The Onnikka weight management app, which can be downloaded onto a mobile phone, has provisionally proved successful in the well-being services county of Central Finland. Last summer and autumn, 154 patients used the app. Their average weight at the time was about 104 kg, and in a self-report after six months it had dropped by 3.7 kg to about 100 kg, after which the weight loss levelled off.
“A weight loss of about 4% is an excellent result when achieved with such a light, mobile therapy that patients use themselves. It’s not on a par with the latest drugs or surgical treatment of obesity, but for a light lifestyle intervention, the result is exceptional. Research shows that a 5% weight loss can reverse the onset of adult-onset diabetes, and this is close to that,” says Anna-Mari Koski, Endocrinologist and Information Management Physician from The wellbeing services county of Central Finland.
Patients’ experiences of using the app has been good, with fewer drop-outs than with traditional lifestyle interventions. Nursing staff liked the app: it was easy to teach patients how to use it and not time-consuming.
For a light lifestyle intervention, the result is exceptionally good.Anna-Mari Koski, Endocrinologist and Information Management Physician, The wellbeing services county of Central Finland
“In many cases, there is no ready evidence of the performance of different digital services in the pilot phase, and performance is only tested in the pilot. But this was not the case with Onnikka. There was already strong research evidence that it works, so it was known that it supports lifestyle changes,” explains Mari Rantamäki, Project Manager of the Future Social and Health Centre project funded by the Ministry of Social Affairs and Health.
At the start of the pilot in autumn 2022, patients met with a nurse or lifestyle counsellor either remotely or in person. Patients were measured for blood glucose, cholesterol, liver function, height, weight and waist circumference. They also had their blood pressure monitored for four days and completed a lifestyle questionnaire. At the same time, they were taught how to use the Onnikka app.
A deliberately discreet app
‘Onnikka’ means ‘bus’ in Oulu dialect. The app was first developed for use on computers by Professor Emeritus of Internal Medicine Markku Savolainen and Professor Harri Oinas-Kukkonen of the University of Oulu, and was later made into a mobile app.
Onnikka takes the user from ‘stop to stop’. Initially, there are two such stops a week. Patients are informed about diet and exercise, as well as about managing change, emotions and eating behaviour.
For example, the app asks the patient to complete tasks to assess their relationship with impulsive eating and asks open-ended questions about their feelings about food. The patient can keep an exercise and food diary.
Onnikka is deliberately discreet. It doesn’t dictate the patient’s menu for the day or tell them to go for a walk, but uses cognitive behavioural therapy and persuasive programming to bring about a lasting change in thinking.
A one stop session lasts between five and ten minutes.
“The time is deliberately short. It’s easy for programmers to fall in love with their creation and want to dump all the information on users. But this provokes users’ resistance. Onnikka has been made to be simple and suitably addictive, and that’s the secret of its success,” says Teppo Virkkula, CEO of Onnikka Health Oy, which manages and markets the app.
“For few people, losing weight is the main goal in life. It’s just one thing among others,” Virkkula adds.
Official results in autumn
The results in Central Finland are preliminary because they are based on patients’ self-assessments after six months. Previous studies have found that self-reported results are relatively good predictors of official results.
The six-month intensive period is followed by a three-month recreational period, during which Onnikka is used only once every two weeks.
Onnikka’s algorithm tailors the content of the recreational period to each patient based on how they have used Onnikka, how they have answered questions and how successful their self-reported weight loss has been. The purpose of the recreation period is to recall the most important issues and to slowly move towards everyday life without Onnikka.
The official results of the Onnikka digital trial in the well-being services county of Central Finland will be available in the autumn, when all patients have been using the Onnikka app for a year and have undergone the same tests as at the start of the pilot project a year ago.
Users’ experience of the app
Read about users’ experiences.
The pilot project was part of Sitra’s Health Data 2030 project, which develops solutions and ground rules for cross-border use of health data in Europe and supports the competitiveness of the Finnish health sector. Sitra’s aim has been to gather information on the use of new digital therapies as part of the care workflow.
Anna-Mari Koski, Endocrinologist and Information Management Physician, the well-being services county of Central Finland, anna-mari.koski(at)hyvaks.fi
Mari Rantamäki, Project Manager, Well-being services county of Central Finland, Future Social and Health Centre Project (Ministry of Social Affairs and Health), mari.e.rantamaki(at)hyvaks.fi
Teppo Virkkula, CEO, Onnikka Health Oy, teppo.virkkula(at)onnikkahealth.fi