Effect of tailored, daily feedback with lifestyle self‐monitoring on weight loss: The SMARTER randomized clinical trial

Abstract

Objective This study aimed to test the efficacy of self‐monitoring and feedback (SM+FB) versus SM without FB (SM) in a behavioral weight‐loss intervention at 6 months. Methods This was a randomized clinical trial. Eligibility criteria included the following: ≥18 years of age, BMI ≥ 27 and ≤43, smartphone user, and ability to engage in moderate physical activity. All participants received a 90‐minute 1:1 counseling session, a Fitbit Charge 2, and a digital scale for SM. SM+FB participants were provided access to a customized smartphone application that provided three daily FB messages. The primary outcome was percentage of weight change from 0 to 6 months. Results The sample (N = 502) was 45 (SD 14.4) years old, BMI was 33.7 (SD 4.00) kg/m2, 79.5% of participants were female (n = 399), and 84.3% were White (n = 423). At 6 months, there was 85.86% retention and a significant percentage of weight change in both groups (SM+FB: −3.16%, 95% CI: −3.85% to −2.47%, p < 0.0001; SM: −3.20%, 95% CI: −3.86% to −2.54%, p < 0.0001) but no significant between‐group mean difference (−0.04%, 95% CI: −0.99% to 0.91%, p = 0.940). A ≥5% weight loss was achieved by 31.9% of the SM+FB group and 28.3% of the SM group. Conclusions There was no significant between‐group difference in weight loss at 6 months.

The Effect of Tailored, Daily, Smartphone Feedback to Lifestyle Self-Monitoring on Weight Loss at 12 Months: the SMARTER Randomized Clinical Trial

“…Most participants were White (414/502, 82.5%), female (399/502, 79.5%) and on average 45.0 (SD 14.4) years old. Sociodemographic, clinical, and psychosocial characteristics, as well as primary outcome measurements at baseline, were similar between the treatment groups [ 37 ].…”

“…If the FB message was not opened within 1 hour of being sent, the SMARTER icon prompt and message disappeared; if the message was opened, the participant could save it for future review. More details on the FB messages and study infrastructure for message delivery are available elsewhere [ 23 , 37 ].…”

“…Continuous variables are summarized as mean and SD, and descriptive statistics for categorical variables are reported as counts with percentages. Appropriate group comparative analyses were performed on participant descriptors and outcome variables at baseline by randomized treatment assignment [ 37 ]. The effect of treatment assignment on percent weight change over 12 months was examined using linear mixed modeling following intention to treat.…”

“…SMARTER was a 2-group randomized controlled trial that enrolled 502 adults with random assignment to either (1) SM alone (n=251) or (2) SM+FB (n=251) and examined the efficacy of the approaches. We examined short-term outcomes at 6 months with 86% retention that demonstrated that both groups lost a significant percent weight from baseline (SM+FB: –3.16%, P <.001; SM: –3.20%, P <.001) but found no significant between-group difference ( P =.94) [ 37 ]. We hypothesized that the SM+FB group would show greater percent weight loss at 12 months compared to the SM group.…”

Effectiveness of Combined Health Coaching and Self-Monitoring Apps on Weight-Related Outcomes in People With Overweight and Obesity: Systematic Review and Meta-analysis

“…The included studies represent 2478 participants with a mean age of 39.1 years and a mean BMI of 31.8 kg/m 2 . Most of the included articles were from the United States (10/14, 71.4%) [20][21][22][23][24][25][26][27][28][29], and one each from Australia (1/14, 7.1%) [30], Belgium (1/14, 7.1%) [31], Korea (1/14, 7.1%) [32], and Japan (1/14, 7.1%) [33]. Half of the articles (7/14, 50%) reported the use of theoretical frameworks including sociocognitive theory [21,25,28], control theory [25,30], transtheoretical model [30,33], learning theory [23], operant conditioning, ecological theory, social network theory [25], cognitive behavioral therapy [32], and self-efficacy theory [28].…”