Experiences of self-monitoring: successes and struggles during treatment for weight loss.

We interviewed 15 individuals who completed a behavioral weight loss treatment study with the aim of exploring participants' reflections on their feelings, attitudes, and behaviors while using a paper diary to self-monitor their diet. Constant comparative and matrix analysis procedures were used to analyze interview data; the qualitative results were then interfaced with descriptive numerical data on individuals' adherence to self-monitoring and weight loss. Three categories of self-monitoring experience were identified: (a) well-disciplined-those who had high adherence to self-monitoring, high weight loss, and a "can do" positive approach, (b) missing the connection-those who had moderate adherence, moderate- to low weight loss, and an "it's an assignment" approach, without integrating self-monitoring into everyday life, and (c) diminished support-those who had poor adherence, poor weight control, and were adversely affected by coexisting negative factors. Given the variations in how individuals integrated the process of self-monitoring, we need to consider individualizing self-monitoring strategies to improve adherence.