JMIR Publications

ABSTRACT

Background:

Self-monitoring is an essential component of behavioral weight loss treatment but declines quickly, resulting in suboptimal treatment outcomes.

Objective:

To examine a novel behavioral weight loss intervention that aims to attenuate the decline in dietary self-monitoring engagement.

Methods:

GoalTracker was an automated RCT (n=105) among adults with overweight or obesity who were randomized to a 12-week standalone weight loss intervention using the MyFitnessPal app for self-monitoring either (1) both weight and diet, with weekly lessons, action plans, and feedback (Simultaneous); (2) weight through week 4, then added diet, with the same behavioral components (Sequential); or (3) only diet (App-Only). Participants were recruited via on- and off-line methods. Weight was collected in-person at baseline, 1-, and 3-months using calibrated scales and via self-report at 6 months. Other assessment data were collected in-person via self-report questionnaires.

Results:

In intent-to-treat analyses, there was no difference in weight change at 3 months between the Sequential arm (mean, 95% CI: -2.7 kg; -3.9, -1.5) and either the App-Only arm (-2.4 kg; -3.7, -1.2; P=.78) or the Simultaneous arm (-2.8 kg; -4.0, -1.5; P=.72). The median [IQR] number of days per week of self-monitoring diet was 1.9 [5.3] in Sequential (once began), 5.3 [4.8] in Simultaneous, and 2.9 [4.0] in App-Only. Engagement did not differ between arms.

Conclusions:

Regardless of the order in which diet is tracked, using tailored goals and a commercial mobile app can produce clinically significant weight loss. Standalone digital health treatments may be a viable option for those looking for a lower intensity approach. Clinical Trial: ClinicalTrials.gov NCT03254953; https://clinicaltrials.gov/ct2/show/NCT03254953 (Archived by WebCite at http://www.webcitation.org/72PyQrFjn)