Expert opinions on reducing dietary self-monitoring burden and maintaining efficacy in weight loss programs: A Delphi study

Abstract

Objective: Dietary self-monitoring is consistently related to both short- and long-term weight loss, but typically declines over time. Adopting an abbreviated approach to self-monitoring might reduce burden and potentially increase engagement while maintaining efficacy. Methods: Using a Delphi-type study, experts were queried about abbreviated self-monitoring approaches that might best balance efficacy and burden and asked to identify when these approaches might best be implemented within a behavioral weight loss program. Experts were surveyed three times until consensus was reached. Results: Experts identified three main categories of promising strategies for abbreviated self-monitoring regardless of whether individuals have been successful with weight loss or full dietary self-monitoring: (1) self-weighing only, (2) reducing the foods/beverages self-monitored to those that are often less routine and higher in caloric density, and (3) reducing the number of days per week to engage in full dietary self-monitoring. Experts recommended transitioning to abbreviated self-monitoring after 2 weeks of no self-monitoring among individuals who were struggling and after reaching 5%–10% weight loss among successful individuals. Conclusions: These expert opinions offer a foundation to experimentally manipulate promising strategies for reducing burden and increasing long-term engagement in self-monitoring, with a goal of enhancing long-term weight control.