Real-world evidence of self-managed weight loss enhancing skeletal muscle rate in individuals with overweight/obesity via mHealth app

Weight loss is essential for obesity management but may be compromised by skeletal muscle loss. This study evaluated the increase in skeletal muscle rate (SMR) and fat loss among individuals with overweight/obesity who achieved weight loss through self-management using a mobile health (mHealth) app, and explored factors associated with favorable SMR improvement. This real-world cohort study included 38,209 adults with overweight/obesity who achieved ≥ 5% weight loss using a mHealth app between January 2020 and July 2022. Participants were divided into weight loss with no SMR improvement (WL-NG) group and weight loss with SMR improvement (WL-MG) group based on ≥ 5% increase in SMR. Body composition changes and predictors of SMR increase were analyzed. Women showed lower fat loss and SMR increase than men, despite higher measurement frequency and weight-loss rate. The WL-MG group exhibited generally higher distributions of weight-loss rate, fat-loss rate and measurement frequency compared with the WL-NG group. There was a stronger correlation between the weight change rate and the SMR change rate, as well as a correlation between the PBF change rate and the SMR change rate. The multivariable regression model identified that higher measurement frequency was associated with SMR improvement during weight loss when adjusting for other independent factors, including gender, age, baseline BMI, and SMR. Men achieve greater fat loss and SMR increase than women during self-managed weight loss. Increased self-monitoring frequency is associated with weight loss and concurrent SMR improvement.