ESPE Yearbook of Paediatric Endocrinology

Int J Obes. 2025 Mar12;49(5):973–976. doi: 10.1038/s41366-025-01738-0. https://pmc.ncbi.nlm.nih.gov/articles/PMC12095034/

Brief Summary: The effect of evidence-based behavior intervention programs on childhood obesity remission is limited [1]. Best results could be seen with contact hours ≥26/year [2]. However, this is often difficult to achieve for both families and health care providers due to time and resource constraints. This 3-year, pragmatic, single-center trial among 428 children evaluated the effectiveness of Evira, a digital tool paired with physical visits (“digi-physical” care, n=107), as an add-on to standard pediatric obesity treatment (n=321). After 3 years, the digi-physical group had greater BMI z-score reduction (–0.29 [95%CI: -0.40, -0.18] vs. -0.12 [-0.21, -0.03], P=0.02) and higher obesity remission rates (31.8% vs. 18.7%, P=0.005), with even more pronounced effects in a subset of adolescents (n=50).

Evira is a modern attractive individualized mobile health technology with regular home measurements presented only as a visual (non-numerical) trend in BMI Z-score, with data transfer and messaging with the clinic. Addition of such a digital tool to physical visits is highly promising regarding sustained weight loss over 3 years, without weight regain as often known from standard care. Moreover, the well-established challenging treatment adherence improved by the digital tool. The study highlights the value of digital data-driven feedback in addition to motivational interviewing over traditionally prescriptive advice to increase parental empowerment. However, long-term sustainability beyond 3 years of digi-physical treatment must be studied, as overall attrition and engagement declined over time (e.g. home weighing frequency dropped from 3.9 to 2.9 times/week by year 3). Further, multicenter trials with larger, diverse populations and standardized lifestyle factor assessment (e.g. diet, sleep, stress) are needed to confirm long-term generalizability. The current plans for wider use of Evira in commercial settings, international clinical trials and in combination with weight loss medication is more than welcome to potentially overcome limitations of behavior intervention programs on childhood obesity so far. Recently, Evira has been commissioned by the UK National Health Service.

References: 1. Putri RR et al. Effect of pediatric obesity treatment on long-term health. JAMA Pediatr 2025;179:302–309. doi: 10.1001/jama.2017.0332