Effectiveness of a weight-loss intervention using selfmonitoring practice with eating behavioral commandments in obese females

Background: The treatment of obesity is challenging, and its management is often intensive and requires significant professionalcommitments. A core principle of behavioral interventions for obesity is self-monitoring, often with a focus on counting calories andmonitoring body weight.Objectives: We tested a newly developed behavioral intervention that concentrates on the self-monitoring of 10 levels of eating behaviorand requires little professional interaction with participants. Effectiveness was assessed in terms of body characteristics, blood health-riskparameters, and food attitudes.Materials and Methods: Morbidly obese females (n=104) from an outpatient obesity clinic at King Fahad Medical City, Riyadh, SaudiArabia took part in the intervention for 3 months and were assessed at baseline and post-treatment. Blood glucose homeostasis and lipidparameters were measured in addition to body characteristics, attitudes toward foods, and intervention commitment.Results: A total of 97 morbidly obese females completed the study. Participants achieved moderate body weight (−7.8%) and fat loss(−5.5%); study commitment was strongly associated with body mass index change (rho=−0.703, P < 0.001). Glucose homeostasisimproved significantly as follows: hemoglobin A1c level improved by −7.5%, fasting glucose by −7.3%, and Homeostasis Model Assessmentinsulin sensitivity and insulin resistance improved by about 16%. Blood lipids improved significantly as follows: triglycerides level improvedby −14%, low-density lipoproteins by −8%, total cholesterol by −6%, and high-density lipoproteins by +5%. Blood health parameters weresignificantly associated with distinct commitment to behaviors suggesting improvements in diet.Conclusion: The intervention based on self-monitoring of eating behaviors was effective in achieving moderate weight loss, lead toimprovements in blood health-risk markers related to metabolic and cardiovascular disease, and improved food attitudes