Since the first technological developments – such as cooking food or the wheel – innovation has favored the accumulation of energy and the reduction of effort. This, which was a blessing for millennia, is beginning to be a serious problem. Obesity and the multitude of associated diseases threaten to crush millions of people individually and collapse health systems. In the absence of changes that make it easier to acquire healthy food and make it difficult to access harmful food or cities are planned to promote physical activity, technological solutions are being sought to solve the problems that technology itself has created: the last one is LPG agonists. 1, fashionable diet pills.
Exercise, which requires more effort than swallowing a pill, but offers a much broader number of benefits, would be one of the great personal tools in the fight against this global pandemic. However, even if its advantages are known, it is not easy to overcome the human tendency to save energy. Personal trainers help build good habits, but they are expensive and that has given rise to alternatives such as mobile applications that help find motivation. Magazine JAMAedited by the American Medical Association, has recently published A study which compares the effect of such an application alone versus the combination of this technology with a human assistant. For now, machines do not outperform humans.
The study wanted to analyze to what extent it is possible to help obese people lose weight without human help, in order to apply cheaper effective treatments. 400 people participated and were divided into two groups: one that only received technological help (one app integrated, a scale with Wi-Fi and an activity bracelet) that the volunteers used to receive information about their diet, activity and weight; and another that, in addition to technology, had a human coach. Depending on the results, the treatment was adapted, adding support messages through the app as a first step and incorporating a human trainer or meal replacement when intensifying treatment was necessary. After a six-month follow-up, which included 342 participants, those who only received technological help lost 2.8 kilos on average and those who also had a trainer lost 4.8 kilos.
“The average person still needs a human trainer to achieve clinically meaningful weight loss goals because the technology is not developed enough,” says Bonnie Spring, first author of the study and professor of preventive medicine at Northwestern University in Chicago ( USA). “We may not be far from having a virtual assistant that can replace a human, but we are not there yet. It is within our reach. The technology is developing very quickly,” she adds.
Although the weight losses are small, an editorial of the magazine JAMA highlights the importance of this type of interventions, which escalate the intensity and tools used, are a way to obtain benefits with a lower cost and lower risks than current pharmacological or surgical treatments for obesity.
Mikel Izquierdo, director of the Department of Health Sciences at the Public University of Navarra, considers that machines are now essential for health professionals, to obtain information about sleep hours, follow the results of a diet or adjust daily the loads of training, but he does not believe that they will be able to replace humans. At least for now: “For a long time, medicine has been depersonalized, and the results of technology, which now provide better information than ultrasound scans and surpass humans in many aspects, are telling us that we must personalize it again, to look into the patients’ eyes, to touch them,” says this specialist.
However, Izquierdo would not recommend starting an exercise plan relying only on one app: “Applications for a physical exercise program have adherence problems, because the person needs to be motivated to continue exercising. What motivates me is not enough to motivate my mother. The machine has to excite us to continue exercising every day,” she explains. He also considers that for the success of a training it is essential to have a person by your side, accompanying and advising, “but also adjusting the load because you are tired or because the pulse has increased a lot or the speed of execution has decreased.” For people who cannot have a professional by their side, he recommends finding a group or person to exercise with to improve motivation.
The keys to motivation
Borja del Pozo, a health researcher at the University of Cádiz, also doubts that technology or applications with artificial intelligence will achieve the same results that a human achieves, but believes that “it is possible that there is a subgroup of the population that “I don’t need humans so much to have results.” Identifying these people would mean significant savings from a public health point of view. His team is already working on interventions in hospitals to get older adults out of bed with the help of an application.
“We use an accelerometer on the leg, we put a tablet next to the patient and we set a movement goal,” explains Del Pozo. “With a chatbot it is possible to make the machine learn, to give information or encouragement to the patient and to do so in a contextualized way. If there is a heavier person, who is going to respond worse, he can intensify the mood; or if the machine detects a voice in the room and sees that you have company, it can suggest that you take a walk with that person,” exemplifies this researcher.
Although technology improves and approaches the results it can achieve in weight reduction or increase in muscle mass that a human professional can achieve, Del Pozo recalls that what is fundamental in the fight against obesity are very broad social measures. “The social gradient is what has the most influence, whether the environment in which you live does not favor obesity, whether it tends towards activity or whether it is cleaner are fundamental factors. Even before birth, if your parents, due to their social and economic circumstances, live with a lot of stress, the chances of triggering obesity increase,” points out this scientist. Reversing obesity will require measures that reduce poverty and inequality, two markers with a close relationship with health.
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