Brief reportSelf-Weighing Promotes Weight Loss for Obese Adults
Introduction
Obesity is a leading cause of mortality1 and morbidity.2, 3 Modest weight loss reduces the incidence of chronic disease4 and allows many individuals to lose weight long term.5, 6 Frequent self-weighing has emerged as a strategy that works by focusing attention on weight and creating opportunities for reinforcement of minor progress.7 Although concerns have been raised over the psychological impact of regular self-weighing,8 it is a common9, 10, 11 and key component of lifestyle therapy.5 Cross-sectional analyses found that monthly self-weighing is associated with an approximate 0.5 kg/m2 reduction in BMI over 1 year, and daily self-weighing with a 2 kg/m2 reduction over 2 years.12 In one study,13 twice as many participants in a face-to-face counseling group who reported self-weighing less than daily (versus those who reported daily self-weighing) regained ≥2.3 kg after treatment.
Previous research has been hampered by methodologic shortcomings. Self-weighing assessments have been conducted exclusively via self-report. Self-reported weight is underestimated by overweight individuals,14, 15 so self-reported weighing frequency may be subject to similar biases. Also, typical self-weighing response options (e.g., daily, weekly) may not accurately reflect true weighing behavior over the long term. Further, participants are usually asked to self-weigh only weekly, thereby creating a ceiling effect that can negatively skew the self-weighing distribution.
Because of these issues, recommendations for the optimal frequency of self-weighing are currently unavailable. The purpose of this investigation was to examine the association between self-weighing and weight change in a cohort of individuals participating in a weight-loss program.
Section snippets
Participants
This research was conducted in the context of an RCT that took place between October 2005 and May 2007. Primary results from this trial are described elsewhere.16 Briefly, participants included 100 adults with a BMI >31 kg/m2. Study procedures were approved by the HealthPartners IRB.
Treatment
Participants were randomly assigned to either an immediate or delayed group. The immediate group received treatment immediately after enrollment, whereas the delayed group received treatment 6 months later.
Results
Of the 100 participants originally randomized, 91, 78, and 47 were available at pretreatment, post-treatment, and follow-up visits, respectively (Table 1). Participants who were available at all time points did not differ significantly from participants who missed one or more follow-up visits.
The first analysis revealed a significant self-weighing by time interaction at post-treatment (β±SE=−0.16±0.04, t=4.37, p<0.001), but not at the follow-up visit (β±SE=−0.06±0.05, t=1.20, p=0.230). Gender
Discussion
More-frequent self-weighing was associated with greater weight loss, a finding consistent with previous research.12 After 6 months, participants could expect to lose, on average, about 1 additional pound of body weight for every 11 additional days of self-weighing. These results were supported by the second analysis, which showed that participants who self-weighed weekly were six times more likely to have lost at least 5% of their pretreatment weight than participants who self-weighed less than
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At the time of research, Mr. VanWormer was affiliated with HealthPartners Health Promotion Department, Minneapolis, Minnesota.