Differential effects of wearable device-based interventions on weight and health outcomes in adults and youth with overweight or obesity: A systematic review and meta-analysis

Objective We sought to evaluate the differential effects of wearable device-based interventions on weight-related and metabolic health outcomes among adults and youth with overweight or obesity. Methods We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) published up to November 2025, identified through PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov. Eligible studies compared wearable device interventions to control conditions and reported outcomes such as weight, body mass index (BMI), waist circumference, blood pressure, lipid levels, and hemoglobin A1c (HbA1c). Data were pooled using random-effects models, and subgroup analysis was performed by age group. Results Eighteen RCTs were included. Wearable device interventions significantly reduced BMI overall (mean difference [MD], −0.63 kg/m 2 ; 95% confidence interval [CI], −1.01 to −0.25; P = 0.001), with a greater effect in children and adolescents (MD, −0.91 kg/m 2 ; 95% CI, −1.26 to −0.56; P < 0.00001). In adults, waist circumference decreased significantly (MD, −5.22 cm; 95% CI, −9.03 to −1.40; P = 0.007), and HbA1c also improved (MD, −0.24%; 95% CI, −0.30 to −0.18%; P < 0.00001). No significant differences were observed for overall weight change, blood pressure, or lipid profiles in adults. Pediatric participants showed more consistent improvements across multiple indicators. Conclusion Wearable device-based interventions led to modest but significant improvements in metabolic health, particularly in children and adolescents. These findings underscore the potential of wearable technologies as supportive tools for obesity management and highlight the importance of age-specific strategies in intervention design.