Patterns of Success: Online Self-Monitoring in a Web-Based Behavioral Weight Control Program

Objectives: Online weight control technologies could reduce barriers to treatment, including increased ease and convenience of self-monitoring. Self-monitoring consistently predicts outcomes in behavioral weight loss programs; however, little is known about patterns of self-monitoring associated with success. Method: The current study examines 161 participants (92% women; 31% African American; mean body mass index = 35.7 +/- 5.7) randomized to a 6-month online behavioral weight control program that offered weekly group "chat" sessions and online self-monitoring. Self-monitoring log-ins were continuously monitored electronically during treatment and examined in association with weight change and demographics. Weekend and weekday log-ins were examined separately and length of periods of continuous self-monitoring were examined. Results: We found that 91% of participants logged in to the self-monitoring webpage at least once. Over 6 months, these participants monitored on an average of 28% of weekdays and 17% of weekend days, with most log-ins earlier in the program. Women were less likely to log-in, and there were trends for greater self-monitoring by older participants. Race, education, and marital status were not significant predictors of self-monitoring. Both weekday and weekend log-ins were significant independent predictors of weight loss. Patterns of consistent self-monitoring emerged early for participants who went on to achieve greater than a 5% weight loss. Conclusions: Patterns of online self-monitoring were strongly associated with weight loss outcomes. These results suggest a specific focus on consistent self-monitoring early in a behavioral weight control program might be beneficial for achieving clinically significant weight losses.