What Matters in Weight Loss? An In-Depth Analysis of Self-Monitoring

Abstract

BackgroundUsing technology to self-monitor body weight, dietary intake, and physical activity is a common practice used by consumers and health companies to increase awareness of current and desired behaviors in weight loss. Understanding how to best use the information gathered by these relatively new methods needs to be further explored.ObjectiveThe purpose of this study was to analyze the contribution of self-monitoring to weight loss in participants in a 6-month commercial weight-loss intervention administered by Retrofit and to specifically identify the significant contributors to weight loss that are associated with behavior and outcomes.MethodsA retrospective analysis was performed using 2113 participants enrolled from 2011 to 2015 in a Retrofit weight-loss program. Participants were males and females aged 18 years or older with a starting body mass index of ≥25 kg/m2, who also provided a weight measurement at the sixth month of the program. Multiple regression analysis was performed using all measures of self-monitoring behaviors involving weight measurements, dietary intake, and physical activity to predict weight loss at 6 months. Each significant predictor was analyzed in depth to reveal the impact on outcome.ResultsParticipants in the Retrofit Program lost a mean –5.58% (SE 0.12) of their baseline weight with 51.87% (1096/2113) of participants losing at least 5% of their baseline weight. Multiple regression model (R2=.197, P<0.001) identified the following measures as significant predictors of weight loss at 6 months: number of weigh-ins per week (P<.001), number of steps per day (P=.02), highly active minutes per week (P<.001), number of food log days per week (P<.001), and the percentage of weeks with five or more food logs (P<.001). Weighing in at least three times per week, having a minimum of 60 highly active minutes per week, food logging at least three days per week, and having 64% (16.6/26) or more weeks with at least five food logs were associated with clinically significant weight loss for both male and female participants.ConclusionsThe self-monitoring behaviors of self-weigh-in, daily steps, high-intensity activity, and persistent food logging were significant predictors of weight loss during a 6-month intervention.

Expert Coaching in Weight Loss: Retrospective Analysis

“…Food log feedback is directly dependent upon the participant’s engagement in providing food logs for an expert coach to review. Females received a greater amount of feedback due to logging a higher number of food logs than males, which has been reported in earlier studies [ 20 ]. However, this finding is linked to the understanding that personalized feedback increases engagement and weight loss outcomes [ 22 - 24 ].…”

“…Although consistent self-monitoring is shown to have a predictive value for weight loss, the challenge is maintaining consistency among participants [ 20 ]. Findings support previous studies that personalized feedback and communication from expert coaches can produce greater engagement in self-monitoring activities when compared with tech-based interventions for self-monitoring without expert feedback [ 23 , 28 , 29 ].…”

“…Self-monitoring is important in achieving greater weight loss [ 20 ]. Coach-provided individualized feedback around self-monitoring increases consistency in both men and women [ 20 ].…”

“…Self-monitoring is important in achieving greater weight loss [ 20 ]. Coach-provided individualized feedback around self-monitoring increases consistency in both men and women [ 20 ]. Personalization proves to be more effective than automated emails providing general health information or tips specifically around nutrition and behavior [ 21 - 24 ].…”

Efficacy of Web-Based Weight Loss Maintenance Programs: A Randomized Controlled Trial Comparing Standard Features Versus the Addition of Enhanced Personalized Feedback over 12 Months

“…Few studies have evaluated the use of eHealth technologies (e.g., websites, smartphone applications, text messages) to deliver WLM interventions. Furthermore, most research in this area has looked at short-term interventions (<6 months) without longer-term follow-up [ 8 , 9 ]. The small number of longer-term studies have reported a gradual regain of weight lost following treatment, with regain occurring after the first six months [ 10 , 11 ].…”