity tracker, either a Fitbit or their own Apple Watch. These devices were connected to a mobile application that delivered automated, personalised feedback on both weight and physical activity.
The programme also included weekly educational sessions delivered through the app, focusing on realistic and achievable goals related to diet and exercise. In parallel, clinicians received guidance on how to discuss gestational weight gain with patients more effectively.
A key feature of the programme was its adaptive design. Individuals whose weight gain began to accelerate received targeted support, including personalised chat messages from a lifestyle coach. If necessary, this support escalated to telephone consultations.
“About half of patients in the LEAP intervention group managed weight well on their own, but for those inching towards the upper limit of recommendations, LEAP provided extra, targeted support,” said Hedderson. “This conserves resources for patients who need help the most.”
Study design and participant outcomes
The effectiveness of the LEAP programme was assessed across 58 clinicians within Kaiser Permanente Northern California. All pregnant patients with overweight or obesity under their care were invited to participate.
Clinicians were randomly assigned to one of two groups:
- Standard care plus the LEAP intervention
- Standard care alone
In total, 1,256 participants were included in the study. Of these, 677 received the LEAP programme, while 588 received standard care.
Standard care involved providing patients with a newsletter at their first prenatal visit outlining healthy weight gain targets and lifestyle advice. At around 20 weeks, clinicians reviewed weight gain against recommended guidelines.
The results showed clear differences between the groups. Participants in the LEAP programme experienced:
- Lower weekly rates of weight gain
- Lower total weight gain during pregnancy
- Reduced likelihood of exceeding recommended guidelines
In addition, fewer individuals in the LEAP group gave birth to infants classified as large for gestational age.
“This study demonstrates that combining wireless self-monitoring tools with an adaptive digital intervention can make a meaningful difference for patients with overweight or obesity at risk of excess weight gain during pregnancy,” said Kari Carlson, MD, director of women’s health for The Permanente Medical Group. “Importantly, it was tested in routine care, making the findings highly relevant for health systems looking for practical solutions.”
Engagement matters
Although all participants assigned to the LEAP group were included in the analysis, only around half actively engaged with the programme. This reflects real-world conditions, where not all individuals fully participate in digital health interventions.
However, among those who did engage, outcomes were notably stronger. Higher levels of interaction with the programme, particularly consistent self-weighing, were associated with lower overall weight gain.
“When we zoomed in on participants who actually engaged, we found that the more they engaged, especially by weighing themselves consistently, the less weight they gained,” Hedderson said.
Participants could view their weight trends in relation to Institute of Medicine guidelines within the app, a feature that appeared to play a particularly important role in supporting behaviour change.
“This seems to be a particularly effective component of the program,” she said.
Implications for clinical practice
The findings suggest that digital, scalable interventions such as LEAP could offer a practical solution to a longstanding challenge in prenatal care. By integrating self-monitoring tools, automated feedback, and targeted coaching into routine workflows, the programme demonstrates how technology can support both patients and clinicians without increasing burden.
“Excess gestational weight gain among these high-risk patients is a common and challenging issue in routine prenatal care,” said senior author Assiamira Ferrara, MD, PhD, a DOR senior research scientist. “What’s compelling about the LEAP study is that it shows we can support healthier weight gain using scalable, technology-enabled tools that fit within real-world clinical workflows, without adding burden for patients or clinicians.”
Looking ahead
The research team continues to follow participants to assess longer-term outcomes for both parents and children. There is optimism that the LEAP programme could be integrated into routine care in the near future.
“Bottom line, using technology to help patients manage their own health can be effective, and patients tend to like it, too,” Hedderson said.
Funding and research team
The study was funded by the National Institutes of Health.
Additional co-authors included Susan D. Brown, PhD; Charles P. Quesenberry, PhD; Fei Xu, MS; Emily Liu, MPH; Karen L. Li, MPH; Sneha B. Sridhar, MPH; Tali Sedgwick, RDN; Page Kissel, BA; and Hillary D. Serrato Bandera, BA, all from the Division of Research. Mibhali M. Bhalala, MD, contributed from Kaiser Permanente Northern California, and Cheryl Albright, PhD, MPH, contributed from the University of Hawaii at Manoa School of Nursing and Dental Hygiene.
About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts epidemiological and health services research aimed at improving health outcomes and healthcare delivery. With more than 720 staff and approximately 630 active research projects, the division focuses on understanding the determinants of illness and advancing the quality and cost-effectiveness of care.
Source: Kaiser Permanente Division of Research
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Automated Weight Loss Programme Shows Promise for People Living with Cancer in Landmark Trial
Key Takeaways:
- A fully automated, web-based programme delivered clinically meaningful weight loss in people living with and beyond cancer, without any in-person support
- More than 43 percent of participants achieved at least 3 percent weight loss, with nearly one in three reaching 5 percent or more
- The intervention also improved a range of health outcomes, including diet quality, physical functioning, and cardiometabolic markers
A new model for post-cancer care
A large national randomised clinical trial has demonstrated that a fully automated, web-based weight loss intervention can deliver substantial health benefits for people living with and beyond cancer. The programme, developed by researchers at the University of Alabama at Birmingham, represents a significant shift in how post-cancer care may be delivered in the future.
Published in the Journal of the National Comprehensive Cancer Network, the study reported the highest level of weight loss ever achieved through a fully automated intervention in this population. The programme, known as the AMPLIFY Diet (AiM, PLan and act on LIFestYles), was designed to provide structured, evidence-based lifestyle support without requiring direct clinician involvement.
Addressing a major unmet need
A substantial proportion of people living with and beyond cancer are also living with overweight or obesity. In the United States, this figure is estimated to be around 70 percent. This places individuals at increased risk of cardiovascular disease, type 2 diabetes, functional decline, cancer recurrence, and the development of second primary cancers.
Despite this, access to specialist oncology dietitians remains limited. Traditional weight management programmes often rely on in-person consultations or regular coaching, which can be difficult to scale and may not be accessible to all patients.
The AMPLIFY Diet intervention was developed specifically to address these barriers by delivering personalised nutrition and behavioural support entirely online.
A fully automated intervention
The programme operates without live coaching, counselling calls, or face-to-face appointments. Instead, it uses a structured digital platform that includes weekly interactive sessions, goal-setting tools, progress monitoring, and automated personalised feedback.
Participants engage with the system independently, receiving guidance that is grounded in established behavioural and nutritional science. This approach allows for scalability while maintaining a consistent standard of care.
“This is a game changer for cancer survivorship care,” said Wendy Demark-Wahnefried, Ph.D., R.D., senior author and professor at UAB’s School of Health Professions and O’Neal Comprehensive Cancer Center. “We showed that a completely automated online program grounded in decades of behavioral and nutrition science can safely and effectively help cancer survivors lose weight and improve their health at scale.”
Study design and participant profile
Between 2020 and 2024, the study enrolled 349 participants aged between 50 and 82 years from 31 states across the United States. All participants were living with and beyond cancers associated with obesity.
The cohort included individuals with a range of cancer types, including breast, colorectal, prostate, endometrial, ovarian, thyroid, renal, and haematologic cancers. Participants were randomly assigned to either the AMPLIFY Diet programme or a control group receiving standard survivorship information.
Clinically meaningful weight loss outcomes
After six months, the results showed clear differences between the intervention and control groups.
More than 43 percent of participants in the AMPLIFY Diet group achieved weight loss of at least 3 percent of their body weight. In comparison, only 13 percent of those receiving usual care reached this threshold.
In addition, nearly one in three participants in the intervention group lost at least 5 percent of their body weight. This level of weight loss is widely associated with reductions in cardiovascular risk and improvements in cancer-related outcomes.
On average, weight loss in the intervention group was nearly five times greater than that observed in the control group.
Broader health improvements
The benefits of the programme extended beyond weight loss alone. Participants in the AMPLIFY Diet group experienced improvements across multiple domains of health and wellbeing.
These included reductions in waist circumference and overall caloric intake, as well as improvements in diet quality. Biochemical markers also shifted in a favourable direction, with lower circulating levels of leptin, a hormone associated with cancer progression and cardiometabolic disease.
Further gains were observed in blood pressure, physical functioning, and cognitive performance. Participants also reported improvements in depression and their ability to engage in social roles, suggesting a broader impact on quality of life.
Strong engagement without human support
One notable finding from the study was the level of participant engagement. Individuals completed an average of 60 percent of the weekly sessions, which is considerably higher than engagement rates typically reported in other digital lifestyle interventions.
This suggests that a well-designed automated system can maintain user engagement even in the absence of direct human interaction.
Implications for scalable care
Unlike many conventional weight management programmes, the AMPLIFY Diet intervention does not require ongoing staff involvement. This makes it particularly well suited for integration into healthcare systems, cancer centres, and community-based services.
The ability to deliver consistent, evidence-based care at scale may help address longstanding gaps in survivorship support, particularly in settings where specialist resources are limited.
The role of behavioural and nutritional care
The researchers emphasise that lifestyle-based interventions remain a cornerstone of care for people living with and beyond cancer, particularly as pharmacological approaches continue to evolve.
“Behavioral and nutritional interventions are essential,” Demark-Wahnefried said. “Diet quality, muscle preservation, cognition, and long-term sustainability of a healthful lifestyle and body weight are critical for cancer survivors, and even if weight loss medications eventually receive broadscale endorsement, they alone do not address all of these needs.”
Future directions
The research team is now focusing on expanding the reach of the AMPLIFY Diet programme across both clinical and non-clinical settings. The aim is to improve access to effective survivorship care while also contributing to broader cancer prevention efforts.
The study was funded by the National Institutes of Health and the American Cancer Society.
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New Study Finds Wearables May Reshape Obesity Care
Key Takeaways:
- A new study from Northwestern University demonstrates how wearable devices can identify five distinct overeating patterns in people living with obesity, paving the way for more personalised interventions.
- The HabitSense body camera and NeckSense necklace provide unprecedented yet privacy-conscious insights into real-world eating behaviour.
- Researchers emphasise that overeating is not simply a matter of willpower but is shaped by complex emotional, environmental and behavioural factors.
Rethinking obesity treatment through technology
What if a smartwatch, necklace or discreet camera could sense when someone is about to overeat, and instead gently encourage healthier decisions?
Northwestern University scientists are exploring this idea through a pioneering lifestyle medicine programme that combines wearable technology with behavioural analysis. The approach uses three different devices – a necklace, a wristband and a body-mounted camera – to capture eating habits in natural settings, with privacy firmly safeguarded.
“Overeating is a major contributor to obesity, yet most treatments overlook the unconscious habits that drive it,” explained corresponding author Nabil Alshurafa, Associate Professor of Behavioural Medicine at Northwestern University Feinberg School of Medicine and, by courtesy, of Computer Science and Electrical and Computer Engineering at Northwestern’s McCormick School of Engineering.
Five distinct overeating patterns identified
In the study, published in npj Digital Medicine (part of the Nature Portfolio), 60 adults living with obesity wore the three sensors and logged contextual information – such as mood, activity and social setting – using a smartphone app over a two-week period. The project generated thousands of hours of data, revealing that overeating typically followed one of five recurring patterns:
- Take-out feasting – heavy consumption of delivered or takeaway meals.
- Evening restaurant revelry – social dining leading to excessive intake.
- Evening craving – compulsive late-night snacking.
- Uncontrolled pleasure eating – spontaneous binges driven by enjoyment.
- Stress-driven evening nibbling – grazing triggered by anxiety.
“These patterns reflect the complex dance between environment, emotion and habit,” said Alshurafa. “What’s amazing is now we have a roadmap for personalised interventions.”
A step towards personalised interventions
The findings create a foundation for future clinical practice, in which individuals may be profiled according to their dominant overeating pattern and then matched with tailored interventions.
Lead author Farzad Shahabi, a PhD student in Computer Science and member of Alshurafa’s laboratory, highlighted the significance:
“What struck me most was how overeating isn’t just about willpower. Using passive sensing, we were able to uncover hidden consumption patterns in people’s real-world behaviour that are emotional, behavioural and contextual. Seeing the patterns emerge from the data felt like turning on a light in a room we’ve all been stumbling through for decades. Our long-term vision is to move beyond one-size-fits-all solutions and toward a world in which health technology feels less like a prescription and more like a partnership.”
HabitSense – A body camera with built-in privacy
The project’s roots date back to when Alshurafa borrowed a police body camera from Northwestern’s campus police. He modified it to record only food-related actions, creating what is now called HabitSense.
HabitSense is the first patented Activity-Oriented Camera (AOC), which uses thermal sensors to activate recording solely when food enters the field of view. Unlike conventional egocentric cameras that capture everything from the wearer’s perspective, AOCs record actions rather than scenes. This innovation preserves bystander privacy while still collecting critical behavioural data.
NeckSense – Recording eating behaviours in real time
Participants also wore NeckSense, a necklace designed by Alshurafa and his team. NeckSense is the first technology able to passively and precisely monitor multiple eating behaviours. It can detect when someone is eating, how many bites they take, their chewing rate and the frequency with which their hand moves to their mouth. This provides researchers with highly detailed insight into real-world eating events.
A wrist-worn activity tracker – similar to a Fitbit or Apple Watch – completed the three-sensor system.
From personal struggles to scientific mission
Alshurafa’s scientific interest in obesity stems from his own personal journey. Throughout his younger life, his weight fluctuated by 40 to 50 pounds, with repeated attempts at dieting often undermined by late-night binge eating in front of the television.
“I tried to turn my personal struggle into a scientific mission that promises to reshape obesity treatment,” he reflected. “By merging computer science, behavioural medicine and a dash of Jane Goodall–style curiosity, we’re working to lead the way toward truly personalised, habit-based health care. This study marks only the beginning of a journey toward smarter and more compassionate interventions for millions grappling with overeating.”
Study team and support
The research team behind this project brought together a wide range of expertise from Northwestern and beyond. Contributors included PhD student in computer science Boyang Wei, HABits Lab research study coordinator Chris Romano, and undergraduate student Rowan McCloskey. They were joined by adjunct faculty members Annie Lin of the University of Minnesota and Mahdi Pedram of the University of North Texas, as well as former Northwestern faculty member Tammy Stump, now at the University of Utah. Jacob Schauer, Assistant Professor of Preventive Medicine, also played a role, alongside computer science PhD student Glenn Fernandes and senior engineer Tanmeet Butani (MS ’23).
The study was funded by the US National Institutes of Health through the National Institute of Diabetes and Digestive and Kidney Diseases.
CCH insight:
This is a fascinating study, which shows how new technologies may be able to provide innovative digital solutions to health issues, in this case identifying behavioural patterns underpinning overeating. These results need to be verified in larger studies, and then interventions trialled to address the different eating patterns, so we are a long way from viable new interventions, but this is an intriguing addition to the development of precision treatments for obesity.
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