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.
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