Health eHeart: Daily Smart-Scale Use Tied to More Weight Loss

Marlene Busko

November 07, 2018

CHICAGO — After 1 year, people who weighed themselves daily or more than once a week lost more weight than those who weighed themselves less often in a new study.

Study participants were 18 years and older, mostly male, had purchased a WiFi-enabled bathroom scale, and joined the online Health eHeart study, which has been described as a Framingham study for the social-media era.

These findings, from Yaguang Zheng, PhD, MSN, University of Pittsburgh, and colleagues, will be presented at the American Heart Association (AHA) Scientific Sessions 2018 on November 10.

The participants did "not necessarily" want to lose weight, senior author Mark J. Pletcher, MD, MPH, associate professor of epidemiology and biostatistics, University of California, San Francisco, clarified to theheart.org | Medscape Cardiology, but they "wanted to track their weight."

The results show, he said, that "people exhibit different trajectories of self-weighing behavior," and these different behaviors are strongly associated with different patterns of weight loss.

However, the study cannot demonstrate cause and effect, he cautioned.

For example, "people who happen to weigh themselves more may also...tend to be more religious about their dietary choices and sticking with their [weight-loss] plan," he said, or conversely, seeing a drop in pounds on the scale may spur people to eat healthier and/or exercise more to try to keep the weight off.

The most that can be concluded from this study, said Pletcher, is that "there's a possibility that it might help to weigh yourself every day."

Invited to comment, AHA spokesperson Nieca Goldberg, MD, cardiologist and director, NYU Center for Women's Health and comedical director of the 92nd Street Y cardiac rehabilitation program in New York City, agrees that the study suggests that clinicians should "consider speaking to their patients about weighing themselves more often."

This use of a smart bathroom scale to track weight change "is a novel way to help promote weight loss. It promotes self-awareness in trying to reduce one of the major risk factors for heart disease."

However, "I think it has to be tried in more people, especially more women, as this study had 78% male participation," Goldberg stressed. Moreover, "one caveat is that some patients may be discouraged by little or no change from one day to the next and give up."

There are no guidelines that recommend specific weighing patterns, she noted. "When I counsel patients on weight loss, I explain that they need to reduce 500 calories to lose one pound a week," she said. "I also discuss diet and exercise recommendations. In my practice, I don't recommend daily weighing."

Digital-Era Framingham Study

For this study, Zheng and colleagues aimed to identify patterns of self-weighing to see if they were associated with differences in weight loss.

They examined data from the Health eHeart study, which has recruited more than 200,000 people since 2013. The study enrolls adults who have an email address, consent to complete online surveys, and allow their devices, such as a FitBit or blood pressure cuff, to transmit data to the researchers.

The current analysis is from 1042 participants who had at least 12 months of data from a WiFi- or Bluetooth-enabled bathroom scale.

Mean age of the participants was 48 years and mean body mass index (BMI) was 29 kg/m2. Most were male (78%) and white (90%).

"Some patients had a previous heart attack or stroke or had heart failure or cardiovascular risk factors," Pletcher reported, "but the majority were healthy."

They were not given any instruction about how often to weigh themselves or how to manage their weight, nor did they receive any weight-loss incentives.  

The researchers identified six types of self-weighing over the course of the year:

  • Consistent daily weighing (n = 281; 27%).

  • Rapid decline from weighing roughly 5 days/week to less than 1 day/week (n = 109; 11%)

  • Slow decline from weighing roughly 5 days/week to 3 days/week (n = 182; 18%)

  • Increased frequency from weighing roughly 2 days/week to 3 days/week (n = 160; 15%)

  • Weekly weighing (n = 189; 18%)

  • Never weighing (n = 121; 12%)

Participants who weighed themselves daily were more likely to be older, female, and check their weight daily right from the start.

At 12 months, those who weighed themselves daily had lost a mean of 1.7 kg; those who had a rapid or slow decline in the frequency of weighing had lost a mean of 1.9 kg and 1.8 kg, respectively; and those who increased their weighing frequency had lost a mean of 0.8 kg. All were significant differences from baseline (< .01).

However, participants who weighed themselves weekly had gained 0.2 kg, and those who never weighed themselves had lost 0.2 kg, differences that were not significant from baseline.

Zheng and Pletcher have no relevant financial disclosures.

American Heart Association (AHA) Scientific Sessions 2018: Abstract Sa2394. To be presented November 10, 2018.

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