Weight loss and frequency of body‐weight self‐monitoring in an online commercial weight management program with and without a cellular‐connected ‘smart’ scale: a randomized pilot study

Abstract

SummaryObjectiveEvaluate the effects of an online commercial weight management program, with and without provision of a ‘smart’ scale with instructions to weigh daily and weekly tailored feedback, on weight loss and the frequency of body‐weight self‐monitoring.MethodsParticipants (N = 92; body mass index 27–40 kg/m2) were randomized to 6 months of no‐cost access to the Weight Watchers Online (WWO) platform alone, or enhanced with a cellular‐connected ‘smart’ scale, instructions to weigh daily and weekly pre‐scripted email feedback (Weight Watchers Online Enhanced [WWO‐E]). The number of days that weight was self‐monitored (via ‘smart’ scale in WWO‐E and manually in WWO) was recorded automatically across the 6‐month trial. Objective weight was measured at baseline, 3 and 6 months.ResultsWhile both groups achieved statistically significant weight loss, mean ± standard error weight loss did not differ between WWO‐E and WWO at 3 months (5.1 ± 0.6 kg vs. 4.0 ± 0.7 kg, respectively; p = 0.257) or 6 months (5.3 ± 0.6 kg vs. 3.9 ± 0.7 kg, respectively; p = 0.116). However, a greater proportion of WWO‐E lost ≥5% of initial body weight at 3 months (52.2% vs. 28.3%; p = 0.033), but not 6 months (43.5% vs. 30.4%; p = 0.280), compared with WWO. Mean ± standard deviation days with self‐monitored weight was higher in WWO‐E (80.5 ± 5.6; 44.7% of days) than WWO (12.0 ± 1.0; 6.7% of days; p < 0.001) across the 6‐month study period.ConclusionsThis is the first study to show that provision of a ‘smart’ scale with weekly tailored feedback substantially increased the frequency of self‐weighing and the proportion of participants achieving an initial clinically significant ≥5% weight loss (52% vs. 28%) in an online commercial weight management program. Both WWO and WWO‐E produced significant weight loss over 6 months. While mean weight losses were slightly greater in the enhanced group, the difference was not statistically significant in this small sample. This study provides support for the clinical utility of online commercial weight management programs and the potential for supporting technology such as ‘smart’ scales to improve adherence to body‐weight self‐monitoring and clinical outcomes.

Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity

“…We identified 4,248 records in our database and hand searches. After the deduplication and screening stages, 53 papers describing 39 unique RCTs met all inclusion criteria (32‐84).…”

“…Eight studies assessed weight outcomes at follow‐up visits ranging from 3 to 12 months after the end of the intervention (46,50,57,59,62,73,74,77). Of the 39 trials, 20 trials had two treatment arms (34,41,42,45,46,53,57,60,70,74,76‐78,80‐84), 15 trials had three arms (35,40,44,49,50,52,54,55,59,62,66,69,73,79), 3 trials had four arms (32,33,71), and 1 trial had five arms (48). In total, there were 67 arms with digital self‐monitoring.…”

“…Supporting Information Table S2 describes the results of the risk of bias assessment. Thirty‐three trials were low risk (33‐35,40,41,44‐50,52‐57,59,60,62,69‐71,73,76‐82,84), and six trials were medium risk (32,42,66,68,74,83). No trials presented a high risk of bias.…”

Examination of a partial dietary self‐monitoring approach for behavioral weight management

“…Participants in the DPP ( n = 1079) lost an average of 7% of their body weight, about 4–5 kg, which was associated with a 58% reduction in risk of developing type 2 diabetes. Four other 6‐month evaluations of previous WW programmes demonstrate weight losses in a similar range 9,30–32 . While aspects of the programmes studied varied (e.g., face‐to‐face and digital), they provided more traditional recommendations to self‐monitor all foods and beverages.…”

A digital health weight-loss intervention in severe obesity

“…[13][14][15] Routine weighing with the use of wireless scales has also been shown to help people achieve clinically significant weight loss through behavior change. 16,17 Unfortunately, there is a paucity of information on digital health weight-loss interventions specifically in the severely obese individuals, who are at highest risk of obesity-related complications.…”