A pilot randomized trial of simplified versus standard calorie dietary self-monitoring in a mobile weight loss intervention

Abstract

Objective: This study tested the efficacy of a lower-burden, simplified dietary self-monitoring approach compared with a standard calorie monitoring approach for self-monitoring adherence and weight loss in a mobile-delivered behavioral weight loss intervention.

Methods: Participants (n = 72) with overweight or obesity who had children 2 to 12 years of age living in the home were randomly assigned to a group that used simplified dietary self-monitoring of high-calorie foods (Simplified) or a group that tracked calories (Standard). Both groups received a wireless scale, Fitbit trackers, and a 6-month intervention delivered via a smartphone application with lessons, text messages, and weekly personalized feedback messages.

Results: Percentage weight loss at 6 months was 5.7% (95% CI: -8.3% to -3.2%) in the Standard group and 4.0% (95% CI: -5.7% to -2.3%) in the Simplified group, which was not significantly different. Similar proportions reached 5% weight loss at 6 months (43.2% in Standard and 42.9% in Simplified). There were no differences in number of dietary tracking days or change in average daily caloric intake between groups.

Conclusions: Two mobile-delivered weight loss interventions produced clinically meaningful levels of weight loss at 6 months, with no differences in dietary tracking adherence or dietary intake. The results suggest that simplified monitoring of high-calorie foods could be a promising alternative to calorie monitoring.

FIGURE 1

Study recruitment, enrollment, and retention (CONSORT). CONSORT, Consolidated Standards of Reporting Trials; MVPA, moderate-to-vigorous physical activity; PA, physical activity

FIGURE 2

Adherence to self-monitoring by treatment group across each program month. (A) Bars represent percent of participants who tracked any dietary information at least one day that month and lines represent the average percent of days that dietary information was tracked among those participants that month. (B) Bars represent percent of participants who wore their activity tracker at least one day that month and lines represent the average percent of days that the activity tracker was worn among those participants that month. (C) Bars represent percent of participants who self-weighed at least one day that month and lines represent the average percent of days that those participants self-weighed that month