A computer device used to treat anorexic patients has been shown to be effective against adolescent obesity, reducing patients' body mass index and rate of food consumption even 6 months after the completion of treatment and monitoring.
The Mandometer, as the device is called, was developed at the Karolinska Institutet in Stockholm. It consists of a scale placed beneath the plate of food, and a small monitor that helps patients compare and align their perceptions of satiety, in real time, with those of a normal eater.
Anorexic patients at Mandometer clinics in Sweden, the United States, and Australia have used the device to retrain themselves to eat more food than would typically cause them feel full.
“With obesity, it teaches patients to eat slower,” Per Södersten, Ph.D., one of the report's authors and the inventor of the device, said in an interview. “Otherwise the principles are identical.”
The report presents results from a randomized controlled trial of 106 obese patients between the ages of 9 and 17 at the Bristol (England) Royal Hospital for Children. Dr. Julian P.H. Shield led the study along with Anna L. Ford, a research nurse trained a Mandometer clinic in Sweden.
Of the participants, 54 were trained to use the device during evening meals at home, while the other 52 were given standard care consisting mostly of advice on exercise and nutrition. The same advice was provided to the group using the Mandometer (BMJ 2010;340:b5388).
After a year, the Mandometer group showed significant improvements in body mass index. Of the 91 patients who were assessed at 12 months, the mean adjusted standard deviation score difference between the two groups was 0.27, the report said. Importantly, that difference was maintained at 18 months, 6 months after treatment and monitoring had ceased. (Nine patients were lost to follow-up in the Madometer group; six were lost in the standard-care group.) Though their Mandometers had been taken away, the subjects still tended to eat significantly smaller portions than they had before beginning treatment.
The discovery of maintained weight loss and consumption of smaller portions 6 months on “was probably the best bit,” Dr. Shield said in an interview. “We specifically chose adolescents because they're a difficult group to persuade to eat better and exercise. But by doing this extra thing to help them eat more slowly it allows them to curtail their portion sizes.”
Using a computer to track eating habits is not entirely novel, said Dr. Södersten, who cited research dating back to the 1960s in the United States, and the 1970s in Germany. “We followed that tradition and realized the device could be used for clinical intervention,” he said.
The adolescent subjects of the Bristol study adapted well to using the device, he added. “Young people like computers and they're used to them. They comply better because it's fun for them.”
Dr. Södersten and another coauthor own shares in the company that manufactures Mandometer.