Effect of E-Health-Assisted Lifestyle Interventions on Weight Loss in Patients With Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD,Formerly NAFLD): A Meta-Analysis

Abstract

Background:

Lifestyle modification remains the cornerstone of managing metabolic dysfunction–associated steatotic liver disease (MASLD). Achieving a weight loss of 7% to 10% of total body weight is known to improve hepatic steatosis and reduce liver-related damage. However, sustained behavioral changes are often difficult to achieve without structured support. E-health technologies may offer scalable and accessible solutions to support weight management in this population.

Objective:

We aimed to evaluate the effect of e-health-assisted lifestyle interventions on weight loss in patients with MASLD.

Methods:

A systematic search was conducted in Ovid, ScienceDirect, Cochrane Library, Web of Science, CINAHL Ultimate, PubMed, Scopus, and MEDLINE. Randomized controlled trials (RCTs) reporting absolute weight change were included. Two reviewers independently assessed methodological quality using the Cochrane Risk of Bias-2 tool. Data were synthesized using a random-effects model in Comprehensive Meta-Analysis (v3).

Results:

Twelve RCTs involving 851 participants met the inclusion criteria. E-health-assisted interventions—delivered via text messaging, telephone/video calls, mobile apps, or multimodal strategies—targeted dietary and/or physical activity behaviors. The pooled analysis demonstrated a statistically significant moderate effect on weight loss (Hedges’ g = −0.45, 95% CI [−0.87, −0.03], P = .03). Moderator analysis indicated that intervention duration significantly influenced effectiveness, with greater effects observed in interventions lasting 3 to 6 months. No significant publication bias was detected.

Conclusion:

E-health-assisted lifestyle interventions are effective in promoting behavioral change and facilitating clinically meaningful weight loss in patients with MASLD. Healthcare providers, including nurses, can leverage these cost-effective, scalable tools to enhance chronic disease management, particularly when implemented over moderate durations.