Defense Date


Graduation Date

Spring 5-8-2020


One-year Embargo

Submission Type


Degree Name





School of Nursing

Committee Chair

Melanie Turk

Committee Member

Melissa Kalarchian

Committee Member

Christine Pellegrini


Self-monitoring, Weight loss, App, Adherence, Diet, mHealth, Mobile phone, eHealth, Obesity, Nutrition


Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned a daily calorie goal to achieve a one-pound weight loss per week. Frequency was measured by the percentage of days that any self-monitoring occurred; consistency was the recording of any dietary intake on ≥ 3 days each week; completeness was the recording of ≥ 50% of the weekly calorie goal. Data were analyzed with paired sample t-test and linear regression. Results: The sample [N = 90, mean (M) age = 42 ± 10 years (SD)] was employed (100%), primarily female (96.7%), White (90%), and married (63.3%) with a Bachelor’s or Associate’s degree (60%). A significant mean difference [t (89) = 6.59, p < .001] was found between baseline and 8-week weight (M = -3.26 ± 4.70 lbs.). Linear regression analysis revealed a significant association [F (1, 88) = 7.18, p = .009] between total weeks of consistently self-monitoring (M = 4.44 ± 2.77) and percent weight loss (M = -1.54% ± 2.26%); a significant association (F (1, 88) = 6.42, p = .013] was also found between the frequency of self-monitoring (M = 50.14% ± 33%) and percent weight loss. Conclusions: Results suggest that consistent and frequent app-based dietary self-monitoring is associated with weight loss. Clinicians may wish to emphasize these aspects of self-monitoring when providing weight loss counseling. Future research should investigate if less stringent self-monitoring requirements, such as three days per week, support self-monitoring adherence and weight change.



Additional Citations

Payne JE, Turk MT, Kalarchian MA, Pellegrini CA. Defining adherence to dietary self-monitoring using a mobile app: A narrative review. J Acad Nutr Diet. 2018;118(11):2094-2119.

Previous Versions

May 22 2020