Objective: To systematically assess contemporary knowledge regarding behavioral physical activity interventions including an activity monitor (BPAI1) in adults with overweight or obesity. Methods: PubMed/MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, and PEDro were searched for eligible full-text articles up to 1 July 2015. Studies eligible for inclusion were (randomized) controlled trials describing physical activity outcomes in adults with overweight or obesity. Methodological quality was independently assessed employing the Cochrane Collaboration's tool for risk of bias. Results: Fourteen studies (1,157 participants) were included for systematic review and 11 for metaanalysis. A positive trend in BPAI1 effects on several measures of physical activity was ascertained compared with both wait list or usual care and behavioral physical activity interventions without an activity monitor (BPAI2). No convincing evidence of BPAI1 effectiveness on weight loss was found compared with BPAI2. Conclusions: Behavioral physical activity interventions with an activity monitor increase physical activity in adults with overweight or obesity. Also, adding an activity monitor to behavioral physical activity interventions appears to increase the effect on physical activity, although current evidence has not yet provided conclusive evidence for its effectiveness. Obesity (2016Obesity ( ) 24, 2078Obesity ( -2091Obesity ( . doi:10.1002 Introduction Worldwide, 1.46 billion adults were overweight and 502 million had obesity in 2008 (1). The global rising prevalence of these conditions is expected to further increase both the health and economic burdens in the following decades (2). Overweight and obesity are frequently caused by a chronic imbalance involving dietary and physical activity patterns (3). Behavioral interventions involving alterations in both physical activity and diet can lead to clinically important weight loss (5% of baseline weight) in adults with overweight or obesity (4). Physical activity should be facilitated in intervention programs to enhance the likelihood of not only successful weight loss and weight maintenance but also for health benefits regardless of weight loss (5). A recent systematic review concluded that physical activity was included in 88% of studies that achieved clinically important weight loss, whereby behavioral training (such as self-monitoring) was included in 92% of these studies (6).Over the previous decades, there has been increasing interest in the therapeutic application of objective measures of self-monitoring. One of the first objective measuring instruments for physical activity was introduced in 1965 with the release of the Japanese manpo-kei pedometer, meaning ''10,000 steps meter'' (7). Currently, devices such as triaxial accelerometers, gyroscopes, and global positioning systems are combined to create activity monitors that are more accurate (8,9) and even integrate behavior change techniques (BCTs) such as social support, prompts/cues, rewards, and behavioral outcome self-monitoring (...

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