Efficacy of a Digital Peer Support Program on Weight Management and Mental Health in University Students With Preobesity: Randomized Controlled Trial.

The peer support program achieved greater BMI reduction than both control groups at 6 months.

• 216 students with preobesity were allocated equally among three 6-month arms (peer support, active wellness control, waitlist control)
• BMI reduction was 0.47 kg/m² greater than active control (95% CI -0.89 to -0.04)
• BMI reduction was 0.54 kg/m² greater than waitlist control (95% CI -0.85 to -0.01)
• Primary outcome was change in BMI from baseline to 6 months
• Analyses used linear mixed effects models

Weekly physical activity was significantly higher in the peer support group compared to both control groups.

• Physical activity was measured in metabolic equivalent of task (MET) minutes per week
• Weekly MET-minutes was 129.5 higher than active control (95% CI 53.3-205.6)
• Weekly MET-minutes was 152.9 higher than waitlist control (95% CI 68.4-237.4)

Self-esteem improved significantly in the peer support group relative to both control conditions.

• Self-esteem increased by 1.81 points versus active control (95% CI 0.22-3.39)
• Self-esteem increased by 1.99 points versus waitlist control (95% CI 0.21-3.76)
• Self-esteem was assessed at 0, 2, 4, and 6 months

Loneliness scores were significantly lower in the peer support group compared to both control groups.

• Loneliness scores fell by 3.79 points relative to active control (95% CI -7.03 to -0.56)
• Loneliness scores fell by 5.02 points relative to waitlist control (95% CI -8.38 to -1.66)
• Loneliness was assessed at 0, 2, 4, and 6 months

No significant differences emerged between the peer support group and control groups for anxiety or depression.

• Anxiety and depression were prespecified secondary outcomes assessed at 0, 2, 4, and 6 months
• Despite improvements in self-esteem and loneliness, the intervention did not produce significant effects on anxiety or depression
• The study aimed to concurrently improve weight management and mental health, but mental health improvements were limited to self-esteem and loneliness

The digital peer support intervention was delivered via WeChat and included multiple engagement components over 6 months.

• The intervention began with an interactive online workshop followed by moderated WeChat group discussions
• Components included daily micro tasks, biweekly group challenges, and digital badges to reinforce engagement
• The active control group received the same schedule and formats but focused on general wellness topics
• The waitlist group completed the same assessments without any intervention during the study period
• Retention exceeded 90% across the trial

Approximately one-third of university students are overweight or obese, and a similar proportion experience anxiety or depression.

• Weight and mental health issues are described as interrelated in young adults
• Interventions rarely address weight and mental health issues simultaneously in young adults
• Evidence was limited on whether a digital peer-driven approach can concurrently improve weight management and mental health in university populations with preobesity