The Use of Weight Tracking Technology to Promote Weight Loss Among Overweight Adults

Obesity continues to be a challenging public health problem. Despite producing large reductions in weight, weight loss interventions require a significant amount of effort because of the detailed self-monitoring of dietary intake and exercise habits that is involved. Consequently, this behavior is difficult to sustain and weight regain occurs. Interventions focused on enhancing simple strategies for self-monitoring may be just as effective and provide more lasting effects.

One of the simplest forms of self-monitoring is self-weighing. Self-weighing is an important tool for regulation of body weight as it provides proximal feedback on how eating and exercise behaviors are impacting weight, and allows individuals to make adjustments to these behaviors to affect energy balance. Observational research indicates that daily self-weighing is associated with greater weight loss as compared to less frequent self-weighing. However, there is limited experimental evidence testing this association and most is derived from intensive interventions that may overshadow the effects of self-weighing. To mitigate this, the investigators will examine whether daily self-weighing is effective under self-directed conditions with minimal contact. The results of this proposal will provide evidence about the efficacy of daily self-weighing on weight loss using a randomized controlled design. Most assessments of self-weighing are measured via self-report, which introduces measurement error. This proposal will improve on this by using an objective measure of self-weighing with a scale that can store and transmit weight data.

Given that self-weighing does not impact weight loss directly but rather via changes in diet and physical activity behaviors, a full understanding of the mechanisms explaining this relationship is necessary. Furthermore, despite evidence indicating that more frequent self-weighing has no adverse psychological effects in adults participating in weight control interventions, there remains debate as to the negative psychological consequences of this behavior. Therefore, it would be informative to test for any adverse effects between treatment groups to further add to the evidence surrounding this debate.

The objective of the WEIGH Study (Weighing to Improve and Gain Health) is to test the efficacy of a self-directed intervention focused on daily self-weighing as the main self-monitoring strategy on weight loss at 6 months compared to a delayed-intervention control group. This will be tested using a 2-group randomized control design. Participants will be randomly assigned to either: [1] Daily Self-weighing Intervention Group or [2] Delayed-Intervention control group. The daily self-weighing intervention group will receive access to a "smart scale" for daily self-weighing and viewing of weight trends over time, and receive weekly emails with tailored messages reinforcing self-weighing and other behaviors associated with reaching weight loss goals. This group will also receive weekly lessons with basic information for weight loss and strategies on how to use the scale to maximize weight loss. The control group will be given the "smart scale" and be told to weigh as often as they normally do, with the goal of observing natural weighing frequency trends in this group. After the end of the 6-month study, they will receive a 3-month modified version of the daily self-weighing intervention, which will include weekly emails, prescription for daily self-weighing, and weight monitoring via the smart scale website. Detailed descriptions of these components are outlined below.

Recruitment and Informed Consent Participants will first undergo screening at www.uncweightresearch.org via Qualtrics or call the study center to complete the screening questionnaire over the phone. For those filling out the questionnaire online, they are still required to call the study center to complete the screening questionnaire, as sensitive medical-related questions are more appropriate to ask over the phone.