Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity

• Published in: Obesity (Silver Spring, Md.) Vol. 29; no. 3; pp. 478 - 499
• Main Authors: Patel, Michele L., Wakayama, Lindsay N., Bennett, Gary G.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-03-2021
• Subjects: Behavior; Boolean; Clinical trials; Dissertations & theses; Gastrointestinal surgery; Health education; Health literacy; Nutrition; Obesity; Overweight; Systematic review; Text messaging; Weight control; United States > US
• ISSN: 1930-7381; 1930-739X
• DOI: 10.1002/oby.23088

Objective
Self‐monitoring is a core component of behavioral obesity treatment, but it is unknown how digital health has been used for self‐monitoring, what engagement rates are achieved in these interventions, and how self‐monitoring and weight loss are related.
Methods
This systematic review examined digital self‐monitoring in behavioral weight loss interventions among adults with overweight or obesity. Six databases (PubMed, Embase, Scopus, PsycInfo, CINAHL, and ProQuest Dissertations & Theses) were searched for randomized controlled trials with interventions ≥ 12 weeks, weight outcomes ≥ 6 months, and outcomes on self‐monitoring engagement and their relationship to weight loss.
Results
Thirty‐nine studies from 2009 to 2019 met inclusion criteria. Among the 67 interventions with digital self‐monitoring, weight was tracked in 72% of them, diet in 81%, and physical activity in 82%. Websites were the most common self‐monitoring modality, followed by mobile applications, wearables, electronic scales, and, finally, text messaging. Few interventions had digital self‐monitoring engagement rates ≥ 75% of days. Rates were higher in digital‐ than in paper‐based arms in 21 out of 34 comparisons and lower in just 2. Interventions with counseling had similar rates to standalone interventions. Greater digital self‐monitoring was linked to weight loss in 74% of occurrences.
Conclusions
Self‐monitoring via digital health is consistently associated with weight loss in behavioral obesity treatment.