Tuesday, October 11, 2011

Self-Monitoring and Weight Loss

I have reviewed the following three research articles, one of which I have read several times because I am critiquing the study for a class assignment.  One of the articles refers to a main clinical weight loss trial that is called PREFER, another refers to a specific study on self monitoring as part of that trial and a third used interviews with select participants after the first two parts were complete.  It is the last one that I am reviewing for class.  Both ancillary studies are of interest to many of you, I would suspect.  They are also entwined.

The rationale for self monitoring of meals,(calories and fat content) and of exercise is provided in the studies. The major study used education, monitoring and group support as the factors involved in weight loss.  The smaller study involved reflections of keeping a food diary.
The main points to share, with the limited time that I have, follow:
There are certain characteristics that people who adhere to self monitoring share.  
When self-monitoring is consistent, complete and timely it usually correlates to weight loss.  This reminds me of my sister's friend who I mentioned before - every bite, lick and taste.  It is important to get everything but also to record the meals in real time.  Successful losers record on the same day that the intake occurs and within minutes of consumption.  It makes sense.  If you wait until the end of the day, the ability to see and attend to over consumption will be lost. 
Persons who keep their record and make the connections between too many calories and weight gain are also more likely to be successful weight losers. In the article, there were quotations of persons who were astonished about the amount of calories they had been consuming.  I think that this is very important and is related to the passive over consumption that I have mentioned lately.
Persons who self monitor, make connections and lose weight are rewarded with increased self-efficacy.  This self-efficacy is empowering and leads to long term monitoring adherence. 
Successful loser/maintainers may not continue to keep food diaries into perpetuity, though some do, but, they employ the strategy at times, or as needed.  
Successful self-monitors also use the information to plan ahead.  They aim to eat a certain amount of calories a day and if they are like me, they like to eat many times a day.   It is this planning that leads the weight loser to decline more caloric foods that they might be offered throughout the day (you know from the food pushers :)).  
Other identified components of success included group support, support from spouses (which was hard to come by) and not having been in numerous weight loss programs prior to the study.

Burke, L. E., Choo, J., Music, E., Warziski, M., Styn, M. A., Kim, Y., & Sevick, M. A. (2006). PREFER study: a randomized clinical trial testing treatment preference and two dietary options in behavioral weight management--rationale, design and baseline characteristics Contemp Clin Trials (Vol. 27, pp. 34-48). United States.

Burke, L. E., Sereika, S. M., Music, E., Warziski, M., Styn, M. A., & Stone, A. (2008). Using instrumented paper diaries to document self-monitoring patterns in weight loss. Contemporary Clinical Trials, 29(2), 182-193. doi: 10.1016/j.cct.2007.07.004

Burke, L. E., Swigart, V., Warziski Turk, M., Derro, N., & Ewing, L. J. (2009). Experiences of Self-Monitoring: Successes and Struggles During Treatment for Weight Loss. Qualitative Health Research, 19(6), 815-828. doi: 10.1177/1049732309335395

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