Weight loss apps: an overview of offers – when does health insurance pay?

Finally reaching your ideal weight: That's the promise of weight-loss apps – just like diet and fitness programs, diet shakes, and weight-loss injections. Heike Krüsi-Heininger (59) from North Rhine-Westphalia lost around 20 kilos with the Oviva app. "Now I weigh the same as I did before I had my children 23 years ago." Other programs, she says, focused more on prohibitions than on a holistic approach designed to bring about long-term lifestyle changes. She finds the regular contact with the app's advisors particularly motivating. "Before, there wasn't an excuse I didn't know."

Krüsi-Heininger's doctor has been prescribing the app to her for about two years now. The costs are covered by her statutory health insurance. Her experience aligns with expert opinions. For example, the German Obesity Society's (DAG) "S3 Guideline on Obesity - Prevention and Therapy" recommends weight-loss apps that aim for weight reduction through self-monitoring. According to the DAG, even greater success can be achieved with apps where users have personal contact with advisors via (video) calls.

The German Weight Loss Association (DAG) also points out that the research on the effectiveness of weight loss apps is limited. There is no universally accepted definition of what constitutes a "weight loss app." Consequently, navigating the jungle of countless offers is difficult. The basic principle is: a nutrition and calorie tracker is not the same as a weight loss app – and not all weight loss apps are the same. What are the differences?

A nutrition and fitness tracker is aimed at anyone who wants to see how many calories they consume daily and how much energy they expend. However, these devices alone are not sufficient to counteract overweight (body mass index between 25 and under 30) or obesity (body mass index between 30 and 40).

For the German Weight Loss Association (DAG), it is crucial that "the use of digital tools is geared towards the wishes and needs of those affected." Ideally, this includes personal consultation via chat or (video) phone call. The weight loss app provides strategies for achieving long-term success in the areas of nutrition, exercise, and habits.

In the following, a weight loss app, in the narrower sense, is defined as one that includes at least the following components:

• Recording and analyzing the food consumed by users
• Searching for the reasons for overweight and obesity (such as incorrect eating habits or lack of exercise, as well as their underlying causes)
• Consultation with qualified experts in the form of chats and/or (video) phone calls

It is important to ensure that the app's advisors can demonstrate their expertise. The title "nutrition specialist" may only be used by those who have obtained a relevant degree or certification from associations such as the German Nutrition Society or the Association for Nutrition and Dietetics.

Two of the weight-loss apps, Oviva and Zanadio, differ from the competition in one important aspect: They are listed by the Federal Institute for Drugs and Medical Devices (BfArM) as Digital Health Applications (DiGA). These apps are medical devices and are intended exclusively for people with diagnosed obesity.

There are two criteria that must be met for health insurance to cover the costs of a weight-loss app. First, the patient must have a doctor's prescription for using the app. The primary target group is people with obesity, but ultimately, the prescription is at the doctor's discretion. Second, the app must be listed as a digital health application (DiGA) by the Federal Institute for Drugs and Medical Devices (BfArM).

This means that only the use of the Oviva and Zanadio app services is financed by the health insurance company.

Zanadio

• Cost: 218 euros for self-payers (for twelve weeks)
• Reimbursement by statutory health insurance: Yes, with a doctor's prescription.
• Reimbursement by private health insurance companies: depends on the insurance policy. Please contact your private insurance provider for details.
• Duration: At least twelve weeks, follow-up prescriptions possible
• Target group: People affected by obesity (BMI between 30 and 40), people with a BMI of at least 25, with comorbidities or abdominal obesity
• Excluded from use: Pregnant women, minors, people who have undergone gastric bypass surgery or similar procedures in the past three years, those affected by secondary obesity, those affected by serious accompanying illnesses with a prioritized need for treatment.
• Included in the offer: introductory webinar, activity tracking, nutrition tracking with barcode scanner, weight goals, learning materials, personal consultation with qualified professionals via chat.

Oviva

• Cost: €220.90 for self-payers (for twelve weeks)
• Reimbursement by statutory health insurance: Yes, with a doctor's prescription.
• Coverage by private health insurance: depends on the policy. Please contact your private insurance provider for details.
• Target group: People affected by obesity (BMI between 30 and 40)
• Duration: At least 12 weeks, follow-up prescriptions possible
• Excluded from use: Minors, those affected by other forms of hypothyroidism (diagnosis E03), those affected by type 1 diabetes, those with hypothyroidism and other disorders of the pituitary gland, those affected by Cushing's syndrome
• Included in the offer: photo food diary with AI-generated nutritional analysis, weight goals, knowledge transfer (on nutrition, health and habits), consultation with qualified professionals in the form of chats and (video) telephone calls, tips on dealing with accompanying and secondary diseases of obesity

Appositas

• Cost: 833 euros per month for a coaching period of three to six months, negotiable for a 12-month coaching period.
• Reimbursement by health insurance companies: No
• Duration: 3 to 12 months
• Target audience: Everyone who wants to lose weight
• Excluded from use: Minors, pregnant women
• Included in the offer: tracking of eating habits, calculation of personal energy requirements, tracking of movement and activity, recipes, video consultation with qualified nutritionists.

Noom

• Cost: Between 50 euros (one month) and 164 euros (one year)
• Reimbursement by health insurance: No
• Duration: Variable, one to twelve months
• Target audience: Everyone who wants to lose weight
• Excluded from use: Minors, pregnant women
• Included in the offer: courses (on nutrition, goal setting and habit formation), food diary, weight chart, recipes, advice from "Noom Guides" in chat, exchange with other users

How helpful are fitness influencers?

The number of weight-loss app providers is now very large. For those with obesity, it is recommended to use an app that is covered by health insurance. For everyone else: If you are still unsure which app best suits your needs, seek advice from your doctor or health insurance provider.