Weight Tracking and Weight Loss Outcomes: Establishing the Standard of Care
Condition: Weight Loss
MeSH terms: Body Weight; Weight Loss
Study type: Interventional

Summary: 
      To achieve the long term goal of strengthening behavioral weight loss programs, the purpose
      of this project is to test an enhanced, daily weight tracking instruction against the current
      standard of care (weekly weight tracking) and an alternative mode of care (no weight
      tracking).

      The investigators postulate that daily weight tracking will boost ongoing awareness of and
      engagement in dietary intake and physical activity monitoring, thus improving weight loss
      outcomes. The central hypothesis of the study is that daily weight tracking will improve
      weight loss processes and outcomes relative to less frequent weight tracking, without adverse
      effects.
    

Detailed description: 
      Given the pernicious reach of obesity and the evidence that current behavioral treatments are
      modestly effective at changing weight, efforts to refine behavioral recommendations in order
      to improve weight loss interventions are crucial. Frequency of tracking body weight presents
      itself as a prime target for behavioral enhancement during weight loss. Daily self-monitoring
      (e.g., of dietary intake and physical activity) is already well-established as a central
      component of the behavioral weight loss process. However, the current standard of care in
      behavioral weight loss with regard to weighing is weekly tracking of weight, and some
      programs caution against any weight tracking. It has been suggested that frequent weight
      tracking may have a negative impact on mental health and outcomes during weight loss, but
      there are minimal data that address this concern experimentally in the context of an active
      weight loss program. Observational evidence from behavioral weight control trials and
      community studies suggests that greater frequency of tracking weight is associated with
      better weight outcomes. Stronger experimental evidence is needed to establish a causal link
      between weight tracking and weight outcomes and to elucidate the impact on mental health
      during weight loss. To achieve the long-term goal of strengthening behavioral weight loss
      programs, the purpose of this project is to test an enhanced, daily weight tracking
      instruction against the current standard of care (weekly weight tracking) and an alternate
      model of care with very limited data (no weight tracking). In pursuit of study goals, 336
      overweight and obese adults will be recruited and randomized to one of three 12-month weight
      loss interventions with a 12-month follow-up (24 months total time in study): the standard of
      care (weekly weight tracking during weight loss), an enhanced condition (daily weight
      tracking during weight loss), or a comparison condition (no weight tracking during weight
      loss). The rationale behind this proposal is that within the context of social ecology and a
      social-cognitive framework of behavior change, enhancement of this key environmental feature
      (i.e., the weight tracking environment) during weight loss will contribute to success by
      promoting self-efficacy for this critical behavior. Specific aims of the study will seek to
      determine the effects of weight tracking frequency on the weight loss process and outcomes,
      as well as to elucidate the effects of weight tracking frequency on mental health during
      weight loss. This study will have the expected outcome of enhancing the standard of care for
      weight loss, leading to better weight control for overweight and obese adults and thus
      directly mitigating the public health impact of the obesity crisis.
    

Intervention name(s): 12 month behavioral weight loss intervention
Intervention type(s): Behavioral
Intervention description(s): The intervention for all groups will follow a standard behavioral weight loss protocol. Participants will meet in groups of up to 20 persons; groups will meet weekly for the first six months, then biweekly for two months and monthly for the remaining four months of the 12-month treatment period. Session content will be centered on behavioral goal setting and attention to caloric intake and physical activity. Participants will be asked to keep daily diet and physical activity logs.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Weight Loss; Self-Weighing; Weight Tracking