Abstract

Background: Approximately 70% of the U.S. adult population has obesity and/or overweight and thus increased risk for heart disease, stroke, and type II diabetes mellitus. Standard obesity treatment includes a behavior modification technique, dietary self-monitoring, which entails recording all foods and beverages consumed with calorie amounts and time of consumption. Greater adherence to dietary self-monitoring using a paper diary is associated with weight loss. Self-monitoring via a mobile phone application (app) is an appealing, convenient alternative to paper-based techniques; however, few studies have examined the relationship between adherence to a dietary self-monitoring app and weight loss. Objectives: The objectives of the study were to 1) examine if there is an association between app-based dietary self-monitoring and weight change and 2) explore the relationships between the frequency, consistency, and completeness of app-based dietary self-monitoring and weight change at 8 weeks among adults with overweight or obesity. Frequency was the percentage of days that any self-monitoring occurred during the study; consistency was the recording of any dietary intake on > 3 days each week; completeness was the recording of 50% or more of the weekly individual calorie goal. Methods: Ninety participants interested in weight loss were recruited to self-monitor dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned a daily calorie goal to achieve a one-pound weight loss per week. Paired sample t-test and linear regression were used to examine the relationships between app-based self-monitoring and weight change as well as the frequency, consistency and completeness of self-monitoring and weight change at 8 weeks. Results: The sample [N = 90, mean ( M ) age = 42 ± 10 years (SD)] was employed (100%), primarily female (96.7%), White (90%), and married (63.3%) with a Bachelor’s or Associate’s degree (60%). Paired-sample t test revealed a significant mean difference [ t (89) = 6.59, p < .001] between baseline and 8-week weight in pounds ( M = -3.26 ± 4.70). Linear regression analysis revealed an association [ F (1, 88) = 7.18, p = .009] between total weeks of consistently self-monitoring ( M = 4.44 ± 2.77) and percent weight loss ( M = -1.54 ± 2.26) as well as an association ( F (1, 88) = 6.42, p = .013] between the frequency of self-monitoring ( M = 50.14 ± 33.0) and percent weight loss. Completeness of self-monitoring was not associated with percent weight loss. Conclusion: Results suggest that consistent ( > 3 days/week) and frequent ( > 50% of days) app-based self-monitoring aids weight loss. Clinicians may wish to emphasize frequent and consistent self-monitoring, rather than complete self-monitoring, when providing weight loss counseling. Future research should examine app-based self-monitoring in men as well as ethnically and racially diverse populations. .

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