Daily Self-weighing and Holiday-associated Weight Gain in Adults
Phase: NA
Conditions: Obesity
Sponsor: University of Georgia

Daily Self-Weighing to Prevent Holiday-Associated Weight Gain in Adults 
Document date: February 6, 2019 
 
Authors: 
Sepideh Kaviani1, Ph.D  
Michelle vanDellen2, Ph.D 
Jamie A. Cooper1, Ph.D 
 
Author Affiliations: 
1Department of Foods & Nutrition, University of Georgia, Athens, GA. 
2Department of Psychology, University of Georgia, Athens, GA.  
 
Corresponding Author:  
Jamie A. Cooper, Department of Foods and Nutrition, University of Georgia, 305 Sanford Drive, 
Athens, GA  30622, Phone: 706-542-4903, Fax: 706-542-5059; Email: jamie.cooper@uga.edu 
 
Clinical trial name: Daily Self-weighing and Holiday-associated Weight Gain in Adults 
Registration identification number: NCT03718000 
URL for clinical trial registry: https://clinicaltrials.gov/show/NCT03718000 
 
Study Protocol 
A screening visit occurred in Human Nutrition Lab (HNL) from late September to early 
November during which a Likert item was administered to measure self-weighing frequency 
habits. Existing (or history of) eating disorders was determined by Drive for Objective Thinness 
Questionnaire which resulted in study exclusion. Qualified subjects were randomized into either 
the DSW+GF or control group (balanced blocks by age, sex, and BMI) by research personnel. 
Pre-Holiday Visit (v1)  

This visit occurred in HNL within a one-week period prior to Thanksgiving after an 8-
12h overnight fast and 12h without exercise. Height, body weight (BW), waist and hip 
circumference (WC and HC), blood pressure, and body composition using Dual Energy X-Ray 
Absorptiometry (DXA™; Hologic Inc., Discovery A, Bedford, MA) were measured. A fasting 
blood draw was taken for blood lipids. Questionnaires administered at this visit included the 
Perceived Stress Scale (PSS), Three factor Eating Questionnaire (TFEQ), Power of Food Scale, 
National Insomnia Screening Questionnaire, self-weighing frequency Likert item, Mindful 
Eating Factors Questionnaire and Fat Preference Questionnaire. To assess participants’ 
perceptions of healthy and unhealthy foods, participants categorized a series of 60 images of 
different foods accompanied by their names (e.g., pizza, pancake, and broccoli). Participants 
selected ‘healthy’ or ‘unhealthy’ for each food item. This was done to examine whether daily 
self-weighing with graphical feedback (DSW+GF) would alter subjects’ perception of foods, and 
whether these perceptions, as well as data from our other questionnaires, would be significant 
mediators for the effects of DSW+GF on BW. 
Intervention Period (Holiday Season) 
Intervention group: At the conclusion of v1, participants in the DSW+GF group received 
the Wi-Fi scale (Nokia (Withings®), Paris, France). They were asked to start DSW the day after 
v1 until their post-holiday visit (v2). They weighed themselves first thing in the morning after 
voiding (and defecating if that is their normal pattern). Once they stepped on the scale, their data 
would automatically transfer to their Withings® account and their Withings® mobile app (Nokia 
Health Mate app). Immediately after a weight measurement, electronic graphical feedback of 
weight fluctuations appeared on the scale’s screen and the app. The average of the first 4 days of 
BW served as the “baseline” weight, which was then set as the participant’s “target” weight in 

their Withings® account. This target weight showed up as a straight line on their graph of daily 
weights. Participants were instructed to try not to gain weight above this target line, and no 
additional instructions on how to achieve that goal were provided. The GF component of the 
DSW was the immediate graphical feedback of their weight fluctuations from the scale and how 
their weight compared to their target “baseline” weight.  
Control group: Control participants did not receive any intervention; however, they 
completed the same study visits as the intervention group.   
Post-Holiday Visit (v2) 
This visit occurred in HNL within a one-week period after New Year’s Day with the 
same conditions and procedures as v1. The DSW+GF group was told they could discontinue 
DSW; however, they were allowed to keep the scales until the follow-up visit and were told to 
use it as they saw fit.  
Follow-up Visit (v3) 
This visit occurred in HNL 14 weeks after v2 under the same conditions and procedures 
as v1 and v2. The scales were collected from the DSW group and weighing frequency data 
during the follow-up period was obtained from their Withings® accounts. All participants were 
debriefed as to the true intent or purpose of the study at the conclusion of this visit. 
Statistical Analysis 
Statistical analyses were performed using JMP Pro 13 (Statistical DiscoveryTM, From 
SAS Institute Inc., Cary, NC). A sensitivity power analysis to determine the smallest detectable 
effect size (was performed using G*Power, 3.1.9.2). Assuming scores at pre-holiday were 

correlated with post-holiday with at least a correlation of r = .40, our study was poised to detect 
differences in change scores from time 1 to time 2 of Cohen’s f = .15 (small-to-medium) effects. 
To test the treatment effects on BW across visits, as well as on the change between visits, a full 
factorial repeated measures ANOVA (mixed-methods) was conducted based on sex and initial 
BMI (normal weight (NW), and overweight and obese (OW&OB)). Participants with the BMI of 
18.5-24.9kg/m2 were categorized as NW and those with a BMI³25kg/m2 were grouped into the 
OW&OB category. This grouping was done due to the relatively lower number of subjects in the 
OW or OB categories compared to NW (control group was 69% NW (n=38) and 31% OW&OB 
(n=17) while the DSW+GF group was 75% NW (n=42) and 25% OW&OB (n=14)). A two-way 
repeated measures ANOVA was used to test the treatment effects on other anthropometrics 
(body fat, WC, HC, and waist-to-hip ratio (WHR)), systolic and diastolic blood pressure (SBP 
and DBP), and blood markers (Total Cholesterol (TC), Triglyceride (TG), High-density 
Lipoprotein (HDL), Low-density Lipoprotein (LDL), and TC/HDL) across all visits. Post hoc 
analyses were performed using a Tukey’s test. Significance was set at p<0.05, and data are 
presented as mean ± SEM unless otherwise specified. Additionally, data collected from 
questionnaires (except the Likert item), was analyzed using a parallel multiple mediator model to 
test whether any component of participants’ responses was a mediator for the impact of 
treatments.