Within-Day Patterns of Self-Monitoring Dietary Intake and Weight Loss in a Behavioral Weight Management Program.

Abstract

Objective: Behavioral weight management programs (BWLPs) encourage participants to self-monitor dietary intake daily, preferably throughout the day as eating/drinking occurs. Despite empirical support for daily self-monitoring, little is known regarding within-day patterns of self-monitoring and their associations with weight loss.

Methods: Within-day patterns of self-monitoring and associations with weight loss were examined in 449 adults with obesity (mean ± SD age = 49.4 ± 11.4 years, BMI = 35.7 ± 4.0 kg/m², 83.5% female, 23.4% Black or African American, 9.8% Hispanic) who enrolled in a 16 week BWLP and were asked to self-monitor dietary intake daily using a smartphone app.

Results: K-means cluster analysis resulted in four patterns: participants who primarily engaged in Minimal Logging (n = 101), Backlogging (n = 124), Logging one occasion/day (n = 59), and Logging two or more occasions/day (n = 165). There was not a difference in weight loss between Logging two or more occasions/day (M ± SD; 9.1 ± 4.1%) and Logging one occasion/day (7.7 ± 4.7%), p = 0.219; however, both lost more weight than Backlogging (5.7 ± 4.1%) and Minimal logging (2.1 ± 3.4%), ps < 0.001. Moreover, 88.5% of Logging two or more occasions/day participants achieved clinically-meaningful weight losses, compared to 71.2% of Logging one occasion/day, 55.6% of Backlogging, and 19.8% of Minimal Logging, all ps < 0.05.

Conclusions: Results support recommendations for daily (and, ideally, throughout-the-day) self-monitoring of dietary intake. Future studies should investigate strategies to increase self-monitoring adherence, including technological supports and lower-burden tools.