Daily Self Weigh-in and Tracking Prevents Holiday Excess

Becky McCall

May 23, 2019

People who weighed themselves daily and tracked fluctuations via an app avoided weight gain over the holiday season compared with those who didn't monitor themselves in this way, show the results of the first randomized controlled trial (RCT) of its kind.

Overall, there was very little weight change in the intervention group (−0.13 kg), but those in the control group, who did not weigh themselves daily, gained a significant amount of weight between Thanksgiving and New Year's Day  (+2.65 kg, P < .001).

In the daily self-weighing group, those who were overweight or obese responded most favorably to daily self-weighing, and actually lost weight (−1.46 kg), whereas those of normal weight in that group maintained it (+ 0.33 kg; P = .01). The drop in the percentage total body fat seen in those in the daily self-weighing group also suggested that the intervention was effective in improving body composition.

"Vacations and holidays are probably the two times of year people are most susceptible to weight gain in a very short period of time," said senior author Jamie Cooper, PhD, from the University of Georgia in Athens, in a press release from The Obesity Society. "The holidays can actually have a big impact on someone's long-term health."

In their study, published online yesterday in the journal Obesity, Cooper and Sepideh Kaviani, PhD, and Michelle vanDellen, PhD, both from the University of Georgia, say previous studies show holiday weight gain can persist long after the holiday.

So they suggest that daily self-weighing "is a potentially effective approach in preventing holiday-associated weight gain in adults, with weight loss in overweight or obesity." They add that holiday weight gain "may be a major contributor to annual weight gain, and therefore to the increasing prevalence of obesity."

Self-Monitoring of Weight With Feedback Prevents Holiday Splurge

To test their hypothesis, a total of 111 adults were randomly assigned between a control group that did not require daily self-weighing, and an intervention group that did. All participants completed a pre-holiday visit before Thanksgiving, a post-holiday visit after New Year's Day, and a follow-up visit 14 weeks after the post-holiday visit.

Daily self-weighing patients used WiFi-enabled scales to track weight daily during the holidays, and participants were told to try and avoid weight gain above baseline weight. Upon weighing, data automatically transferred to the participant's dedicated account and associated mobile app (Nokia Health Mate), and electronic graphical feedback of weight fluctuations immediately appeared on the scale's screen and on the app.

No additional advice or instruction on avoiding weight gain was provided, allowing participants to make their own choices on how to maintain their weight (for example, by more physical activity or eating less).

Participants in the control group received no instructions.

Commenting on the finding that the group who self-weighed either maintained or lost weight during the holiday season, Cooper explained that, "Maybe they exercise a little bit more the next day, after seeing a weight increase, or they watch what they are eating more carefully. The subjects self-select how they are going to modify their behavior, which can be effective because we know that interventions are not one-size-fits-all."

Coauthor vanDellen said the findings support theories around discrepancy and differences in the self.

"When they see that discrepancy, it tends to lead to behavioral change," she said. "Daily self-weighing ends up doing that for people in a really clear way."

Susan Yanovski, MD, an obesity researcher at the National Institute of Diabetes and Digestive and Kidney Diseases who was not involved in the study, added, "Replication in larger studies with more diverse participants would help to determine the generalizability of this approach for weight gain prevention."

Temptation to Consume More During Holidays

Of note, those participants in the control group who gained weight over the holiday period also showed an increase in percentage total body fat.

And there was a difference between men and women in this group, in terms of whether they subsequently lost the weight they had gained over the holidays.

Overall, the control group participants lost some weight during follow-up (−1.14 kg, P = .01) but retained 57% of the holiday weight gain, so that overall excess from November to May was significant. But there was a big difference by gender: men in the control group lost approximately 95% of their holiday weight gain at follow-up, whereas women retained approximately 77% of their holiday weight gain. 

The authors report that the reduction in the uncontrolled eating score after follow-up in the daily self-weighing group suggests that the intervention may result in better control over quantity and frequency of food intake.

"Conversely, in the absence of daily self-weighing, the increase in the external cues score verifies the appetizing components of the holidays, such as larger portions, more social eating, and more access to food," they write.

They note, however, that they do not have a mechanistic explanation for the stronger responses to daily self-weighing in those with overweight or obesity, based on their findings.

"Daily self-weighing plus graphical feedback may be an ideal target for all adults, but especially for those with overweight and obesity. However, … future research is warranted to verify the effectiveness of this intervention," they conclude.

The study authors have disclosed no relevant financial relationships.

Obesity. Published online May 22, 2019. Full text

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