Using instrumented paper diaries to document self-monitoring patterns in weight loss.
Self-monitoring of eating is associated with successful weight loss, but adherence is imperfect and deteriorates over time. Moreover, intentionally or not, many individuals have difficulty keeping faithful records. We used instrumented paper diaries (IPDs) to study self-monitoring in randomly chosen participants in the PREFER trial, a behavioral treatment for weight-loss study. The diaries they used to self-report eating were periodically replaced with IPDs at various times during an 18-month weight-loss program, consisting of three successive phases: intense treatment (n=35), less-intense treatment (n=13), and maintenance (n=16). We compared electronically documented self-monitoring data, showing when and how often IPDs were used, with self-reported data, then compared the electronically validated adherence and weight loss. Self-reported diary usage exceeded IPD-documented usage while the electronic data demonstrated a significant decline in self-monitoring over time. Diary recording often was not timely. Percentage weight lost correlated significantly with frequency of IPD use (p=.001) and the number of diary entries made within 15 min of opening the IPD (p=.002). This is the first study to document patterns of self-monitoring among participants in a weight-loss program, which demonstrated that individuals may falsify the times and frequency of self-monitoring. Furthermore, our results showed that adherence to self-monitoring and the timeliness of recording significantly correlate with improved weight loss.
Burke
Lora E
LE
University of Pittsburgh, United States. lbu100@pitt.edu
Sereika
Susan M
SM
Music
Edvin
E
Warziski
Melanie
M
Styn
Mindi A
MA
Stone
Arthur
A
D015930:Diet Records; D004038:Diet, Reducing; D004435:Eating; D001330:Electronic Data Processing; D006801:Humans; D008499:Medical Records; D010349:Patient Compliance; D016032:Randomized Controlled Trials as Topic; D012650:Self Disclosure; D015431:Weight Loss
Annu Rev Nutr. 2001;21:323-41
11375440
Arch Intern Med. 2006 Aug 14-28;166(15):1620-5
16908795
Annu Rev Psychol. 2003;54:579-616
12499517
Control Clin Trials. 2003 Apr;24(2):182-99
12689739
Pain. 2003 Jul;104(1-2):343-51
12855344
Addict Behav. 1986;11(3):337-40
3739819
Diabetes Care. 1989 Jul-Aug;12(7):500-3
2758955
Health Psychol. 1998 Jul;17(4):367-70
9697946
Health Psychol. 1999 Jul;18(4):364-8
10431937
J Ren Nutr. 2005 Jul;15(3):304-11
16007560
N Engl J Med. 2005 Aug 4;353(5):487-97
16079372
N Engl J Med. 2005 Nov 17;353(20):2111-20
16291981
Blood Press Monit. 2000;5 Suppl 1:S31-4
10904240
Contemp Clin Trials. 2006 Feb;27(1):34-48
16233990
Contemp Clin Trials. 2006 Feb;27(1):23-33
16311076
Am J Health Promot. 2006 Jan-Feb;20(3):165-70
16422134
JAMA. 2006 Apr 5;295(13):1549-55
16595758
BMJ. 2002 May 18;324(7347):1193-4
12016186