Weekly home-based weight self-monitoring: a simple adjuvant strategy for reduction of BMI in children with obesity

To examine the feasibility and effectiveness of weekly home-based weight measurements as a motivational tool for improvement of Body Mass Index (BMI) among children with obesity followed in an academic outpatient clinic. Subjects ages 8–18 years, with a mean age of 13 years and 7 months, were recruited from a pediatric endocrinology clinic. Inclusion criteria were BMI > 95th percentile and willingness to participate in weekly weight measurements for at least 3 months. Patients with obesity related to medication, genetic syndromes, or endocrine conditions were excluded. Participants were weighed at baseline and asked to weigh themselves at home weekly (same day, same time), recording weights via the Qualtrics survey platform. BMI z-scores were calculated using each weight measurement (from clinic visits or home self-weighing) paired with the most recently available height measured by clinical staff at an in-person clinic visit, which occurred approximately every 4 months. Weekly reminders were sent by email, text messaging, and/or phone calls. Mann-Whitney U test was used for statistical analysis with significance set at p 0.05. Fifty-four subjects (26 male, 28 female) were recruited. Twenty-four subjects (8 male, 16 female) completed 3- to 6-month follow-up. Fourteen subjects (5 male, 9 female) obtained at least one home weight measurement (adherent group), while ten subjects did not report any measurement (non-adherent group). The adherent group achieved a statistically significant reduction in median BMI z-score of 0.23 points (from 2.32 to 2.09), compared with an increase of 0.13 points (from 1.95 to 2.08) in the non-adherent group ( p = 0.026). Barriers to adherence included difficulty with patient contact, insufficient parental involvement, absence of financial incentives, and lack of a home scale. Weekly home-based self-weighing was associated with a greater reduction in BMI z-score among engaged participants in this pilot cohort; these hypothesis-generating findings warrant confirmation in a randomized controlled trial.