January 2011

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

Lora E. Burke, PhD, MPH; Jing Wang, PhD, MPH, RN; Mary Ann Sevick, ScD, RN

The purpose of this article was to complete a systematic review of the current literature that is available regarding self-monitoring in weight loss. Self-monitoring is a key component of many behavioral weight loss programs. This typically involves participants recording their food intake, physical activity, and weights so they become more aware of their behaviors.

The researchers used two databases, MEDLINE and OVID PsycInfo to search for appropriate literature. They used the key words: obesity, weight loss, overweight, and self-monitoring. The authors also perused the references sections of the articles they found to look for other relevant studies. The criteria for a study to be included was that it was written in the English language, that human beings were the subjects, that it was conducted in the United States, and that it focused on the effect of self-monitoring on weight loss. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was used as guidelines for their review. The authors ended up with 22 studies that met the inclusion criteria. All of them were conducted between 1993 and 2009 and they focused on three different types of self-monitoring. Fifteen of these articles concentrated on dietary self-monitoring, one was centered on self-monitoring exercise, and the other six were about self-weighing.

In this review, the researchers summarized the study as well as the primary intervention and the duration of the study. They also looked at sample characteristics, which self-monitoring approach was used, and any results that were pertinent to self-monitoring and weight loss. The authors of this review also reported the mean and standard deviation of age, BMI or weight, and the distribution of gender and race of the participants for each of the 22 studies. The American Heart Association and the American College of Cardiology’s method was utilized to evaluate the results that were presented in the various studies.

In all of the 15 studies that focused on self-monitoring diet, it was found that there was a significant association between recording dietary intake and increased weight loss. The different methods used to monitor one’s diet included paper diaries, electronic diaries, or a combination of both. Some studies asked participants to record physical activity, eating situation, mood, water consumption, and other variables as well. Another finding was that there was a correlation between how complete diary entries were and increased weight loss. In general, the more a person used their food diary, the more weight was lost. Since the advent of electronic food diaries [via personal digital assistant (PDA), computers, or cell phones], there was not a significant difference in the amount of weight loss from studies using paper diaries. However, when using a PDA in combination with daily feedback messages versus a paper diary, there were higher amounts of weight loss seen in participants using the PDAs with daily feedback.

There was one study that looked at self-monitoring of exercise and its effect on weight loss. From this study, it was found that people who recorded their exercise not only lost more weight than those who did not, but they also had less difficulties with exercising and would work out more frequently. Of the six studies that centered on self-weighing, it was found that greater weight loss was associated with increased frequency of self-weighing. Participants that weighed themselves daily lost more weight than those who did not weigh themselves as frequently.

Overall, the authors conclude that more self-monitoring of diet, exercise, and weights is associated with greater weight loss. However, there were some limitations that were seen in all of the studies in this review. For example, the largest group of participants were overweight and obese, white women. One problem the authors of this article had was that none of the studies provided a number for what the optimal frequency of self-monitoring was to achieve weight loss results. Also, many of the studies did not explain how self-monitoring was assessed and did not provide criteria for assessment of the participants self-monitoring or for how complete entries needed to be. Furthermore, self-reported data was being used in these studies, which can easily be falsified. The authors reported that future research needs to be done with different populations, with more objective measures of adherence to self-monitoring, and to determine the amount of self-monitoring required to achieve the desired outcomes.

Burke LE, Wang J, Sevick M. Self-monitoring in weight loss: A Systematic review of the literature. J Am Diet Assoc. 2011; 111 (1): 92-102.

Related Article:

Helsel DL, Jakicic JM, Otto AD. Comparison of techniques for self-monitoring eating and exercise behaviors on weight loss in a correspondence-based intervention. J Am Diet Assoc. 2007; 107 (10): 1807-1810.