An addiction‐based digital weight loss intervention: A multi‐centre randomized controlled trial

Summary Objective This randomized clinical trial tested the effectiveness of an addiction‐based digital weight‐loss intervention, focusing on withdrawal/abstinence from self‐identified problem foods, snacking and excessive amounts at meals, and discomfort displacement, with and without coaching, compared to an in‐person, multi‐disciplinary, care model among adolescents with obesity. We hypothesized that the digital intervention with coaching would yield greater weight loss and lower delivery burden than the standard clinical arm, and greater participant engagement than the digital arm without coaching. Methods Adolescents were randomized to app intervention, with or without coaching, or in‐person multidisciplinary obesity intervention for 6 months. The primary outcome was change in %BMIp95 at weeks 12 and 24. A mixed‐effects linear regression model was used to assess the association between change in %BMIp95 and intervention arm. We were also interested in assessing delivery burden, participant engagement and evaluating the relationships between weight change and demographic characteristics, mood, executive function and eating behaviours. Results All adolescents (n = 161; BMI ≥95th%, age 16 ± 2.5 year; 47% Hispanic, 65% female, 59% publicly insured) lost weight over 24‐weeks (−1.29%, [−1.82, −0.76], p