It’s no surprise that obesity rates are crazy-high and continue to rise in the U.S. The latest CDC numbers cite a 42% obesity prevalence among U.S. adults in 2017-2018, up from 30.5% in 1999-2000. We’ve written about telehealth weight loss programs, employee health programs to lose weight, and even an app that shows measuring one’s breath can reveal weight loss. Diets and weight loss programs fade in and out but obesity rates persist. Weight loss programs often work for only a brief time before people give up and typically regain any weight lost and possibly pick up a few more pounds. The occurrence of yoyo dieting is all too common. The specifics of weight loss programs may in the end be less important than meta issues that support longer lasting results.

A team from the Stanford Prevention Research Center explored a meta issue related to self-monitoring in weight loss prevention. Led by Michele Patel, a postdoctoral fellow in cardiovascular disease prevention, the researchers conducted a study of studies. The goal was to determine whether digital self-monitoring related to more or less engagement and weight loss success than paper-based monitoring. Patel’s team published the results of their inquiry in Obesity.

The Stanford team sought out weight loss intervention studies from 2009 to 2019. The team identified 53 studies that met the following criteria: randomized controlled trials with interventions lasting at least 12 weeks, weight outcome data for at least 6 months, and self-monitoring outcome data. From the greater set, 39 of the studies included digital self-monitoring and the remainder used paper-based self-tracking.

Among the test group with digital monitoring, 72% tracked weight, 81% tracked diet, and 82% tracked physical activity. The test group studies used various means of digital self-monitoring. Monitoring modes included websites, mobile apps, wearables, electronic scales, and text messaging, in order of greatest frequency. Following data analysis from the 53 groups, the Stanford group reported that engagement rates were higher with digital self-monitoring than paper monitoring in 21 of 34 comparisons and higher with paper monitoring in only 2 comparisons. The team also observed that higher rates of digital self-monitoring related to the amount of weight loss in 74% of the instances.

Patel’s team concluded that digital health self-monitoring correlates positively with weight loss in behavioral obesity treatment and is superior to paper monitoring modes. The researchers also found that passive forms of digital self-monitoring, such as wearing a tracker or stepping on an electronic scale related to higher engagement than active engagement modes, such as those that required entering data on a website or app. This last observation is consistent with our belief that health tech needs to “disappear” into our lives to be widely adopted and effective.