Abstract
Background: The escalating prevalence of obesity underscores the urgent need for effective and scalable interventions. Global Positioning System (GPS)-enabled technologies have emerged as promising strategies to promote physical activity (PA) and address obesity. However, the comparative effectiveness of GPS-enabled PA interventions integrated with dietary components versus PA interventions alone remained unclear. This study aimed to systematically evaluate and compare the effectiveness of GPS-enabled PA interventions, with or without dietary strategies, in improving obesity-related outcomes among adults. Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Randomized controlled trials (RCTs) published between January 2000 and April 2025 were retrieved from five databases. Eligible studies included GPS-enabled PA interventions targeting adults (≥18 years old), and reported at least one primary obesity-related outcome. Meta-analyses were performed using random- or fixed-effects models, depending on heterogeneity levels, and subgroup analyses explored effect modifiers. Results: Nine studies (involving 1363 participants, 424 males and 939 females, aged from 34.5-64.8) were included. GPS-enabled PA interventions significantly reduced body weight (Hedges' g = -0.241, 95% CI: -0.356 to -0.127, I(2) = 6.5%, Q = 7.49, p = 0.380) and body fat percentage (BFP) (Hedges' g = -0.412, 95% CI: -0.804 to -0.020, I(2) = 76.0%, Q = 16.66, p = 0.002). Subgroup analyses revealed that interventions involving PA alone produced a moderate effect on weight reduction (Hedges' g = -0.328; 95% CI: -0.616 to -0.039), whereas those combining PA with dietary strategies showed a slightly smaller yet significant effect (Hedges' g = -0.208; 95% CI: -0.372 to -0.044). Short-term interventions (≤3 months) demonstrated greater effects on weight reduction. Sensitivity and bias assessments supported the robustness of short-term outcomes. Conclusions: GPS-enabled PA interventions were effective for promoting short-term reductions in body weight and BFP. Notably, the addition of dietary components did not consistently provide greater benefits compared to PA interventions alone. These findings highlight the utility of geospatial technology in enhancing behavioral interventions and support the development of scalable digital health strategies aligned with public health priorities such as "Healthy China 2030".