Self-Monitoring: Keyboard Beats Pencil

As blogged before – step one of weight management is self-monitoring.

As I explain to my patients, the very act of self-monitoring your intake, activity and perhaps even your mood, changes your behaviour. This is why virtually all credible weight management programs emphasize the importance of keeping a food diary – whether you are counting points, calories, or simply describing when and what you ate and how much you moved.

But for anyone, who has tried this, it can be tedious and most people abandon self-monitoring after a while – this is when I tell them that consistent self-monitoring is part of their treatment – when treatment stops – weight comes back!

So while self-monitoring is key to weight management does it matter if you use a pencil and notebook or one of the many electronic apps, devices, or online services?

This question was now addressed in a randomised controlled trial by Lora Burke and colleagues from the University of Pittsburgh, the results of which were just published OBESITY.

Two hundred adults with an average BMI of 34 were randomised to three different forms of self-monitoring: using a personal digital assistant (PDA) with dietary and exercise software, either with or without a feedback (FB) message vs. the traditional paper diary/record (PR).

All participants received standard behavioral treatment and adherence to self-monitoring and change in body weight was assessed at 6 months

Over 90% of participants completed the study and everyone lost weight with no differences in average weight loss between the groups.

However, a greater proportion of PDA+FB participants (63%) achieved ≥ 5% weight loss in comparison to the PDA group (49%) and the PR group (46%).

Self-monitoring adherence over the 6 months was higher in the PDA groups (PDA 80%; PDA+FB 90%) than in the PR group (55%).

This study clearly suggests that using an electronic journal, especially one that provides feedback , may not only help more people lose and sustain clinically relevant weight loss (probably for as long as they keep doing it) and that using an electronic monitoring app may be easier and therefore more sustainable in the long-term.

As there are now numerous such sites, programs, devices, and apps out there, I wonder if my readers have any favourite self-monitoring resources they would recommend.

Perhaps readers, who find self-monitoring helpful, may also want to share why this works for them (or does not?).

Heidelberg, Germany

Burke LE, Conroy MB, Sereika SM, Elci OU, Styn MA, Acharya SD, Sevick MA, Ewing LJ, & Glanz K (2011). The effect of electronic self-monitoring on weight loss and dietary intake: a randomized behavioral weight loss trial. Obesity (Silver Spring, Md.), 19 (2), 338-44 PMID: 20847736