What monitoring strategies are most successful for promoting weight loss? A randomised controlled trial

Abstract

Objectives: While tracking progress is one of the strongest predictors of success in healthy eating and physical activity interventions, it is uncertain whether it matters which behavior (diet, activity or weight) is being tracked. The aim of this study was to determine the effectiveness of four different monitoring strategies on weight loss, body composition, blood markers, and psychosocial indices in overweight and obese adults undertaking a 12-month weight loss program.

Methods: 250 overweight or obese adults were randomized to track either a) their weight daily, b) dietary intake using My Fitness Pal, c) hunger (using a novel method called “hunger training”), d) progress via regular face-to-face meetings, or a control group for 12 months. All participants received diet and exercise advice and 171 participants completed the study.

Results: All groups lost weight over the course of the intervention (typically 3.9–6.8kg) with no difference between the intervention groups and the control (all p ≥ 0.084). However, participants who tracked hunger lost significantly more weight at 1-year than those who tracked dietary intake (3.2kg, 0.1–6.4kg, p=0.046), or who met regularly with a support person (2.9kg, 95% CI 0.8–5.1kg, p=0.008). Few significant differences were observed in eating behavior (all p≥0.111), although the face-to-face and hunger tracking groups reported more favorable effects on depression and anxiety at 1-year than control participants. Adherence to the monitoring strategies (% recommended days) ranged from 29.6% for hunger training to 63.6% for attendance at the monthly face-to-face sessions.

Conclusions: Daily tracking of weight, food, or hunger, or regular face-to-face support did not result in significantly greater weight loss compared with diet and exercise advice alone. However tracking hunger may be a promising approach for encouraging weight loss.