October 21, 2016
Weight loss is the new mantra. Unless you have been on an island, the weight of our nation has increased exponentially over my career in medicine. About 1% of people had diabetes in the United States when I was in my training. Now in some states it is nearing 11%, and nationally affects about 9% of our population. Additionally, Pre-diabetes is a condition that affects about 86 million in the United States. The Centers for Medicare and Medicaid Services (CMS) decision to pay for diabetes prevention is revolutionary as this may apply to literally half of all people on Medicare. Their model is to use coaches, at YMCAs and other similar organizations, but there are not enough coaches in the country to actually do the job. This problem inspired me to explore an interesting company that is using a digital approach to this burgeoning problem.
I have written a lot about some of the companies focused on this area, but I just found one that has a very interesting and very simple approach. The company is ScaleDown, founded by Kate Wolin, ScD, Gary G Bennett, PhD, and Dori Steinberg, PhD, RD.
ScaleDown’s founders, Harvard-trained researchers with academic appointments at Duke University and Northwestern University, are leaders in the science of weight loss and behavior change. ScaleDown strongly feels that in order to help patients lose weight you need to provide a personalized approach, using the latest behavior change science. The company uses advanced algorithms to monitor trends in a patient’s weight and combine this with information that the patient provides on their initial survey as well as periodic questions asked during the daily interactions. With over 100,000 users in the program since their launch in October 2014, ScaleDown has been able to leverage user feedback and more than 12 million weight measurements collected to continually refine their algorithms and improve the program.
The foundation of their program is a “simple” weight scale. Something that a person can use every day as part of their daily routine in the privacy of their house with no need to receive a phone call from a coach. They have proven that daily weighing is a key component of weight loss, as it keeps a person keenly aware of their weight and allows the person to make connections between their diet, exercise habits, and their measured weight each day. This starts a connection in their brain that daily activity and decisions are integrally involved in their weight.
But the scale is far from simple. It is connected to a hub using an integral cell phone technology, which in turn collects data, and provides feedback to the patients. Their program also uses text messaging to assist with the back and forth communication and personalized messaging, allowing the program to reach those who may not have a smart phone, such as older and lower-income adults.
Their program does not require a person to record their food intake or exercise. They simply have to stand on the scale daily. And ScaleDown has proof of efficacy. In a published clinical trial, the ScaleDown approach yielded weight loss of 6% in 6 months, comparable to the gold standard coaching programs, at a much lower cost. In the “real world”, ScaleDown outcomes hold, with 93% of users achieving clinically meaningful weight loss. The key to delivering outcomes is engagement. The simple but meaningful approach in ScaleDown is behind their impressive engagement rates, with users weighing in an average of four days/week after 6 months in the program.
As our nation attempts to face our diabetes crisis, a simple digital strategy will become the foundation. ScaleDown has shown efficacy and value in this important battle and deserves a close look!