JMIR Mhealth Uhealth. 2025 Nov 7. doi: 10.2196/64139. Online ahead of print.
ABSTRACT
BACKGROUND: Overweight and obesity, as defined by the World Health Organization, correspond to body mass index (BMI) values of 25.0-29.9 kg/m² for overweight and ≥ 30 kg/m² for obesity. Both conditions remain major public health challenges worldwide due to their strong link with type 2 diabetes, cardiovascular disease, and hypertension, which place a heavy clinical and economic burden on healthcare systems. In Canada, obesity rates are notably high, with vulnerable populations disproportionately affected due to socioeconomic barriers, limited access to preventive care, and higher comorbidity rates. Mobile health (mHealth) technologies, particularly calorie-counting apps, have emerged as promising tools for dietary self-monitoring and weight control. However, their heterogeneity in design and evidence base complicates the evaluation of their clinical feasibility and real-world effectiveness.
OBJECTIVE: This study systematically evaluated the structure and content of 46 calorie-counting apps, identify factors of their acceptability and feasibility among adults living with obesity or weight-related chronic diseases, and formulate evidence-based recommendations for app developers, clinicians, and researchers.
METHODS: We conducted a scoping review of the literature on calorie counting apps published between January 2013 and March 2024. A total of 771 records were identified and, after following PRISMA-ScR guidance, sixty-eight studies met the inclusion criteria. Data were extracted on app functionalities, features, and user engagement metrics, as well as factors influencing app acceptability and feasibility among adults living with overweight or weight-related chronic conditions. The findings were synthesized to provide practical recommendations for the design and clinical implementation of calorie counting apps.
RESULTS: Sixty-eight studies met the inclusion criteria and were included in the analysis. Randomized controlled trials (34.0%) and cohort studies (24.0%) were the most common designs. Most studies targeted adults with overweight or obesity (78.0%), while diabetes and hypertension were less frequently represented. In total, forty-six distinct calorie counting apps were identified, with MyFitnessPal and Lose It! being the most frequently studied. Nearly all apps (98.0%) offered calorie logging, often through manual entry supported by food databases, and about half included goal-setting features. Factors of acceptability most often cited were personalization, automated functionalities, user-friendly design, and data sharing with healthcare professionals, while barriers included technical issues, limited food databases, and the time burden of manual entry. Adherence declined over time. For example, self-monitoring with MyFitnessPal decreased from 5.4 days/week at 4 weeks to 1.4 days/week at 12 weeks, while daily use of Lose It! dropped to 4 days/week by the end of 12 weeks. A total of twelve recommendations were developed to enhance the feasibility and acceptability of calorie-counting apps for people living with weight-related chronic diseases.
CONCLUSIONS: Calorie counting apps hold potential as tools for supporting individuals living with obesity and weight-related chronic diseases. To enhance their clinical utility, app developers should focus on improving user engagement through personalized and automated features, ensuring comprehensive food databases, and minimizing the effort required for dietary self-monitoring. Further research is needed to validate these apps' effectiveness and explore strategies to sustain user adherence. The findings provide valuable insights for developing more effective and user-friendly mHealth interventions.
PMID:41329042 | DOI:10.2196/64139