The effect of electronic self-monitoring on weight loss and dietary intake: a randomized behavioral weight loss trial

Obesity (Silver Spring). 2011 Feb;19(2):338-44. doi: 10.1038/oby.2010.208. Epub 2010 Sep 16.


Technology may improve self-monitoring adherence and dietary changes in weight loss treatment. Our study aimed to investigate whether using a personal digital assistant (PDA) with dietary and exercise software, with and without a feedback message, compared to using a paper diary/record (PR), results in greater weight loss and improved self-monitoring adherence. Healthy adults (N = 210) with a mean BMI of 34.01 kg/m(2) were randomized to one of three self-monitoring approaches: PR (n = 72), PDA with self-monitoring software (n = 68), or PDA with self-monitoring software and daily feedback messages (PDA+FB, n = 70). All participants received standard behavioral treatment. Self-monitoring adherence and change in body weight, waist circumference, and diet were assessed at 6 months; retention was 91%. All participants had a significant weight loss (P < 0.01) but weight loss did not differ among groups. A higher proportion of PDA+FB participants (63%) achieved ≥ 5% weight loss in comparison to the PR group (46%) (P < 0.05) and PDA group (49%) (P = 0.09). Median percent self-monitoring adherence over the 6 months was higher in the PDA groups (PDA 80%; PDA+FB 90%) than in the PR group (55%) (P < 0.01). Waist circumference decreased more in the PDA groups than the PR group (P = 0.02). Similarly, the PDA groups reduced energy and saturated fat intake more than the PR group (P < 0.05). Self-monitoring adherence was greater in the PDA groups with the greatest weight change observed in the PDA+FB group.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Behavior Therapy
  • Body Mass Index
  • Combined Modality Therapy
  • Computers, Handheld
  • Diet Records
  • Diet, Reducing / psychology
  • Energy Intake / physiology*
  • Exercise / physiology
  • Exercise / psychology*
  • Female
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Obesity / therapy*
  • Patient Compliance / psychology*
  • Self Care
  • Software
  • Weight Loss*
  • Young Adult