Module 1: Monitoring Food Intake, Physical Activity and Body Weight

  • Riccardo Dalle Grave
  • Massimiliano Sartirana
  • Marwan El Ghoch
  • Simona Calugi


Module 1 introduces self-monitoring of food intake and physical activity and weekly weighing. These two procedures are central to cognitive behavioural therapy of obesity (CBT-OB), because evidence has shown that the greater the use of self-monitoring, the larger the amount of weight lost. Furthermore, regular checking of weight is associated with better long-term weight-maintenance outcomes. The Monitoring Record used in CBT-OB differs from a traditional food diary, since it is used to record both mealtimes and the food, drink and calories that the patient is planning to consume in advance and also to record in “real time” (i.e. in the precise moment at which the food is consumed), whether or not the patient adhered to their meal plan. By providing patients with a detailed picture of their eating habits, advance meal planning and real-time monitoring of eating can focus their attention on their specific obstacles to weight loss. It assists them to eat consciously and to interrupt dysfunctional and automatic eating habits that had previously seemed uncontrollable. In this module, patients are also trained to calculate a rough estimate of their energy expenditure in dedicated sessions. Finally, collaborative weighing is introduced to educate patients to weigh themselves at an appropriate frequency, i.e. once a week, and to help them to interpret variations in their body weight correctly.


  1. 1.
    Cooper Z, Fairburn CG, Hawker DM. Cognitive-behavioral treatment of obesity: a clinician’s guide. New York: Guilford Press; 2003.Google Scholar
  2. 2.
    Calugi S, Marchesini G, El Ghoch M, Gavasso I, Dalle Grave R. The influence of weight-loss expectations on weight loss and of weight-loss satisfaction on weight maintenance in severe obesity. J Acad Nutr Diet. 2016;117:32. Scholar
  3. 3.
    Dalle Grave R, Calugi S, Compare A, El Ghoch M, Petroni ML, Tomasi F, et al. Weight loss expectations and attrition in treatment-seeking obese women. Obes Facts. 2015;8(5):311–8. Scholar
  4. 4.
    Calugi S, Marchesini G, El Ghoch M, Gavasso I, Dalle Grave R. The association between weight maintenance and session-by-session diet adherence, weight loss and weight-loss satisfaction. Eat Weight Disord. 2018.
  5. 5.
    Lent MR, Vander Veur SS, Peters JC, Herring SJ, Wyatt HR, Tewksbury C, et al. Initial weight loss goals: have they changed and do they matter? Obes Sci Pract. 2016;2(2):154–61. Scholar
  6. 6.
    IOM. Institute of Medicine and Food & Nutrition Board. Dietary reference intakes—energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). Washington, DC: National Academy Press; 2002.Google Scholar
  7. 7.
    Westerterp KR. Diet induced thermogenesis. Nutr Metab (Lond). 2004;1(1):5. Scholar
  8. 8.
    Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011;111(1):92–102. Scholar
  9. 9.
    Boutelle KN, Kirschenbaum DS. Further support for consistent self-monitoring as a vital component of successful weight control. Obes Res. 1998;6(3):219–24.CrossRefPubMedGoogle Scholar
  10. 10.
    Dalle Grave R, Pasqualoni E, De Kolitscher L, Ginetti S. Il contacalorie AIDAP. Verona: Positive Press; 2007.Google Scholar
  11. 11.
    Lichtman SW, Pisarska K, Berman ER, Pestone M, Dowling H, Offenbacher E, et al. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992;327(27):1893–8. Scholar
  12. 12.
    Harris JA, Benedict FG. A biometric study of human basal metabolism. Proc Natl Acad Sci U S A. 1918;4(12):370–3.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C, et al. 2011 compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–81. Scholar
  14. 14.
    Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett Jr DR, Tudor-Locke C, et al. The compendium of physical activities tracking guide. Healthy Lifestyles Research Center, College of Nursing & Health Innovation, Arizona State University. Retrieved [2017] from the World Wide
  15. 15.
    Zheng Y, Klem ML, Sereika SM, Danford CA, Ewing LJ, Burke LE. Self-weighing in weight management: a systematic literature review. Obesity (Silver Spring). 2015;23(2):256–65. Scholar
  16. 16.
    Pacanowski CR, Linde JA, Neumark-Sztainer D. Self-weighing: helpful or harmful for psychological Well-being? A review of the literature. Curr Obes Rep. 2015;4(1):65–72. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Riccardo Dalle Grave
    • 1
  • Massimiliano Sartirana
    • 1
  • Marwan El Ghoch
    • 1
  • Simona Calugi
    • 1
  1. 1.Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly

Personalised recommendations