COBRA: Multimodal Sensing Deep Learning Framework for Remote Chronic Obesity Management via Wrist-Worn Activity Monitoring

Chronic obesity management requires continuous monitoring of energy balance behaviors, yet traditional self-reported methods suffer from significant underreporting and recall bias, and difficulty in integration with modern digital health systems. This study presents COBRA (Chronic Obesity Behavioral Recognition Architecture), a novel deep learning framework for objective behavioral monitoring using wrist-worn multimodal sensors. COBRA integrates a hybrid D-Net architecture combining U-Net spatial modeling, multi-head self-attention mechanisms, and BiLSTM temporal processing to classify daily activities into four obesity-relevant categories: Food Intake, Physical Activity, Sedentary Behavior, and Daily Living. Validated on the WISDM-Smart dataset with 51 subjects performing 18 activities, COBRA's optimal prepro-cessing strategy combines spectral-temporal feature extraction, achieving high performance across multiple architectures. D-Net demonstrates 96.86% overall accuracy with category-specific F1-scores of 98.55% (Physical Activity), 95.53% (Food Intake), 94.63% (Sedentary Behavior), and 98.68% (Daily Living), outperforming state-of-the-art baselines by 1.18% in accuracy. The framework shows robust generalizability with low demographic variance ( < 3%), enabling scalable deployment for personalized obesity interventions and continuous lifestyle monitoring.