Objective: Self- monitoring is a core component of behavioral obesity treatment, but it is unknown how digital health has been used for self- monitoring, what engagement rates are achieved in these interven-tions, and how self- monitoring and weight loss are related.
Methods: This systematic review examined digital self- monitoring in behavioral weight loss interventions among adults with overweight or obesity. Six databases (PubMed, Embase, Scopus, PsycInfo, CINAHL, and ProQuest Dissertations & Theses) were searched for randomized controlled trials with interventions ≥ 12 weeks, weight outcomes ≥ 6 months, and outcomes on self- monitoring engagement and their relationship to weight loss.
Results: Thirty- nine studies from 2009 to 2019 met inclusion crite-ria. Among the 67 interventions with digital self- monitoring, weight was tracked in 72% of them, diet in 81%, and physical activity in 82%. Websites were the most common self- monitoring modality, followed by mobile applications, wearables, electronic scales, and, finally, text messaging. Few interventions had digital self- monitoring engagement rates ≥ 75% of days. Rates were higher in digital- than in paper- based arms in 21 out of 34 comparisons and lower in just 2. Interventions with counseling had similar rates to standalone inter-ventions. Greater digital self- monitoring was linked to weight loss in 74% of occurrences.
Conclusions: Self- monitoring via digital health is consistently asso-ciated with weight loss in behavioral obesity treatment