Cardiology · General Practice · 3 h ago
Digital commitment devices modestly improve activity and weight in at-risk adults
A systematic review and meta-analysis included 29 randomized trials with 7,534 adults with elevated cardiometabolic risk. Digital commitment devices were associated with higher daily step counts and greater weight loss, although weight-loss results varied across studies and long-term effects remain uncertain.
- Review included 29 randomized trials and 7,534 participants.
- Daily step counts increased by about 665 steps.
- Weight loss averaged 1.90 kg more than control.
- Long-term durability and cardiovascular outcomes remain uncertain.
Lifestyle changes can reduce cardiovascular risk, but maintaining them is difficult. This systematic review searched 12 databases through August 2025 and included 29 randomized controlled trials involving 7,534 adults with elevated cardiometabolic risk. Two reviewers assessed study quality, and random-effects meta-analyses were conducted where appropriate; certainty of evidence was assessed using GRADE.
Compared with control conditions, digital commitment devices increased daily steps by a weighted mean of 664.87 (95% CI, 463.22 to 866.51; I²=0%). They were also associated with 1.90 kg greater weight loss (95% CI, 1.21 to 2.59 kg; I²=70%). The review additionally reported improvements in self-reported emotional and uncontrolled eating, body-fat percentage, diet, and medication adherence.
The findings suggest these digital approaches may support some lifestyle outcomes in adults at cardiometabolic risk. However, the substantial heterogeneity in weight-loss results and the lack of long-term follow-up limit conclusions about durability or effects on clinical cardiovascular outcomes. The authors call for trials with follow-up beyond 12 months; the reported findings do not establish that these devices prevent cardiovascular events.
In practice
For adults with elevated cardiometabolic risk, digital commitment devices may help increase physical activity and support modest weight loss: pooled estimates showed about 665 additional daily steps and 1.90 kg greater weight loss versus controls. These findings support potential use as a lifestyle-support approach, but do not show prevention of cardiovascular events or establish lasting benefit. Weight-loss results varied substantially between trials, and the review identifies a need for follow-up beyond 12 months; the evidence does not justify assuming durable effects.
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European Journal of Preventive Cardiology: Effectiveness of Digital Commitment Devices in Improving Lifestyle and Cardiometabolic Outcomes in Adults with Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.