scholarly journals Comparing Self-Monitoring Strategies for Weight Loss in a Smartphone App: Randomized Controlled Trial

10.2196/12209 ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. e12209 ◽  
Author(s):  
Michele L Patel ◽  
Christina M Hopkins ◽  
Taylor L Brooks ◽  
Gary G Bennett
2018 ◽  
Author(s):  
Michele L Patel ◽  
Christina M Hopkins ◽  
Taylor L Brooks ◽  
Gary G Bennett

BACKGROUND Self-monitoring of dietary intake is a valuable component of behavioral weight loss treatment; however, it declines quickly, thereby resulting in suboptimal treatment outcomes. OBJECTIVE This study aimed to examine a novel behavioral weight loss intervention that aims to attenuate the decline in dietary self-monitoring engagement. METHODS GoalTracker was an automated randomized controlled trial. Participants were adults with overweight or obesity (n=105; aged 21-65 years; body mass index, BMI, 25-45 kg/m2) and were randomized to a 12-week stand-alone weight loss intervention using the MyFitnessPal smartphone app for daily self-monitoring of either (1) both weight and diet, with weekly lessons, action plans, and feedback (Simultaneous); (2) weight through week 4, then added diet, with the same behavioral components (Sequential); or (3) only diet (App-Only). All groups received a goal to lose 5% of initial weight by 12 weeks, a tailored calorie goal, and automated in-app reminders. Participants were recruited via online and offline methods. Weight was collected in-person at baseline, 1 month, and 3 months using calibrated scales and via self-report at 6 months. We retrieved objective self-monitoring engagement data from MyFitnessPal using an application programming interface. Engagement was defined as the number of days per week in which tracking occurred, with diet entries counted if ≥800 kcal per day. Other assessment data were collected in-person via online self-report questionnaires. RESULTS At baseline, participants (84/100 female) had a mean age (SD) of 42.7 (11.7) years and a BMI of 31.9 (SD 4.5) kg/m2. One-third (33/100) were from racial or ethnic minority groups. During the trial, 5 participants became ineligible. Of the remaining 100 participants, 84% (84/100) and 76% (76/100) completed the 1-month and 3-month visits, respectively. In intent-to-treat analyses, there was no difference in weight change at 3 months between the Sequential arm (mean −2.7 kg, 95% CI −3.9 to −1.5) and either the App-Only arm (−2.4 kg, −3.7 to −1.2; P=.78) or the Simultaneous arm (−2.8 kg, −4.0 to −1.5; P=.72). The median number of days of self-monitoring diet per week was 1.9 (interquartile range [IQR] 0.3-5.5) in Sequential (once began), 5.3 (IQR 1.8-6.7) in Simultaneous, and 2.9 (IQR 1.2-5.2) in App-Only. Weight was tracked 4.8 (IQR 1.9-6.3) days per week in Sequential and 5.1 (IQR 1.8-6.3) days per week in Simultaneous. Engagement in neither diet nor weight tracking differed between arms. CONCLUSIONS Regardless of the order in which diet is tracked, using tailored goals and a commercial mobile app can produce clinically significant weight loss. Stand-alone digital health treatments may be a viable option for those looking for a lower intensity approach. CLINICALTRIAL ClinicalTrials.gov NCT03254953; https://clinicaltrials.gov/ct2/show/NCT03254953 (Archived by WebCite at http://www.webcitation.org/72PyQrFjn).


Obesity ◽  
2017 ◽  
Vol 25 (9) ◽  
pp. 1490-1498 ◽  
Author(s):  
Michelle R. Jospe ◽  
Melyssa Roy ◽  
Rachel C. Brown ◽  
Sheila M. Williams ◽  
Hamish R. Osborne ◽  
...  

2017 ◽  
Vol 24 (4) ◽  
pp. 232-239 ◽  
Author(s):  
Dieter Melchart ◽  
Erich Wühr ◽  
Wolfgang Weidenhammer

Background/Objectives: Unhealthy lifestyle is often related to overweight and obesity and thus to chronic diseases. Web-based programs might be an option for a comprehensive approach to improving long-term weight management. Data from a randomized controlled trial (RCT) evaluating the impact of a lifestyle program on weight reduction were used for a secondary analysis. The objectives were (a) to identify potential predictors for marked weight loss, (b) to explore associations of weight reduction with changes in health-related variables, and (c) to evaluate whether self-monitoring of the daily lifestyle is associated with weight loss. Methods: 67 subjects with a body mass index of 28-35 who underwent the 1-year ‘Individual Health Management' (IHM) program were included in the analysis (mean age 49.8 years, 79% female). Two subgroups (high response: ≥7.5% weight reduction vs. low response: <7.5%) were compared in terms of sociodemographic data, baseline values, and pre-post changes of various risk and protective factors. A logistic regression was performed to identify potential predictors of weight loss. Results: 70% of the subjects fulfilled the criterion of high response. There were no statistically significant differences between the two subgroups with respect to sociodemographic and baseline data. Regression analysis failed to identify any predictors for the amount of weight reduction. Subjects with high response showed a more distinct improvement in life satisfaction and neurovegetative stability. The findings indicated an association between the level of self-monitoring and weight loss. Conclusions: More research is needed to establish optimal strategies for maximizing the longer-term maintenance of weight loss and prevention effects. For weight reduction, support strategies like feedback learning through self-monitoring, reporting systems, and self-performance measurement with questionnaires might ameliorate high-intensity lifestyle modification programs.


10.2196/16780 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e16780
Author(s):  
Victoria Whitelock ◽  
Inge Kersbergen ◽  
Suzanne Higgs ◽  
Paul Aveyard ◽  
Jason CG Halford ◽  
...  

Background Short-term laboratory studies suggest that eating attentively can reduce food intake. However, in a recent randomized controlled trial we found no evidence that using an attentive eating smartphone app outside of the laboratory had an effect on energy intake or weight loss over 8 weeks. Objective This research examined trial participants’ experiences of using an attentive eating smartphone app and whether app usage was associated with energy intake and weight loss outcomes over 8 weeks. Methods We conducted thematic analysis of semistructured interviews (N=38) among participants in the attentive eating smartphone app group of the trial who completed the 8-week assessment. Linear regression models examined the associations between energy intake and weight loss outcomes at 8 weeks and app usage. Results Participants reported several barriers and facilitators to using the smartphone app, including repetition of app content, social setting, motivation, and habitual use of the app. Participants believed that using the app had some beneficial effects on their eating behavior and diet. Exploratory analyses indicated that more frequent recording of eating episodes in the app was associated with lower body weight (B=–0.02, P=.004) and greater self-reported energy intake (B=5.98, P=.01) at 8 weeks, but not body fat percentage or taste-test energy intake. Total audio clip plays, gallery views, and percentage of food entries recorded using an image were not significantly associated with energy intake or weight. Conclusions Frequent recording of eating episodes in a smartphone app was associated with greater weight loss. There are barriers and facilitators to frequent use of an attentive eating smartphone app that may be useful to address when designing dietary behavior change smartphone apps. Trial Registration ClinicalTrials.gov NCT03602001; https://clinicaltrials.gov/ct2/show/NCT03602001; Open Science Framework DOI 10.17605/osf.io/btzhw; https://osf.io/btzhw/


2019 ◽  
Author(s):  
Jeong Sun Ahn ◽  
Heejin Lee ◽  
Jiae Kim ◽  
Haemin Park ◽  
Dong Woo Kim ◽  
...  

BACKGROUND Mobile health (mHealth) tools may be useful platforms for dietary monitoring and assessment. OBJECTIVE This study aims to evaluate the effectiveness of a mobile dietary self-monitoring app for weight loss versus a paper-based diary among adults with a BMI of 23 kg/m<sup>2</sup> or above. METHODS A total of 33 men and 17 women aged 18-39 years participated in a 6-week randomized controlled trial. We randomly assigned participants to one of two groups: (1) a smartphone app group (n=25) or (2) a paper-based diary group (n=25). The smartphone app group recorded foods and dietary supplements that they consumed and received immediate dietary feedback using Well-D, a dietary self-monitoring app developed by our team. The paper-based diary group was instructed to record foods or supplements that they consumed using a self-recorded diary. The primary outcomes were weight, BMI, waist circumference, body fat mass, and skeletal muscle mass. We also examined changes in nutrient intake, including energy, carbohydrate, protein, fat, dietary fiber, vitamins, and minerals, using 3-day 24-hour recalls. Differences in changes between the two groups were analyzed using independent t tests or Wilcoxon Mann-Whitney tests. All of the data were analyzed using intent-to-treat analysis. RESULTS The mean number of days recorded was 18.5 (SD 14.1) for the app group and 15.5 (SD 10.1) for the paper-based diary group. The differences in changes in weight, BMI, and waist circumference were not significantly different between the app group and paper-based diary group (<i>P</i>=.33, .34, and .70, respectively). Similarly, changes in body fat mass or skeletal muscle mass did not differ between the two groups (<i>P</i>=.71 and .054, respectively). Although energy intake was reduced in both groups, there was no significant difference in changes in energy intake between the two groups (<i>P</i>=.98). CONCLUSIONS There were no differences in changes in anthropometric measures and nutrient intake between the app group and the paper-based diary group. Both mobile dietary self-monitoring app and paper-based diary may be useful for improving anthropometric measures. CLINICALTRIAL Clinical Research Information Service KCT0003170; https://cris.nih.go.kr/cris/search/search_result_st01_en.jsp?seq=11642&amp;ltype=&amp;rtype=


2019 ◽  
Author(s):  
Victoria Whitelock ◽  
Inge Kersbergen ◽  
Suzanne Higgs ◽  
Paul Aveyard ◽  
Jason CG Halford ◽  
...  

BACKGROUND Short-term laboratory studies suggest that eating attentively can reduce food intake. However, in a recent randomized controlled trial we found no evidence that using an attentive eating smartphone app outside of the laboratory had an effect on energy intake or weight loss over 8 weeks. OBJECTIVE This research examined trial participants’ experiences of using an attentive eating smartphone app and whether app usage was associated with energy intake and weight loss outcomes over 8 weeks. METHODS We conducted thematic analysis of semistructured interviews (N=38) among participants in the attentive eating smartphone app group of the trial who completed the 8-week assessment. Linear regression models examined the associations between energy intake and weight loss outcomes at 8 weeks and app usage. RESULTS Participants reported several barriers and facilitators to using the smartphone app, including repetition of app content, social setting, motivation, and habitual use of the app. Participants believed that using the app had some beneficial effects on their eating behavior and diet. Exploratory analyses indicated that more frequent recording of eating episodes in the app was associated with lower body weight (<i>B</i>=–0.02, <i>P</i>=.004) and greater self-reported energy intake (<i>B</i>=5.98, <i>P</i>=.01) at 8 weeks, but not body fat percentage or taste-test energy intake. Total audio clip plays, gallery views, and percentage of food entries recorded using an image were not significantly associated with energy intake or weight. CONCLUSIONS Frequent recording of eating episodes in a smartphone app was associated with greater weight loss. There are barriers and facilitators to frequent use of an attentive eating smartphone app that may be useful to address when designing dietary behavior change smartphone apps. CLINICALTRIAL ClinicalTrials.gov NCT03602001; https://clinicaltrials.gov/ct2/show/NCT03602001; Open Science Framework DOI 10.17605/osf.io/btzhw; https://osf.io/btzhw/


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