New Drugs — Does Lifestyle Intervention Still Count? Part 7

A multi-author paper discussed mHealth, or the use of mobile phones and other wireless technology to deliver medical care. It is more thoroughly defined as…

[…] the delivery of preventive, monitoring, or clinical procedures and protocols through the mobile communication devices, such as mobile phones, tablets, personal computers, personal digital assistants, biosensors, and other up-to-date technological devices.

But why? Well, when it comes to obesity, traditional chronic care management apparently has had some thin spots. Typically, distance has been a problem. Patients are unable, or simply not inclined, to make repeated journeys back and forth to a clinic or medical center. But everything has changed since the introduction of distance-vanquishing interventions.

The concept of mHealth is also described as “the integration of Internet-based technologies into psychological and multidisciplinary protocols according to a stepped-care approach.” Now we need another definition.

Stepped care is about right-sizing, about landing on the level of support that neither under-treats nor over-treats the patient. The idea is to start with the most effective treatment that uses up the least resources, and then “step it up” or “step it down” until the fit is right for the level of client need. The important thing to know is, “[T]he mHealth applications have achieved positive results in adult obesity and in childhood obesity too.”

The ingredients

Whether close-up or from a distance, treatment may be required to address any or all of these factors, as listed by the Mayo Clinic:

Symptoms of mental illness
Relapse of those symptoms
Medications aren’t a good option
Stressful life situations
Ways to manage emotions
Relationship conflicts
Better ways to communicate
Grief or loss
Emotional trauma related to abuse or violence
Medical illness
Chronic physical symptoms

In the area of weight loss for health, two things are clear: Long-term sustainability is the prevention of relapse, and relapse avoidance is long-term viability. What kinds of counseling have been associated with weight loss up until now? One is Cognitive Behavioral Therapy, which seems flexible enough to meet quite a few needs. Childhood Obesity News talked about some of its sub-varieties.

The whole point is to break negative behavior cycles and create new patterns. Any program that is going to last, has to address all areas of life — the family, the peer network at school or job, the community at large; and presumably must also harmonize with a person’s moral and spiritual beliefs and practices.

That is a tall order. Obviously no drug, regardless of how revolutionary or seemingly miraculous, can handle all this. But with the help of a mHealth application, it might.

Your responses and feedback are welcome!

Source: “Cognitive behavioral therapy to aid weight loss in obese patients,”, 06/06/17
Source: “Cognitive Behavioral therapy,”, undated
Image by bluesbby/CC BY 2.0 DEED

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources