Adherence to Self-Monitoring Predicts Weight Loss and Weight Regain in Rural Breast Cancer Survivors

Abstract

Background: Pre-packaged food is a common and successful dietary approach used in commercial, medically supervised, and some academic weight loss programs. Prepackaged food enhances weight loss results and minimizes weight regain, however the role of self-monitoring has not been investigated. Predictors of self-monitoring adherence have also not been addressed. Objective: To examine the role of self-monitoring consistency in weight loss and weight loss maintenance in which prepackaged entrees, meal replacement shakes, servings of fruits and vegetables, unplanned snacks and meals out were tracked ≥5 days/week. Depressive symptoms as a predictor of self-monitoring adherence were explored. Methods: 210 Breast cancer survivors (BMI=27 to 45kg/m2) living in the rural Midwest enrolled in an intervention with two phases: non-randomized 6-month weight loss followed by 12-month weight maintenance where participants were randomized to either continued bi-weekly conference calls or bi-weekly newsletters. Final analyzed sample included 191 participants. Results: Higher weekly self-monitoring consistency was associated with higher weight loss at 6 months, F(2, 189) =29.87, p<0.001, R2=0.13. Higher levels of self-monitoring predicted lower weight regain at 18 month, β4 = 0.10, t(254.9) = 3.012 p = 0.0029. Depression severity measured at baseline significantly predicted average self-monitoring consistency across the first 6 months, F(1,189) = 5.91, p<0.02; R2=0.025. Depressive symptom severity at 6 months predicted average self-monitoring consistency across months 6 to 18, F(1,166) = 9.95, p=0.002, R2=0.051. Conclusion: Weight management relies on self-regulation strategies promoted by self-monitoring and food environment. These strategies may help individuals continue positive behavior changes long term. Mood may need to be addressed as a barrier to self-monitoring.