Abstract 19852: When is the Ideal Time to Boost Dietary Self-Monitoring in the Prevention of Weight Regain?
Background: Dietary self-monitoring (DSM) is a key strategy in standard behavioral treatment for weight loss and weight gain prevention. Research has demonstrated the temporal decline in DSM adherence, which precedes the onset of weight regain. Our aim was to identify the time to boost DSM adherence and prevent weight regain.
Methods: This is a secondary analysis of daily self-weighing and daily DSM data in EMPOWER, a 12-month behavioral weight loss intervention. Weight data were collected using an in-home Wi-Fi enabled scale that uploaded data in real time. DSM was conducted using the smartphone app, Lose It! We used subject-specific piecewise linear models to detect weight regain onset and classified participants as maintainers vs. regainers. Failure in DSM before weight regain was indicated by a significant structural break (p<.05) in time-series of daily DSM adherence. We constructed a three-stage Markov model for the DSM failure in the weight regain process.
Results: Participants (N=137) were defined as regainers (72.3 %) vs. maintainers (27.7%) and 62.0% participants experienced failure in DSM. More regainers (68.4%) had failure in DSM than maintainers (59.6%). On average, participants began to fail in DSM at 126 ± 71 days, and after a mean 186 ± 79 days, participants began weight regain. Failure in DSM was a more hazardous stage for weight regain than the initial stage without failure (p<.05). Participants were more likely to fail in DSM first (hazard= 0.0039, 95% CI = (0.0031, 0.0048)) than regain weight without going through failure in DSM (hazard=0.0018, 95% CI = (0.0013, 0.0025)). Failure in DSM peaked (35.8%) at 195-201 days. (Figure)
Conclusions: Participants tended to fail in DSM first, the hazardous stage, then to regain weight. We recommend booster strategies to enhance adherence to DSM at 18-20 weeks (126-140 days), which may prevent DSM failure and weight regain and thus promote cardiovascular health.
Figure. Timeline for DSM failure and weight regain
Author Disclosures: Q. Ma: None. S.M. Sereika: None. G.M. Marsh: None. L.E. Burke: None.
- © 2016 by American Heart Association, Inc.