Mobile weight self-monitoring adherence and eating behavior changes: A secondary analysis of a 12-month RCT

Mobile health behavior change support systems (mHBCSS) have been shown effective in weight management by promoting self-monitoring, a persuasive strategy that enhances engagement and supports healthier behaviors. Daily weight tracking supports weight loss but may increase the risk of disordered eating, particularly in individuals with obesity.

To assess the 12-month impact of weight self-monitoring on eating behaviors among individuals with obesity using a mHBCSS.

We analyzed data from 98 participants in a 12-month randomized controlled trial using a mHBCSS. Participants were grouped into "continuous self-monitors" (monitored ≥6 months) and "non-continuous self-monitors." Outcomes included binge eating scale (BES), cognitive restraint (CR), emotional eating (EE), and uncontrolled eating (UE). Between-group differences at each time point (0, 6 and 12 months) were evaluated with the Mann-Whitney U test. Within-group changes over time were analyzed using the Friedman test, followed by Wilcoxon signed-rank tests for pairwise comparisons.

Continuous self-monitors exhibited significantly higher CR at six months (p < 0.01) and lower BES across all time points (p < 0.05, < 0.01, < 0.001) when compared to non-continuous self-monitors. Within-group analysis revealed that in the continuous self-monitor group, BES, UE and EE showed significant reductions over time (p < 0.0001), while CR increased (p < 0.0001).

Continuous self-monitoring appears to support sustained improvements in eating behaviors, including increased CR and reductions in disordered eating patterns over time. These findings highlight the potential of tailored mHBCSS, using evidence-based strategies, personalized feedback, and subtle reminders, to enhance engagement, promote healthier habits, and reduce the risk of disordered eating.