A new study has found that self-monitoring by using digital health tools is associated with weight loss. The findings of the study were published in Obesity, The Obesity Society's flagship journal.
A systematic review of multiple randomised controlled studies among adults who are overweight or are struggling with 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.
"Digital health tools have flourished in the past decade," said Michele L. Patel, PhD, post-doctoral research fellow, Stanford Prevention Research Center, Stanford University School of Medicine in Stanford, California.
"What this paper sought out to explore was whether tracking via these digital tools is effective at producing greater weight loss," added Patel, who is the corresponding author of the study.
Given the widespread prevalence of obesity with rates of 42 per cent among US adults and 13 per cent worldwide, treatment options that have high efficacy, acceptability, and reach are needed. Interventions that leverage technology, including SMS, apps, wearables, and websites often produced weight loss similar to or less than that of in-person interventions. However, those earlier studies did not focus on self-monitoring. The current research addresses this gap and contributes to the science of engagement in behavioral interventions.
Conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the review included 39 randomised controlled studies of behavioural weight loss interventions for adults with overweight or obesity using digital health technologies for self-monitoring.
Six databases--PubMed, EMBASE, Scopus, PsycInfo, CINAHL, and ProQuest Dissertations and Theses--were searched for studies that included interventions 12 weeks or longer in duration, weight outcomes for six months or longer, and outcomes on self-monitoring engagement and their relationship to weight loss. The studies were published between January 2009 and September 2019.
Among the 67 interventions with digital self-monitoring, weight was tracked in 72 per cent of them, diet in 81 per cent, and physical activity in 82 per cent. Websites were the most common self-monitoring technology tools followed by apps, wearables, electronic scales, and text messaging. No studies used social media platforms for self-monitoring.
Digital self-monitoring was linked to weight loss in 74 per cent of occurrences. This pattern was found across all three major behaviors that are tracked (dietary intake, physical activity, and body weight). Few interventions had digital self-monitoring engagement rates greater than 75 per cent 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.
"Given that previous reviews conducted before the emergence of these newer tools have established that self-monitoring also plays a key role in the maintenance of weight loss (i.e., preventing weight regain), a critical next step for our field is to examine how we can help sustain engagement with these tools longer term after the initial novelty wears off," said Assistant Professor Kathryn M. Ross, PhD, MPH, Department of Clinical and Health Psychology, University of Florida, Gainesville. Ross was not associated with the research.