- A recent review finds that self-monitoring of diet, exercise levels, and weight using digital health tools could be helpful, in the short term, for people with obesity who are trying to lose weight.
- The participants most commonly used websites used to track weight loss interventions. However, there was higher engagement among people using passive technology, such as wearable devices and e-scales.
- Tracking weight loss interventions over short periods of time seems to be more effective than tracking them long term. This is due to reductions in engagement with recording over time.
While the world grapples with the COVID-19 pandemic, the ongoing obesity epidemic takes at least 2.8 million lives each year. The Centers for Disease Control and Prevention (CDC) report that the prevalence of obesity increased from 30.5% in 1999–2000 to 42.4% in 2017–2018.
People who have overweight or obesity can reduce their overall mortality risk by losing weight. Weight loss also lowers the risk of cancer, metabolic syndrome, and other conditions. A 2018 CDC report found that in 2013–2016, 66.7% of adults with obesity attempted to lose weight.
Difficulty losing weight
Various psychological and biological factors influence weight loss.
A 2019 study in the journal BMC Public Health suggests that people with obesity were more successful in losing weight when they reported being personally motivated to lose weight after receiving a diagnosis of obesity and when their doctors acknowledged their past efforts to lose weight.
Managing realistic expectations is also necessary for losing weight. According to one 2018 study, realistic goals of 5–10% weight loss differed from a person’s ideal weight. The authors suggest that people with severe and morbid obesity were at higher risk of creating these unrealistic goals of over 10% weight loss.
There are also biological reasons behind not losing weight. A study covered by Medical News Today in 2017 suggests that faulty signals in the brain could promote obesity by reducing the amount of fat burned after eating.
Mental health concerns may also worsen attempts at losing weight. A 2018 study suggests that stress decreased motivation to exercise and increased cravings and overall weight gain. A small study, also from 2018, suggests that managing stress levels helped with weight loss and decreased the participants’ body mass index (BMI).
Although losing weight can be difficult, it is not impossible. In a recent paper, researchers showcase evidence suggesting that digital technologies are effective in managing weight loss.
The review appears in the journal Obesity, which is the Obesity Society’s flagship journal. Michele L. Patel, Ph.D. — from the Stanford Prevention Research Center at the Stanford University School of Medicine in California — is the first and corresponding author of the review.
Digital self-monitoring
The authors of the new research reviewed past data from 39 trials that used digital self-monitoring over 12 or more weeks of weight loss interventions in people with obesity or overweight.
The participants used the following digital health technologies to manage weight loss:
- websites: 66%
- apps: 33%
- wearable devices: 16%
- e-scales: 12%
- SMS texts: 12%
- personal digital assistants: 3%
- interactive voice response technology: 3%
In total, the team observed 67 different permutations of digital self-monitoring in the studies. Weight was tracked in 48 (72%) of these.
Overall, 74% of interventions, including digital self-monitoring, were positively correlated with weight loss. Association with weight loss did not vary much between the type of self-monitoring, such as diet, exercise, weight, or a combination of these.
Success waned over time, however. People who participated in self-monitoring during short weight loss interventions (under 12 months) had 84% success, compared with those following longer-term weight loss interventions (over 12 months), who had 47% success in weight loss.
The findings indicate modest engagement with daily digital health technology tracking. Self-monitoring on half of all days or more was achieved 58% of the time, while this fell to just 9% for achieving self-monitoring on 3 out of 4 days (75%).
“Longer intervention duration tempered this relationship, however, suggesting that self-monitoring may be less effective for weight loss over time either because engagement declines or because rates of weight loss slow despite similar degrees of engagement,” write the study authors.
People found it easier to make recordings on at least 50% of days for weight monitoring (65%) than diet (58%) or physical activity (50%).
Tracking weight loss progress was higher in people who used digital technology over paper-based methods.
The researchers observed higher engagement rates with passive digital technology, such as wearable technologies and e-scales, than with active technology, such as apps requiring people to input numbers manually.
The authors suggest that this is because passive self-monitoring is easier to incorporate into one’s daily routine.
Achieving health goals
Based on the evidence, the authors recommend using digital health technology to track the progress of one’s weight loss journey. Self-monitoring builds accountability for eating habits and exercise.
“This self-regulatory process of gathering data and receiving feedback enables individuals to identify behaviors to change and, in doing so, can bring them closer to their health goals.”
– Michele L. Patel, Ph.D., et al.
Strengths and limitations of the research
The participants in these studies were mainly white women, so the team’s findings cannot be extrapolated to men or women of other racial backgrounds.
Also, the researchers did not randomize the participants by interest and engagement in self-monitoring activities.
For example, people who are interested and able to make regular recordings of their diet, weight, or physical activity may differ substantially from people who are not interested in regularly recording their activities. These differences may influence their ability to lose weight.
The review has systematically charted the superiority of digital over paper-based systems of self-monitoring and that of passive over active measures. However, both approaches are less effective after a year.
The review has also, for the first time, highlighted that self-monitoring is helpful for weight loss, at least in the short term. What is measured — such as diet, physical activity, weight, or a combination — is less important.
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