Researchers tested a smartphone app called Sidekick that teaches people about healthy eating, exercise, sleep, and stress management to help with a common liver condition called fatty liver disease. After 12 weeks of coaching through the app, people lost weight, their liver fat decreased, and their blood pressure improved. The exciting part? These improvements stuck around for 6 more months even after the coaching stopped. This suggests that once people learn healthy habits through the app, they can keep doing them on their own without constant reminders from a coach.

The Quick Take

  • What they studied: Can a health app help people with fatty liver disease lose weight and improve their health, and do the improvements last after the coaching ends?
  • Who participated: 34 adults (average age 63, mostly overweight) with fatty liver disease, high blood pressure, or type 2 diabetes who used the Sidekick app. Most completed the full 9-month study.
  • Key finding: People lost an average of 4 kg (9 pounds), their liver fat dropped by 18%, and their blood pressure fell significantly. These improvements lasted 6 months after coaching stopped, suggesting the healthy habits stuck.
  • What it means for you: If you have fatty liver disease or related health issues, a structured app-based program may help you make lasting changes without needing a coach forever. However, this was a small study, so talk to your doctor before starting any new health program.

The Research Details

This was a 9-month study where 34 people with fatty liver disease used the Sidekick Health app. For the first 12 weeks, they received daily coaching and lessons about diet, exercise, stress, and sleep. Then for the next 6 months, they had access to the app but no new coaching or materials—they were on their own to maintain what they’d learned. Researchers measured their weight, liver fat (using a special MRI scan), blood pressure, and blood sugar levels at the start, after 12 weeks, and again at 9 months.

The study design is called a ‘single-arm’ study, which means everyone got the same treatment (there was no comparison group getting a different treatment or placebo). This type of study is useful for checking if something works and is practical to use, but it’s not as strong as studies that compare two different treatments.

The researchers specifically looked at whether the improvements from the first 12 weeks stayed the same during the 6-month period with no coaching. This is important because many health programs work while people are being coached, but improvements disappear once the coaching stops.

This research matters because fatty liver disease is becoming very common, and many people struggle to stick with health programs long-term. If an app can help people make changes that last even after coaching ends, it could be a practical and affordable way to help many people. Most health programs require ongoing support, which is expensive and hard to maintain. This study suggests that once people learn the right habits through an app, they might be able to keep going on their own.

The study has some strengths: 82% of people who started finished the whole 9 months, which shows good participation. The researchers used objective measurements like MRI scans for liver fat and blood tests, not just what people reported. However, the study is relatively small (34 people) and didn’t have a comparison group, so we can’t be completely sure the app caused the improvements or how it compares to other programs. The study also didn’t track what people were actually doing during the 6-month maintenance period, so we don’t know exactly how they stayed on track.

What the Results Show

After 9 months, people in the study had lost an average of 4 kg (about 9 pounds), which was statistically significant. More importantly, their liver fat decreased by 2.5 percentage points, representing an 18% relative reduction—meaning their livers were noticeably less fatty. This improvement happened during the first 12 weeks and then stayed stable during the 6 months without coaching.

Blood pressure also improved significantly. Systolic pressure (the top number) dropped by 8.3 mm Hg on average, and diastolic pressure (the bottom number) dropped by 2.5 mm Hg. For context, these are meaningful improvements that doctors look for when treating high blood pressure. Waist circumference decreased by 4.7 cm (about 2 inches), suggesting people lost fat around their middle, which is particularly important for liver and heart health.

Blood sugar control improved too. HbA1c, which measures average blood sugar over 3 months, decreased by 19.5 mmol/mol. This is significant for people with type 2 diabetes or prediabetes. The key finding is that all these improvements were maintained during the 6-month follow-up period when people weren’t receiving new coaching, suggesting the habits people learned stuck with them.

The study also tracked how many people stayed engaged with the app during the maintenance phase (the 6 months without coaching). 82% of the original 34 people completed the full 9-month study, which is a high completion rate. This suggests the app was practical and people found it useful enough to keep using it. The researchers didn’t report detailed engagement metrics for the maintenance phase, but the fact that people stayed in the study and maintained their improvements suggests they were still using the app or had internalized the lessons.

The original 12-week Sidekick program had already shown it was feasible and produced improvements. This follow-up study extends that work by asking the crucial question: do improvements last? Previous research on lifestyle programs for fatty liver disease shows mixed results—some improvements fade when coaching stops. This study suggests that the Sidekick app’s approach may be different, possibly because it focuses on building sustainable habits rather than just short-term changes. However, direct comparisons to other apps or programs aren’t available in this study.

The main limitation is that this was a small study with only 34 people, so the results might not apply to everyone. There was no comparison group (like people using a different app or getting standard care), so we can’t say for certain that the app caused the improvements rather than other factors like increased awareness of health or seasonal changes. The study didn’t track exactly what people were doing during the maintenance phase, so we don’t know if they were still using the app regularly or had just learned the lessons well enough to continue on their own. The study also included mostly older adults (average age 63) with serious health conditions, so results might be different for younger people or those with milder fatty liver disease. Finally, the study was only 9 months long, so we don’t know if improvements continue beyond that timeframe.

The Bottom Line

If you have fatty liver disease, high blood pressure, or type 2 diabetes, a structured digital health program like Sidekick may help you lose weight, reduce liver fat, and improve blood pressure and blood sugar control. The evidence suggests these improvements can last at least 6 months after active coaching ends. However, this is based on a small study, so discuss with your doctor whether this app is right for you. Confidence level: Moderate—the results are promising but need confirmation in larger studies.

This research is most relevant for adults with fatty liver disease, especially those who also have obesity, high blood pressure, or type 2 diabetes. It may also interest people who prefer digital tools over in-person coaching. Healthcare providers managing these conditions should know about this option. However, people with severe liver disease, those unable to use smartphone apps, or those who need intensive medical supervision should talk to their doctor before relying on an app alone.

Based on this study, you can expect to see meaningful improvements in weight and liver fat within 12 weeks of consistent use. Blood pressure and blood sugar improvements also appear within this timeframe. The important finding is that these improvements appear to stick around for at least 6 months if you maintain the habits you’ve learned. However, individual results vary, and some people may see faster or slower changes.

Want to Apply This Research?

  • Track weekly weight, waist circumference (measured at the same spot each time), and blood pressure if you have a home monitor. These are the same measurements the study used and are easy to measure at home. Record them in your app weekly to see your progress over 12 weeks.
  • Start with the app’s lessons on one area at a time: first focus on diet changes for 2-3 weeks, then add a physical activity goal, then work on sleep or stress management. This gradual approach matches how the Sidekick program works and makes changes feel less overwhelming.
  • After completing the initial 12-week program, continue checking in with your app weekly or monthly to review your progress and refresh the lessons you learned. Set calendar reminders to measure weight and waist circumference monthly for the next 6 months to ensure improvements stick. If you notice backsliding, review the specific lessons related to that area.

This research describes a digital health program for managing fatty liver disease and related conditions, but it is not a substitute for medical care. If you have fatty liver disease, high blood pressure, type 2 diabetes, or other chronic health conditions, consult with your healthcare provider before starting any new program, including digital health apps. Your doctor can assess whether this approach is appropriate for your specific situation, monitor your progress, and adjust medications if needed. This study was small and had limitations; larger studies are needed to confirm these findings. Do not stop or change any medications without talking to your doctor first.