Self-Monitoring in Weight Loss: A Systematic Review of the Literature

doi:10.1016/j.jada.2010.10.008

Journal of the American Dietetic Association

Volume 111, Issue 1, January 2011, Pages 92-102

https://doi.org/10.1016/j.jada.2010.10.008 Get rights and content

Abstract

Self-monitoring is the centerpiece of behavioral weight loss intervention programs. This article presents a systematic review of the literature on three components of self-monitoring in behavioral weight loss studies: diet, exercise, and self-weighing. This review included articles that were published between 1993 and 2009 that reported on the relationship between weight loss and these self-monitoring strategies. Of the 22 studies identified, 15 focused on dietary self-monitoring, one on self-monitoring exercise, and six on self-weighing. A wide array of methods was used to perform self-monitoring; the paper diary was used most often. Adherence to self-monitoring was reported most frequently as the number of diaries completed or the frequency of log-ins or reported weights. The use of technology, which included the Internet, personal digital assistants, and electronic digital scales were reported in five studies. Descriptive designs were used in the earlier studies whereas more recent reports involved prospective studies and randomized trials that examined the effect of self-monitoring on weight loss. A significant association between self-monitoring and weight loss was consistently found; however, the level of evidence was weak because of methodologic limitations. The most significant limitations of the reviewed studies were the homogenous samples and reliance on self-report. In all but two studies, the samples were predominantly white and women. This review highlights the need for studies in more diverse populations, for objective measures of adherence to self-monitoring, and for studies that establish the required dose of self-monitoring for successful outcomes.

Section snippets

Search Strategies

An electronic literature search within two databases, Ovid MEDLINE and Ovid PsycINFO, were conducted. Key words included obesity, weight loss, overweight, and self-monitoring. A manual search of the reference sections of the included studies and also other relevant articles was also performed. Search limiters included English language and human beings.

Inclusion and Exclusion Criteria

The inclusion criteria of the studies for review were: conducted in the United States, reported between 1989 and 2009, investigated the effect of

Results

Of the 22 studies reviewed (10, 12, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34), most (n=14) used descriptive designs and examined the association of self-monitoring with weight loss (10, 12, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 31, 34). Six were secondary data analyses (10, 21, 22, 34) or ancillary studies (18, 19) of existing weight loss programs. Fifteen studies focused on dietary self-monitoring (12, 15, 16, 19, 20, 22, 23, 24, 25, 26, 28, 29, 30, 33,

Discussion

The studies reviewed in this paper represent the state of the science pertaining to self-monitoring as a strategy to increase a person's awareness of targeted behaviors and the circumstances that surround those behaviors. This review included 22 studies that focused on self-monitoring diet, physical activity or exercise, and self-weighing.

Each study contributed to the body of evidence supporting the role of self-monitoring; more frequent self-monitoring was consistently and significantly

Conclusions

Although there were methodologic limitations to the studies reviewed, there was ample evidence for the consistent and significant positive relationship between self-monitoring diet, physical activity, or weight and successful outcomes related to weight management. The review identified several gaps, including the optimal frequency and duration of self-monitoring diet and exercise, the effectiveness of self-monitoring among subpopulations under-represented in weight loss studies, and the need

L. E. Burke is a professor of Nursing, Epidemiology, and Clinical and Translational Science, School of Nursing and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.

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L. E. Burke is a professor of Nursing, Epidemiology, and Clinical and Translational Science, School of Nursing and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.

J. Wang is a postdoctoral associate, School of Nursing and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.

M. A. Sevick is a research scientist, Veterans Affairs Pittsburgh Healthcare System, and an associate professor of medicine and public health, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA.

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ResearchReviewSelf-Monitoring in Weight Loss: A Systematic Review of the Literature

Abstract

Section snippets

Search Strategies

Inclusion and Exclusion Criteria

Results

Discussion

Conclusions

Am J Clin Nutr

Addict Behav

J Nutr

Behav Ther

J Am Diet Assoc

Am J Prev Med

Contemp Clin Trials

J Nutr Educ Behav

Am J Prev Med

Eat Behav

Contemp Clin Trials

Eat Behav

Contemp Clin Trials

Self-Management Methods

Self-monitoring: Methodological limitations and clinical applications

J Consult Clin Psychol

The maintenance of behavior by self-generated stimuli and reinforcement. 1971

Health promotion from the perspective of Social Cognitive Theory

Psychol Health

Lifestyle modification for the management of obesity

Gastroenterology

Behavioral approaches to the treatment of obesity

Self-weighing in weight gain prevention and weight loss trials

Ann Behav Med

Behavioral approaches to the treatment of obesity. 1998

Research
Review
Self-Monitoring in Weight Loss: A Systematic Review of the Literature