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Self-monitoring of progress in weight-reduction: A preliminary report

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Abstract

This paper reports a weight-graphing technique which combines feedback with goal-setting and thus makes progress toward goal weight salient. The technique was used by 11 individuals who lost a mean of 9.6 lb in a mean of 39 days. These results are within the range of those obtained with more comprehensive treatments, suggesting that well-chosen feedback as to progress toward naturally-occurring rewards may be an effective change influence.

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... Soon after Stuart's behavioral approach was published, Fisher, Green, Friedling, and Levenkron (1976) published the first clinical study on the effectiveness of self-weighing to produce a weight loss. They reported the weight loss of 11 case studies in which participants were instructed to weigh themselves daily and graph their weight on a chart. ...
... They tested whether it was more Source. Fisher, Green, Friedling, and Levenkron (1976). ...
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The objective of this study is to review the history of daily self-weighing for weight control, discuss the possibility that selfweighing may cause adverse psychological symptoms, and propose mechanisms that explain how self-weighing facilitates weight control. A systematic forward (citation) tracking approach has been employed in this study. In the early literature, experimental tests did not demonstrate a benefit of adding daily self-weighing to traditional behavioral modification for weight loss. More recent studies have shown that daily self-weighing combined with personalized electronic feedback can produce and sustain weight loss with and without a traditional weight loss program. Daily self-weighing appears to be effective in preventing age-related weight gain. Apart from these experimental findings, there is considerable agreement that the frequency of self-weighing correlates with success in losing weight and sustaining the weight loss. The early literature suggested frequent self-weighing may be associated with negative psychological effects. However, more recent experimental trials do not substantiate such a causal relationship. In conclusion, daily self-weighing may be a useful strategy for certain adults to prevent weight gain, lose weight, or prevent weight regain after loss. More research is needed to better understand the role of different types of feedback, who benefits most from self-weighing, and at what frequency.
... A speculative behavioral treatment composed of several techniques was used as a control. One of these, a self-monitoring procedure had appeared to be a useful approach to weight reduction in a series of clinical case studies (Fisher, Green, Levenkron , Porter, and Friedling, 1976 ). Other aspects of the control procedures focused on the general notions of self-initiated self-control and problem solving. ...
... The manual did not prescribe any self-control strategies but was designed to illustrate a wide range of selfcontrol activities and to give individuals a general understanding from which they could develop their own techniques. The second component of the SI was a weight graphing technique based on the assumption that measures that increase the salience of the long-term goals of weight loss and increase the salience of progress toward that goal will support continued preferences for it (Fisher et al., 1976). This technique was designed, then, to make effective, rather than to replace, the naturally occurring positive consequences of changes in behavior. ...
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A central component of a commonly used weight-loss procedure developed by Stuart (1967), which emphasizes situational engineering (SE), was compared to eating behavior control (EBC), a treatment employing reinforcement of changes in eating habits. A third treatment encouraged development of individuals' own applications of a model of self-control and attempted to provide effective feedback regarding progress toward weight-loss goals. This self-initiated treatment (SI) was designed to be less directive than many behavioral treatment packages and to be more realistic about the expectations of subjects and the actual eating habits of overweight and normalweight people. Following baseline, treatment lasted six weeks and followup lasted 16 weeks. While all treatments produced weight losses, EBC surpassed SE during treatment. SI losses during treatment did not differ from SE or EBC, but SI was the only group that lost weight throughout followup, indicating the possible utility of more subtle, less directive interventions than those that have often been associated with behavioral approaches. The results of SE question the applicability to clinical procedures of the external cue hypersensitivity theory of obesity (Schachter and Rodin, 1974), to which SE is closely related.
Chapter
One scarcely has to build a case for the seriousness of obesity as a hazard to both physical and psychological health. Obesity is associated with coronary heart disease, atherothrombotic brain infarction, congestive heart failure, high blood pressure, high serum cholesterol, high triglycerides, and high density lipoproteins. And then there is the great social and psychological price the overweight individual must pay. We are told that obesity is one of the most serious and prevalent health disorders in the United States (29), with estimates that as many as 80 million Americans are dangerously overweight.
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Empirical evaluations of therapies designed to improve self-regulatory skills have not as yet demonstrated their success as methods of ensuring long-lasting behavior change. The clinical use of concepts and procedures derived more from assumptions about the nature of self-regulation than from empirical evidence may be responsible for some of these outcomes. This paper demonstrates that a fine-grained, empirically-based, analysis of the active elements of “self-regulatory failure” is both possible and useful. Based on an examination of three literatures (successful vs. unsuccessful self-regulation; the relapse process; attention in self-regulation), eight components of self-regulatory failure are identified: depressogenic cognitions; difficulties coping with emotional Stressors; disengagement from habit change; social pressure; initial relapse episode; physiological pressure; problematic attentional focusing; and disengagement from self-monitoring. It is noted that further empirical work is necessary to specify probable patterns of interaction between these elements. One exception is discussed: it appears that many of the proposed elements can lead to disengagement of self-monitoring which, in turn, often precipitates a rapid failure to sustain effective self-regulation. Finally, a general strategy to prevent self-regulatory failure is discussed that accords well with this conceptualization—engaging in “obsessive-compulsive self-regulation.”
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When offered a choice (Choice Y) between a small immediate reward (2-sec exposure to grain) and a large reward (4-sec exposure to grain) delayed by 4 sec, pigeons invariably preferred the small, immediate reward. However, when offered a choice (Choice X) between a delay of T seconds followed by Choice Y and a delay of T seconds followed by restriction to the large delayed reward only, the pigeon's choice depended on T. When T was small, the pigeons chose the alternative leading to Choice Y (and then chose the small, immediate reward). When T was large, the pigeons chose the alternative leading to the large delayed reward only. The reversal of preference as T increases is predicted by several recent models for choice between various amounts and delays of reward. The preference for the large delayed alternative with long durations of T parallels everyday instances of advance commitment to a given course of action. Such commitment may be seen as a prototype for self-control.
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Items considered valuable by the subject and originally his property were surrendered to the researcher and incorporated into a contractual system of prearranged contingencies. Each subject signed a legal contract that prescribed the manner in which he could earn back or permanently lose his valuables. Specifically, a portion of each subject's valuables were returned to him contingent upon both specified weight losses and losing weight at an agreed-upon rate. Furthermore, each subject permanently lost a portion of his valuables contingent upon both specified weight gains and losing weight at a rate below the agreed-upon rate. Single-subject reversal designs were employed to determine the effectiveness of the treatment contingencies. This study demonstrated that items considered valuable by the subject and originally his property, could be used successfully to modify the subject's weight when these items were used procedurally both as reinforcing and as punishing consequences. In addition, a systematic analysis of the contingencies indicated that punishing or aversive consequences presumably were a necessary component of the treatment procedure.
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Hypothesized that the motivational effects of knowledge of results (KR) were a function of the goals Ss set in response to such knowledge. Previous studies were classified into 4 categories according to the degree to which KR and goal setting effects were separated: (1) 1 group of studies explicitly confounded the 2 variables by assigning KR and no-KR Ss different goals; (2) other studies gave KR only in relation to standards or gave S a record of his previous performance, both of which procedures probably encouraged goal setting by KR Ss; (3) a 3rd group of studies did not involve any obvious manipulation of goals but the goals set spontaneously by the KR and no-KR Ss were not actually measured; (4) 4 studies which separated KR and goal-setting effects found significant relationships between goals and performance but no effect of KR per se. Other studies which gave multiple KR (based on independent performance parameters) found performance improvement to be restricted to that parameter on which S set a goal of improvement. (52 ref.)
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Questions the widespread use of tokens to effect desired changes in behavior. Analysis of data from attribution-type research demonstrates that learning to perform an activity on the basis of external, token reinforcement does not generalize to natural reinforcement but leads, instead, to a decrease of intrinsic interest in the activity. Withdrawal of the token reinforcement often reduces performance. This may be because the generalization paradigm used is often either a discrimination or an extinction paradigm. It is suggested that employment of token reinforcement be restricted to situations in which an important behavior has a low base-rate of occurrence. (26 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Seventy overweight subjects were assigned to five groups to assess the reactive nature of self-monitoring procedures. The groups were: (1) no treatment control; (2) self-recording daily weight; (3) self-recording daily weight and daily caloric intake; (4) behavior management and stimulus control instruction; and (5) behavior management, stimulus control, and self-recording of daily weight and daily caloric intake, with the initial treatment phase lasting 4 wk. Results indicated no significant difference between self-recording of daily weight and no-treatment control. Self-recording of daily weight and daily caloric intake, without therapist contact, was as effective as the behavior management and the behavior management and self-recording groups, both of which had weekly therapist contacts. Follow-up evaluations at 4 and 13 wk, respectively, indicated that the behavior management and behavior management and self-recording groups were not significantly different, although both showed a substantial weight loss that was maintained over the follow-up period. Implications for obesity, self-monitoring, and self-control research are discussed.
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Obese adult volunteers (N=49) were randomly assigned to one of fourconditions: (1) Self-Reward for Weight Loss, (2) Self-Reward for Habit Improvement, (3) Self-Monitoring, and (4) Delayed Treatment Control. Individuals in the first three groups were given information on basic stimulus control techniques for weight loss and self-monitored their weight and eating habits for a 2-wk baseline. Thereafter, Self-Monitoring subjects continued their recording and received standardized weight loss and habit change goals at individual weekly weight-ins. In addition to the above self-monitoring procedures, Self-Reward subjects awarded themselves portions of their own deposit for attainment of either their weight loss (SR-Weight) or their habit improvement (SR-Habit) goals. Control subjects received no treatment during the first 8 wk but thereafter participated in a program which combined the procedures of the previous Self-Reward groups. Weight reduction analyses revealed brief and variable losses during the self-monitored baseline. However, even after the addition of goal-setting, these reductions did not prove to be either enduring or significant. When self-reward was added to self-recording, substantial weight loss improvements were observed. These improvements were more pronounced when subjects rewarded themselves for habit change rather than weight loss. A significant relationship was found between successful weight reduction and degree of eating improvement. Clinical implications and contemporary research issues are briefly discussed.
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Examined the reactive effect of self-monitoring in 3 experiments with a total of 250 undergraduates. In each experiment, performance on a sentence-construction task, the dependent measure, was determined immediately before and after the experimental manipulations were presented. Exp I evaluated the effect of valence or social desirability of the behavior and self-monitoring and being observed by another person; and Exp III replicated the effect of performance standard and also evaluated the role of response feedback. Results indicate that (a) self-monitoring was reactive, (b) the valence given to the target response determined the direction of behavior change, (c) self-monitoring and response valence were necessary but not sufficient conditions for behavior change, (d) monitoring one's own behavior or being monitored by someone else were equally reactive, (e) providing a performance goal or feedback augmented the reactive effects of self-monitoring, and (f) the act of self-recording led to behavior change. (33 ref)
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Randomly assigned 48 female and 5 male obese adults to 5 groups: (a) self-reward, (b) self-punishment, (c) self-reward and self-punishment, (d) self-monitoring, and (e) information control. All Ss were given information on effective stimulus control techniques for weight loss. Self-monitoring Ss were asked to weigh in twice per week for 4 wks and to record their daily weight and eating habits. Self-reward and self-punishment Ss, in addition to receiving self-monitoring instructions, were asked to award or fine themselves a portion of their deposit contingent on changes in their weight and eating habits. After 4 wks of treatment, self-reward Ss lost significantly more weight than either self-monitoring or control Ss. At a 4-mo follow-up, Ss who had received self-reward instructions continued to show greater improvement than either the self-punishment or control Ss. Findings provide a preliminary indication that self-reward strategies are superior to self-punitive and self-recording strategies in the modification of at least some habit patterns.
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The relative efficacy of the major techniques typically used in behavioral treatment programs for weight reduction was investigated using obese adult volunteers. Study 1 compared the effects of self-monitoring, self-control procedures, monetary rewards, aversive imagery and relaxation training. These procedures resulted in significantly greater weight reduction than either a no treatment group or subjects who graphed and recorded daily weight. Self-monitoring of daily caloric intake was as effective as the other methods, both singly and combined, over a 4 week treatment period. Study 2 compared the long-term effects of self-monitoring vs the full complement of behavioral techniques used in Study 1. The full behavior management program was significantly more effective, both during the treatment period and at 3 and 12 week follow-ups, although self-monitoring again produced substantial weight loss.
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Discusses objections to the use of tangible reinforcers, e.g., prizes, candy, cigarettes, and money. The objections range from concerns about bribery to concerns about adverse behavioral effects. While the use of tangible reinforcers has been extensively shown to change certain behaviors, their misuse is all too frequent. Treatment programs using tangible reinforcers are recommended as powerful modifiers of behavior to be implemented only after less powerful means of modification have been tried. (27 ref.)
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Obesity is seen as a consequence of a positive balance of energy consumed over energy expended. The reduction of obesity is accordingly sought through the reduction in the amount of food eaten coupled with an increase in the rate at which energy is expended. Both the reduction in the rate of eating and the increase in the rate of exercise are sought through management of critical aspects of the environment. Specific recommendations are made for the behavioral treatment of obesity, with the success of the treatment seeming to depend upon the effectiveness with which environmental stimuli are brought under control rather than depending upon motivational or other personal characteristics of the overeater Pre-test data generated by the use of this procedure, coupled with the results of several recent studies appear to indicate uniquely positive results for the behavioral control of overeating.
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