Kinect for fun, not weight loss

(Note: I’m about to date myself).

As a kid, I was a geek pioneer. That’s right, I was part of the first generation of children to be transfixed by the beeps, blinks, and bouncing pixels of video games played on devices like the TI-99/4A, ATARI 2600, (remember that attached audiocassette “drive”?) and Commodore 64. That means I was also part of the first generation that considered staying inside as a reward, not a punishment. For us, there was a linear association between sedentary time and video game proficiency. And I was very proficient.

Every generation since has basically put us to shame. With advances in technology, screens have increased in number, and as screen time has grown, so have our kids’ waistlines.

That’s why so many were excited by the release of Microsoft’s Kinect (and the Wii). Many thought these active gaming approaches would be like those funky vegetable pastas — sneaky ways to get kids to be more healthful (still working on my metaphors).

A fascinating new study suggests that much of our exuberance was premature. The study found that adolescent boys (and only boys, unfortunately) burned more energy while playing Kinect games, compared to playing non-Kinect games or just sitting. But after a day, there was no difference in energy expenditure. This means that at some point, the boys were compensating for the extra exercise they got while playing Kinect.

Compensation is common when we exercise. There’s good science that we tend to eat a bit more after being physically active (and sometimes, more than a bit). Interestingly, in the study, when researchers offered the kids food, there were no difference in the amount that kids ate. This suggests that kids compensated, but we’re not sure how, or when.

TL; DR: Kinect is great fun. Nothing beats using a game as an excuse to hurl yourself around the room dance. However, if you want your kids to do meaningful exercise, turn off the TV.

Why buy a wearable when they’re [almost] free?

In this week’s addition of Another Day, Another Wearable, we present the latest offering from Pivotal Living.


Wrist-worn? Check.
UI? Check.
Bluetooth? Check.
Hypoallergenic? Hopefully.
Price? Free (with a $12 annual subscription to their premium app … so that’s more like free-ish).

I’ve long been predicting that we’re going to see wearables (at least the non Apple variety) rapidly enter Commodity Land. It’s becoming more difficult to differentiate on features (although FitBit is trying), it’s hard to justify high prices for cheap innards, and all the action is in the software anyway. Now, for the dreaded self-quote:

I predict that we’ll see these things [on discount] lining the shelves at your local drugstore. Just like paper towels. — Me

Whoops, wrong quote. Try this one.

Commoditization … will redirect the market’s focus where it should be: on the software. After all, the challenge isn’t the [data] collecting, it’s the changing. Tracker makers have done an excellent job in developing cool tools for gathering data, but they’ve been much less creative in designing software that reliably improves people’s health. And it’s the software that offers tracker makers the greatest opportunity for differentiation. — Me

I haven’t yet used the Pivotal Living app and on first glance, I don’t see much that isn’t available in other apps. And remember, we don’t know if any of these apps or devices actually work. But, what’s important is that we’re beginning to see new business models for wearables that prize (and price) the software. If this business model catches on, I suspect that developers will need ways to better differentiate their apps. This might create opportunities for those of us who’ve been clamoring to get evidence-based approaches into the app market. Admittedly, that’s a lot of ifs, but I’m willing to play the long game because I’m convinced that focusing on the changing (vs. the collecting) will give us the best shot at using wearables to improve consumer health.

mHealth for weight loss. Help or hype?

Dr. Sherry Pagoto is totally right about the limitations of mobile apps for weight loss. The whole piece is worth a read, but this point is key:

The vast majority of apps are tools for weight, diet, and activity tracking. Apps do a great job here, but these strategies represent a very small segment of a much larger body of effective behavioral strategies that are used to help people lose weight. The situation is tantamount to asking someone to build a house but giving them only a hammer.

As I’ve mentioned, app form is critical but function is what gets the job done.

A bitter pill?

The FDA recently announced that it is approving Belviq, the first weight loss drug it’s allowed in over a decade. Let’s ignore for a moment the drug’s rather unimpressive outcomes ( <– couldn’t resist). Here’s the thing: over 6 months, a large number of [totally behavioral] strategies can produce enough weight loss to improve — and in some cases, prevent —  hypertension, diabetes, and cholesterol.

What we can’t do is get people to keep the weight off (and drugs can’t do that either).

Let’s leave aside all of the issues associated with weight loss medications (safety, cost, safety, questionable efficacy, safety, cost, safety) — it’s always useful to have more tools in our arsenal. And there is certainly a subset of patients for whom weight loss drugs can be helpful.

The problem is that drugs help people lose weight. They don’t help you maintain that lost weight. You’re unlikely to take any weight loss drug in perpetuity (remember Fen-Phen?). So, for long term maintenance, people need to learn the same behavioral strategies that can help with weight loss in the first place.

I’m sensitive to the idea that people want some help with losing weight. Drugs can definitely give you that extra bumpHowever, many studies show that over time — and even with that extra drug-induced bump — most people gain the weight back.