Effectiveness of eHealth Weight Management Interventions in Overweight and Obese Adults from Low Socioeconomic Groups: A Systematic Review

Abstract Background Low socioeconomic status (SES) is associated with increased rates of overweight and obesity. Proponents of electronic health (eHealth) hypothesise that its inclusion in weight management interventions can improve efficacy by mitigating typical barriers associated with low SES. Objectives To establish the scope of eHealth weight management interventions for people with overweight and obesity from a low SES. Secondary objectives were to determine the efficacy of eHealth interventions in facilitating weight loss, physical activity, and fitness improvements. Methods Four databases and grey literature were systematically searched to identify eligible studies published in English from inception to May 2021. Studies examining an eHealth intervention with low SES participants were included. Outcomes included temporal change in weight and BMI, anthropometry, and physical activity levels. The number and heterogeneity of studies precluded any meta-analyses, thus a narrative review was undertaken. Results Four experimental studies with low risk of bias were reviewed. There was variance in how SES was defined. Study aims and eHealth media also varied and included reducing/maintaining weight or increasing physical activity using interactive websites or voice responses, periodic communication and discourse via telephone, social media, text messaging, or eNewsletters. Irrespectively, all studies reported short-term weight loss. eHealth interventions also increased short-term physical activity levels where it was assessed, but did not change anthropometry. None reported any effect on physical fitness. Conclusions This review revealed short-term effects of eHealth interventions on weight loss for low SES participants. Inter-study comparison is challenging because of considerable variability. Future work should prioritise how to utilise eHealth in the longer-term either as a supportive public health measure or by determining its long-term efficacy in engendering volitional health behaviour changes. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42021243973 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021243973)