Use of smartphone application in obesity management

The study was planned to include 30 control and 30 intervention groups. Thirty-one control and 34 intervention group participants were reached, but one person from the intervention group left the study due to a change of city. In March 2020, the study was conducted remotely by creating two separate WhatsApp groups as control and intervention due to the global pandemic in March 2020; in Türkiye, the bans on going out, the lack of outpatient services other than emergency services and the fear of patients coming to the hospital. Participants continued to be advised to continue their diets, exercises they could do at home, and behavior change suggestions. Motivational interviews were held regularly on the phone with patients who requested them. The intervention group was again asked to continue using the smartphone application and to regularly send us visuals of the foods they consumed and their weekly exercises. In the study, the participants in the intervention group were enabled to use a smartphone application. The Samsung Health smartphone application was downloaded to their phones during the first interview, and they were told how to use it. When the application is first downloaded, the patient's age, gender, height, and weight values are requested. When the values are entered, the number of calories that the patient can take per day close to the basal metabolic rate is determined. The main screen includes data entry for goals, sleep, food, weight, water, and exercise. At each visit, the records were evaluated together with the participant. The intervention group could record everything they ate and drank at that meal in the breakfast, lunch, dinner, morning snack, lunch snack, and evening snack options with the add option in the food section. The carbohydrate, fat, protein, vitamin, iron, vitamin-iron ratios, and calories of each recorded food were displayed in detail. For each meal, it was possible to add, subtract, and see the content and calories of the food before recording. When entered into the goals section, the protein, fat, and carbohydrate ratios that the patient should take at the end of the day; the number of vitamins, minerals, iron, and the amount taken by the participant could be seen. The exercise section offers many options, from walking to mountain biking, swimming to dancing, squash to jumping rope. Manage items allowed participants to choose the exercise that suited them, target duration, location, and calories burned. The calories, protein, fat, and carbohydrate ratios of the foods consumed, the protein, fat, and carbohydrate ratios compliance with the given diet; the exercise performed, duration, and calories spent were monitored, and the participants were guided on proper nutrition and proper exercise. In June 2020, with the relaxation of the measures, the participants were invited to be evaluated and measured at the hospital again, but. However due to the ongoing epidemic, the participants left the study since the people they lived with had chronic diseases and were worried about carrying diseases to them from the hospital. Some of them stated that they were psychologically affected by this process and did not want to come to the hospital. The study was completed with 19 intervention group and 20 control group participants. Considering the basal metabolic rate data obtained from bioelectrical impedance analysis, diet lists were prepared in cooperation with the dietitian per the WHO (World Health Organization) and The Society of Endocrinology and Metabolism of Türkiye (TEMD) guidelines, with three main meals and three snacks. At six months, 5-10% of basal weight was planned for clinically significant weight loss. Both groups were offered one hour of moderate-intensity walking or equivalent aerobic exercise (swimming, climbing stairs, etc.) daily for significant weight loss. To make it easier for the participants to understand, the exercise intensity was indicated as light if they could both speak and sing, moderate if they could speak but not sing, and heavy if they could neither speak nor sing. Each visit, a half-hour motivational interview was conducted with both groups per Miller and Rollnick's guiding principles. Although measurements were interrupted due to the the global pandemic, diet, exercise, behavior change advice, and motivational interviewing continued over the phone. Patients were advised to change their behavior using the Beck Diet Solution book (Have a flexible list, eat slowly, be conscious of what you eat, etc.) . All motivational interviews, visual tracking of food intake and weekly exercise, and bioelectrical impedance analyses were conducted by a single, trained researcher every 15 days for the first 2 months and monthly for the next 4 months. The patient's gender, height, age, and body structure were entered into the bioelectrical impedance analyzer, and the patient's weight, BMI, fat percentage and fat mass, muscle mass and water content, fat percentage, fat mass, and muscle mass ratios in the extremities were determined.