Texting your way to weight loss

(Press-News.org) Contact information: Steve Hartsoe
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Duke University
Texting your way to weight loss Duke study finds tracking workout, diet habits through text messages could save time and improve healthy routines DURHAM, N.C. -- If the idea of keeping a food and exercise diary keeps you from joining a weight-loss program, there may be a better way.

Texting.

Research shows that when people keep track of their diet and exercise habits, they do better at losing weight. But sticking with detailed monitoring of what you eat and your exercise habits electronically or via traditional pen and paper can prove cumbersome. If people stop doing it, they may stop losing weight.

Tracking this information through text messages could save time and improve the likelihood of people sticking with their get-healthy routine, say researchers at Duke University.

Their study, published in the online edition of the Journal of Medical Internet Research, found that after six months, 26 obese women who used daily texting as part of the Shape Plan weight-loss intervention lost nearly 3 pounds, while another 24 who followed traditional methods gained 2 ½ pounds. The average age of participants was 38.

The daily text messages focused on tracking tailored behavioral goals (i.e., no sugary drinks, 10,000 steps per day) along with brief feedback and tips.

Every morning, participants got a text from an automated system that said, "Please text yesterday's # of steps you walked, # of sugary drinks, and if you ate fast food." Based on how they responded to the text, the automated system sent another text with personalized feedback and a tip.

"Text messaging has become ubiquitous and may be an effective method to simplify tracking of diet and exercise behaviors," said lead author Dori Steinberg, a post-doctoral obesity researcher in the Duke Obesity Prevention Program.

Text messaging offers several advantages compared to other self-monitoring methods, she said:

Unlike Web-based diet and exercise diaries, data in a text message can be entered quickly on nearly all mobile phone platforms. This provides more portability, nearly real-time tracking and more accessibility for receiving tailored feedback.

Previous studies show that long-term adherence to traditional monitoring is poor, possibly because they are time- and labor-intensive, require extensive numeracy and literacy skills, and can be perceived as burdensome.

Text messaging has been conventionally limited to about 15-20 words per message, thus reducing the detail and cognitive load that is required for documenting diet and exercise behaviors.

The study primarily focused on helping obese black women lose weight (82 percent of participants were black). Researchers said that's because 59 percent of black women are obese, and many use cell phones. This combination makes text messaging a good way to reach this high-risk population.

About half of participants texted every day throughout the six-month program, with 85 percent texting at least two days per week. Most participants reported that that texting was easy, and helped them meet their goals.

The key challenge in weight loss is helping people keep weight off for the long-term. So the next step is to see if texting can help people maintain their weight loss.

"Given the increasing utilization of mobile devices, text messaging may be a useful tool for weight loss, particularly among populations most in need of weight-loss treatment," Steinberg said.

### CITATION: Dori Steinberg, Erica Levine, Sandy Askew, Perry Foley, Gary Bennett, Duke Global Health Institute, Duke University. "Daily Text Messaging for Weight Control Among Racial and Ethnic Minority Women: Randomized Controlled Pilot Study." Journal of Medical Internet Research DOI: 2013;15(11):e244