Fighting Fat with Fitbit, Text Messages, and Other Electronic Interventions to Promote Exercise

Most self-improvement intervention programs rely on self-monitoring, or increased awareness of bad habits, to help people change their behaviors. Traditionally, programs have used diaries, calendar notes, or check-ins at daily or weekly meetings to help individuals recognize and replace unhelpful routines. The October 2015 issue of Telemedicine and e-Health includes a study that describes how simple electronic feedback can help people with weight problems—and its limitations.

The study’s goal was to determine the effect of self-monitoring on physical activity. These investigators enrolled overweight and obese 67 adults into a randomized, prospective study. They tested 2 interventions. Half of the study population wore a sensor/device (Fitbit® One™; Fitbit Inc., San Francisco, CA) that provided instant feedback for 6 weeks. The other half wore the Fitbit, and also received 3 short message service (SMS) text-messaging prompts daily that encouraged them to exercise. The researchers tracked steps, minutes and intensity of physical activity.

Participants who wore the Fitbit One device had small, statistically significant increases in moderate to vigorous physical activity throughout the 6 week period. They increased their activity by about 1300 steps per day.

Participants who had the Fitbit One and received SMS-based prompts to exercise increased their physical activity over the first week, but by Week 2, they had reached a plateau of around 500 steps/day.

The investigators conducted a follow-up survey to try to determine why the group with the lesser of the 2 interventions (FitBit One alone) was more successful than those who also received SMS texts as well. They found that the FitBit One-only group was more engaged.

The investigators found that participants who received the SMS prompts reported the messages were too frequent and automated. It may be that the structure the researchers used—42 messages dispersed over 2 weeks and repeated twice over the next 4 weeks—lacked variety. The investigators also suggest that participants who only had the Fitbit One were more focused or less distracted from their goals.