Self-Monitoring Works for Weight Loss

Key Takeaways

• Systematic review provides extensive evidence that self-monitoring via digital platforms is associated with superior weight loss
• More frequent self-monitoring is linked to greater weight loss
• Engagement rates are higher using digital rather than paper-based tools

A systematic review of multiple randomized controlled studies among adults with overweight or obesity showed that greater engagement in self-monitoring using digital health tools was associated with significant weight loss.

This is the first comprehensive systematic review to examine the relationship between digital self-monitoring and weight loss.

What is Self-Monitoring?

Self-monitoring is essentially the monitoring of one’s own behaviour.

In a weight loss context, it includes the monitoring of behaviour connected to body weight – the main ones being:

• Self- weighing
• Recording calories/foods eaten
• Logging exercise

Through regular self-monitoring we gain increased awareness of our weight, eating and exercise behaviours. Tracking over time enables us to compare progress with our goals.

This process of gathering data and tracking progress enables us to identify behaviours to change to bring us closer to our goals.

The Study

"What this paper sought out to explore was whether tracking via these digital tools is effective at producing greater weight loss." said Michele L. Patel PhD, research fellow at Stanford University School of Medicine and corresponding author of the study.

Among the 67 interventions with digital self-monitoring included in the study:

• Weight was tracked in 72%
• Diet in 81%
• Physical activity in 82%

Websites were the most common self-monitoring technology tools followed by apps, wearables, electronic scales and text messaging.

Results

Digital self-monitoring was linked to weight loss in 74 percent of occurrences.

This pattern was found across all three major behaviours that are tracked (dietary intake, physical activity and body weight).

More frequent self-monitoring was linked to greater weight loss.

Few interventions had digital self-monitoring engagement rates greater than 75 percent of days. Rates were higher in digital tools than in paper-based journals in 21 out of 34 comparisons.

"This may be because many digital tools are highly portable, and therefore allow the user to track any time of the day; digital tools also may make tracking quicker, and may be less burdensome to use," said Patel.

The researchers were surprised to find that pairing digital self-monitoring with counselling did not seem to improve engagement.

Passive VS Active Self-Monitoring

Passive forms of self-monitoring, such as wearing a device to track physical activity, or self-weighing on an e-scale that automatically records results, resulted in higher engagement than manually entering data into an app.

However, only manually entering data into a website/app was associated with weight loss.

The authors say it is possible that manually entering self-monitoring data into a device promotes greater awareness of one’s current behaviour than does passive self-monitoring.

Study Authors’ Conclusion

In summary, more frequent self-monitoring via digital health is linked to greater weight loss in behavioural interventions. This association held regardless of which domains were self-monitored or which digital modalities used.

Engagement rates were higher in digital than in paper-based self-monitoring: no noticeable trend was detected when comparing these rates in counselling-based versus standalone interventions.

Reference

Patel, M.L., Wakayama, L.N. and Bennett, G.G. (2021), Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity. Obesity, 29: 478-499. https://doi.org/10.1002/oby.23088