Abstract
Background Diet and fitness apps are often promoted in university and college settings and touted as a means to improve health with little attention given to unanticipated negative effects, especially among those at risk for or with eating disorders. Aims Few researchers have studied how these apps affect women with eating disorders in university and college settings. This research investigates the unintended negative consequences of engaging with these tools. Method Data collection sessions comprised three components conducted with 24 participants: survey (demographic and eating disorder symptoms), think-aloud exercise and semi-structured interview. Thematic analysis was used to analyse data. Results Participants reported that diet and fitness apps trigger and exacerbate symptoms by focusing heavily on quantification, promoting overuse and providing certain types of feedback. Eight themes of negative consequences emerged: fixation on numbers, rigid diet, obsession, app dependency, high sense of achievement, extreme negative emotions, motivation from ‘negative’ messages, and excess competition. Although these themes were common when users’ focus was to lose weight or eat less, they were also prevalent when users wanted to focus explicitly on eating disorder recovery. Conclusions Unintended negative consequences are linked to the quantified self movement, conception of appropriate usage, and visual cues and feedback. This paper critically examines diet and fitness app design and discusses implications for designers, educators and clinicians. Ultimately, this research emphasises the need for a fundamental shift in how diet and fitness apps promote health, with mental health at the forefront.
Highlights
Diet and fitness apps are often promoted in university and college settings and touted as a means to improve health with little attention given to unanticipated negative effects, especially among those at risk for or with eating disorders
This paper critically examines diet and fitness app design and discusses implications for designers, educators and clinicians
This research emphasises the need for a fundamental shift in how diet and fitness apps promote health, with mental health at the forefront
Summary
Data collection sessions comprised three components conducted with 24 participants: survey (demographic and eating disorder symptoms), think-aloud exercise and semi-structured interview. To capture rich information from individuals about how diet and fitness apps may affect eating disorder-related behaviours and perceptions, a primarily qualitative research approach was employed This methodology allowed for users to share their stories and experiences in their own words and emergent themes unlikely to be discovered when using only quantitative approaches. This study represents users whose needs are largely invisible This population is important to study because anorexia nervosa, bulimia nervosa and related eating disorder behaviours tend to affect university women,[8] and diet and fitness app users tend to be younger.[1] To recruit users, on-campus groups were asked to share information on a campus listserv and fliers were posted to social media. Posting paper fliers in discreet locations, such as on the backs of doors in public restroom stalls where participants could covertly obtain information for the study, was the most successful approach
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