Self-Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity

Obesity (Silver Spring). 2021 Mar;29(3):478-499. doi: 10.1002/oby.23088.


Objective: Self-monitoring is a core component of behavioral obesity treatment, but it is unknown how digital health has been used for self-monitoring, what engagement rates are achieved in these interventions, and how self-monitoring and weight loss are related.

Methods: This systematic review examined digital self-monitoring in behavioral weight loss interventions among adults with overweight or obesity. Six databases (PubMed, Embase, Scopus, PsycInfo, CINAHL, and ProQuest Dissertations & Theses) were searched for randomized controlled trials with interventions ≥ 12 weeks, weight outcomes ≥ 6 months, and outcomes on self-monitoring engagement and their relationship to weight loss.

Results: Thirty-nine studies from 2009 to 2019 met inclusion criteria. Among the 67 interventions with digital self-monitoring, weight was tracked in 72% of them, diet in 81%, and physical activity in 82%. Websites were the most common self-monitoring modality, followed by mobile applications, wearables, electronic scales, and, finally, text messaging. Few interventions had digital self-monitoring engagement rates ≥ 75% of days. Rates were higher in digital- than in paper-based arms in 21 out of 34 comparisons and lower in just 2. Interventions with counseling had similar rates to standalone interventions. Greater digital self-monitoring was linked to weight loss in 74% of occurrences.

Conclusions: Self-monitoring via digital health is consistently associated with weight loss in behavioral obesity treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Systematic Review

MeSH terms

  • Adult
  • Behavior Therapy / instrumentation
  • Behavior Therapy / methods
  • Body Weight
  • Diet
  • Exercise / physiology
  • Female
  • Humans
  • Male
  • Mobile Applications*
  • Monitoring, Physiologic / methods
  • Monitoring, Physiologic / statistics & numerical data
  • Obesity / epidemiology
  • Obesity / psychology
  • Obesity / therapy*
  • Overweight / epidemiology
  • Overweight / psychology
  • Overweight / therapy*
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Self-Management / methods*
  • Self-Management / psychology
  • Self-Management / statistics & numerical data
  • Telemedicine / methods
  • Telemedicine / trends
  • Weight Loss
  • Weight Reduction Programs / methods*
  • Weight Reduction Programs / statistics & numerical data
  • Weight Reduction Programs / trends