Patterns of success: Online self-monitoring in a web-based behavioral weight control program.

Abstract

Objectives Online weight control technologies could reduce barriers to treatment, including increased ease and convenience of self-monitoring. Self-monitoring consistently predicts outcomes in behavioral weight loss programs; however, little is known about patterns of self-monitoring associated with success. Methods The current study examines 161 participants (93% female; 31% African-American; mean BMI=35.7±5.7) randomized to a 6-month online behavioral weight control program which offered weekly group “chat” sessions and online self-monitoring. Self-monitoring log-ins were continuously monitored electronically during treatment and examined in association with weight change and demographics. Weekend and weekday log-ins were examined separately and length of periods of continuous self-monitoring were examined. Results We found that 91% of participants logged in to the self-monitoring webpage at least once. Over 6 months, these participants monitored on an average of 28% of weekdays and 17% of weekend days, with most log-ins earlier in the program. Women were less likely to log-in, and there were trends for greater self-monitoring by older participants. Race, education and marital status were not significant predictors of self-monitoring. Both weekday and weekend log-ins were significant independent predictors of weight loss. Patterns of consistent self-monitoring emerged early for participants who went on to achieve greater than a five percent weight loss. Conclusions Patterns of online self-monitoring were strongly associated with weight loss outcomes. These results suggest a specific focus on consistent self-monitoring early in a behavioral weight control program might be beneficial for achieving clinically significant weight losses.

Interest in a Twitter-delivered weight loss program among women of childbearing age

“…We found that a greater proportion of women were interested in reading about other women's progress via their tweets (83 %) than were interested in tweeting about their own progress (71 %). Despite evidence that engagement is strongly related to outcomes [35][36][37][38][39][40], waning use is common in web-based behavioral interventions [41]. More frequent engagement in an online social network for weight loss is associated with better outcomes [22].…”

Dietary Self-Monitoring in Weight Management: Current Evidence on Efficacy and Adherence

“…The adherence to self-monitoring declines over time and the decline appeared to start in the third to fifth week in several studies. 26,39,45,62 According to Burke and colleagues 26 and other researchers, 62,67,68 adherence to self-monitoring, regardless of the method used (PDA, PDAþfeedback, or paper record), is highest in the second week but steadily declines over time.…”

“…In a 6-month behavioral weight control program, participants consistently self-monitored (eg, periods of self-monitoring 6 days) were more likely to achieve clinically notable weight loss compared with inconsistent self-monitorers. 62 In another study, the individuals who were most consistent at self-monitoring (as represented by therapist rating of high) lost substantially more weight than the group that was least consistent at selfmonitoring (as represented by therapist rating of low). 23 …”

“…71 In another study, female participants were less likely to log in on weekdays and showed a trend for fewer log-ins on weekends compared with male participants. 62 In addition, some populations seem to face more challenges than others in terms of self-monitoring. These include individuals who previously tried and failed a weight loss program or those who have limited social support.…”

Cognitive-Behavioral Therapy: Current Paths in the Management of Obesity

“…Patients who join internet-based programs show greater levels of adherence to self-monitoring than participants of traditional treatments [20]. A study conducted by Krukowski et al [27] shows that participants who consistently self-monitor during program are more likely to achieve better results in weight loss within 6 months than others. It appears important to continue self-monitoring throughout a 6-month weight loss program.…”