Is Text Message Pestering Better Than a Soda Ban?

Despite our collective optimism about modern technology's power to disrupt everything in sight, obesity and weight loss have still proved tough nuts to crack. The recent proliferation of self-tracking devices like the "smart-fork" and numerous wrist and armbands occupy an ever-growing chunk of the Consumer Electronics Show (CES) each January in Las Vegas, which only goes to show that developers increasingly see this area as prime for new ideas. And now, local governments are throwing themselves into the mix as well.

This week, the local government council of Stoke-on-Trent, a city in Staffordshire, England, announced a new public health initiative to send residents daily text messages in order to help motivate them to lose weight. According to a BBC report, the current plan is entirely voluntary and available for 500 residents for a 10-week trial program, though that number is expected to increase if the program proves effective. It will cost £10,000 (around $16,000), but the council described the program as an intervention that could ultimately curb total spending on obesity-related illnesses, which cost the local National Health Service (NHS) some £50 million a year, the council said.

It's easy to see where the incentive for new, experimental ideas like this come from. The city council for Stoke-on-Trent said that about 70,000 residents are now classified as obese. A report this week from the regional newspaper The Sentinel said that while obesity levels are improving, roughly two-thirds of residents above the age of 16 are still classified as overweight, granting it the undesirable reputation as "one of Britain's fattest cities." In general, the UK is also relatively supportive of incentive-based technological initiatives. Late last year, for instance, the country's National Department of Health helped sponsor a smartphone game called the The Walk, which, as its name implies, encourages people to take more steps each day by gamifying the entire perambulation process.

It's hard to fault public institutions for putting forth a sincere effort to promote weight loss, particularly when it's not something controversial like a regressive sin-tax on unhealthy foods. But even compared to some like The Walk, the texting program seems unobtrusive to a fault. By the council's description, the program sends several messages to participants throughout the day with reminders like "eat slightly smaller portions" or "maybe walk to the shops or use the stairs more often."

Helpful, no doubt. Life changing? I asked Madelyn Fernstrom, the health and diet editor for NBC News and a widely consulted resource on these kinds of initiatives, and she told me that the "results are hard to show—and mixed" for this kind of approach. Like any weight loss regimen, much of the success rests on an individual's adherence to the program irrespective of its overall quality. She told me that therefore the real question isn't whether or not this particular program will "work," but "whether the money could be used for another health-related issue—more playground equipment, a walking trail, etc."

"Bands and forks are self-pay—and people purchase them, so [there's] no controversy," Fernstrom told me in an email. "It’s when a health plan pays, or a town (like here), where people want documented evidence that this is money well spent. Sadly, when it comes to lifestyle, only a small portion of the population responds—and the question still remains, is it worth it? The only downside is when there is great competition for funds, could you do better with the money for a health related area? There is not 'right answer' here."

Conservative council members have already begun to raise the same concern about public funding. But there's a deeper moral quandary here as well that theorists and critics like Evgeny Morozov have begun to point to: whether these sorts of technologically-abled fitness regimens will ultimately produce adverse social effects such as raising the insurance rates of people who choose to "opt out" of such programs.

Still, Morozov's critique—like many of those recoiling at the thought of something like a "smart fork"—came from a growing concern about private companies bargaining with customers' personal data on an aggregate scale. As the political scientist Matthew Flinders wrote in a takedown of the smart fork last year: "it is possible that we need to revisit certain baseline assumptions about the market and the state and not simply define the role of the latter as an inherently illegitimate, intrusive, and undesirable one."

It's nice to see local and federal authorities taking a proactive role to help address obesity, not to mention one that's learned from some recent initiatives in the public sector. But we'll just have to wait and see if something like texting can prove balanced enough to actually prove effective.