Differences in Self-Monitoring Technology Use and Perceptions Between National Weight Control Registry Participants Maintaining and Regaining Weight.

Background: Self-monitoring technology (e.g., smartphone applications) aids weight loss, but its role in weight maintenance remains under studied.

Purpose: To evaluate use and perceptions of self-monitoring technologies in National Weight Control Registry (NWCR) participants (adults who have maintained a ≥30lbs loss for ≥1 year) who maintained versus regained weight.

Methods: NWCR participants completed an online survey about self-monitoring technology use and perceptions. Of 1,000 invited participants, 794 completed the survey. Those who reported gaining ≥2.3kg (5lbs) in the past year were categorized as the "regain" group (40.8%); those reporting <2.3kg gain were the "maintain" group (59.2%).

Results: The sample (n=794) was mostly female, White, middle-aged adults. "Regain" was more interested in technology than paper-based methods to self-monitor weight (p<.01) and diet (p<.01) but not exercise (p=.23) than "maintain". There were no differences in wearable trackers interest, most valued features, or use barriers, but the "regain" group was more likely to report guilt, discouragement, body image concerns, and anxiety about weight loss when using behavior-tracking technologies (p<.001); rates of discontinuation from these feelings or unhealthy weight control practices were not different between groups.

Conclusions: This appears to be the first study investigating naturalistic use of self-monitoring technology in a demographically homogenous sample maintaining significant weight loss. The "regain" group was more likely to use self-monitoring technology but reported more tracking-associated negative feelings. Future research must determine how to support individuals emotionally and with weight maintenance when self-monitoring contributes to negative byproducts. Other work should identify the optimal elements of self-monitoring technology for weight loss maintenance.