Improving Self-Monitoring in Weight Loss With Technology
Condition: Obesity; Overweight
MeSH terms: Overweight; Weight Loss
Study type: Interventional

Summary: 
      We propose to conduct a randomized study of standard behavioral weight-loss treatment to test
      if using an electronic diary with or without tailored feedback will improve adherence to
      self-monitoring and subsequently improve weight loss. Subjects will be randomly assigned to
      different methods to self-monitor food and exercise habits: (1) use of the traditional paper
      diary , (2) use of a personal digital assistant (PDA), or (3) use of a personal digital
      assistant that also provides daily feedback.
    

Detailed description: 
      The prevalence of obesity, a major chronic health problem that is an independent risk factor
      for coronary heart disease (CHD), continues to increase at an alarming rate. Although weight
      control research has significantly improved short-term treatment success, long-term weight
      loss maintenance has lagged behind. Research has demonstrated a consistent relationship
      between self-monitoring eating and physical activity habits and success in weight loss as
      well as in maintenance of weight loss. However, the methods primarily used for
      self-monitoring continue to be the paper diary (PD), which is time consuming and burdensome.
      Moreover, PDs do not permit immediate external feedback to support and motivate the
      individual. Emerging technologies could improve self-monitoring and weight loss treatment.
      However, the use of these technological advances, such as a personal digital assistant (PDA),
      has not been studied in weight loss treatment. The primary aim of this behavioral weight loss
      treatment study is to determine if self-monitoring of daily eating and physical activity
      habits using a PDA, with or without a tailored feedback intervention, is superior to using a
      PD in terms of promoting and maintaining short- and long-term weight loss. Secondary aims
      include comparing the effect of treatment group assignment on adherence to self-monitoring
      and on risk factors for CHD (lipids, glucose, insulin, C-reactive protein). We propose to
      enroll 198 subjects and randomize them to one of three treatment groups that will use
      different methods to self-monitor eating and physical activity habits: (1) use of the
      traditional PD with delayed written feedback, (2) use of a PDA with limited feedback on daily
      targets, or (3) use of a PDA with limited feedback on daily targets plus receive daily,
      subject-tailored feedback messages via the PDA. The proposed study includes prolonged (24
      months) supervision of self-management with three important components: self-monitoring,
      feedback, and ongoing contact. Subjects will complete assessments at baseline, 6, 12, 18, and
      24 months. This innovative study will provide information on the efficacy of combining
      technological advances with proven behavioral strategies.
    

Intervention name(s): Standard behavioral treatment (SBT) for weight loss; SBT for weight loss using a PDA; SBT for weight loss using a PDA with feedback messages
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Participants attend group sessions where they learn about healthy eating and exercise. They are asked to self-monitor all calories consumed (food and drink) and all calories expended through exercise. Standard paper diaries are used for self-monitoring.; Participants attend group sessions where they learn about healthy eating and exercise. They are asked to self-monitor all calories consumed (food and drink) and all calories expended through exercise. Personal Digital Assistants (PDAs) are used for self-monitoring.; Participants attend group sessions where they learn about healthy eating and exercise. They are asked to self-monitor all calories consumed (food and drink) and all calories expended through exercise. Personal Digital Assistants with a customized feedback program are used for self-monitoring.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: technology in weight loss; standard behavioral therapy for obesity