Adoption of diet-related self-monitoring behaviors varies by race/ethnicity, education, and baseline binge eating score among overweight-to-obese postmenopausal women in a 12-month dietary weight loss intervention

Abstract

Recent research has identified self-monitoring behaviors as important strategies for both initial weight loss and weight loss maintenance, but relatively little is known about adopters and nonadopters of these behaviors. To test our hypothesis that key characteristics distinguish adopters from nonadopters, we examined the demographic characteristics and eating behaviors (eg, restrained, uncontrolled, emotional, and binge eating) associated with more frequent compared with less frequent use of these behaviors. Baseline demographic characteristics and eating behaviors as well as 12-month self-monitoring behaviors (ie, self-weighing, food journaling, monitoring energy intake) were assessed in 123 postmenopausal women enrolled in a dietary weight loss intervention. Logistic regression models were used to test associations of self-monitoring use with demographic characteristics and eating behaviors. Nonwhites, compared with non-Hispanic whites, were less likely to monitor energy intake regularly (adjusted odds ratio [OR], 0.36; 95% confidence interval [CI], 0.13-0.97; P < .05), controlling for intervention arm and baseline body mass index. Participants with a college degree or higher education were less likely to self-weigh daily (adjusted OR, 0.30; 95% CI, 0.13-0.67; P < .01) compared with individuals who attended some college or less. Those with higher baseline binge eating scores were less likely to monitor energy intake (adjusted OR, 0.84; 95% CI, 0.73-0.97; P < .01) compared with participants with lower binge eating scores. In summary, use of diet-related self-monitoring behaviors varied by race/ethnicity, education, and binge eating score in postmenopausal women who completed a year-long dietary weight loss intervention. Improved recognition of groups less likely to self-monitor may be helpful in promoting these behaviors in future interventions.

Introduction

Previous research has identified diet-related self-monitoring behaviors such as self-weighing, maintaining food journals, and monitoring energy intake as important strategies for both initial weight loss and weight loss maintenance [1], [2], [3], [4], [5], [6], [7], [8]. Although adherence to these behaviors may contribute to the effectiveness of behavioral interventions for weight loss, adoption of these behaviors might vary by demographic characteristics (eg, age, race/ethnicity) and eating behaviors [1], [9], [10]. For instance, daily weighing and food journal use have been found to be associated with older age among individuals enrolled in the National Weight Control Registry [1] and in the Diabetes Prevention Program clinical trial [11]. In a large multiethnic sample of adults participating in a weight loss trial, African Americans were less likely to adhere to food journal use compared with non-Hispanic whites [9]. In studies of successful weight maintainers, daily self-weighing has been associated with higher dietary restraint and less disinhibition [1], [10]. However, it is unclear if demographic characteristics and eating behaviors vary across the constellation of self-monitoring behaviors common in dietary weight loss interventions and if previous findings also apply to postmenopausal women in the context of a weight loss trial. We hypothesized that there would be characteristics that distinguish adopters and nonadopters of self-monitoring behaviors. Therefore, the objective of this study was to assess baseline differences in demographic characteristics and cognitive aspects of eating behaviors by diet-related self-monitoring behavior use among postmenopausal overweight-to-obese women enrolled in a year-long dietary weight loss intervention. To test our hypothesis that key characteristics distinguish adopters from nonadopters, we examined the demographic characteristics and eating behaviors (eg, restrained, uncontrolled, emotional, and binge eating) associated with more frequent compared with less frequent use of these behaviors.