Abstract

BackgroundHealthy eating and fitness mobile apps are designed to promote healthier living. However, for young people, body dissatisfaction is commonplace, and these types of apps can become a source of maladaptive eating and exercise behaviors. Furthermore, such apps are designed to promote continuous engagement, potentially fostering compulsive behaviors.ObjectiveThe aim of this study was to identify potential risks around healthy eating and fitness app use and negative experience and behavior formation among young people and to inform the understanding around how current commercial healthy eating and fitness apps on the market may, or may not, be exasperating such behaviors.MethodsOur research was conducted in 2 phases. Through a survey (n=106) and 2 workshops (n=8), we gained an understanding of young people’s perceptions of healthy eating and fitness apps and any potential harm that their use might have; we then explored these further through interviews with experts (n=3) in eating disorder and body image. Using insights drawn from this initial phase, we then explored the degree to which leading apps are preventing, or indeed contributing to, the formation of maladaptive eating and exercise behaviors. We conducted a review of the top 100 healthy eating and fitness apps on the Google Play Store to find out whether or not apps on the market have the potential to elicit maladaptive eating and exercise behaviors.ResultsParticipants were aged between 18 and 25 years and had current or past experience of using healthy eating and fitness apps. Almost half of our survey participants indicated that they had experienced some form of negative experiences and behaviors through their app use. Our findings indicate a wide range of concerns around the wider impact of healthy eating and fitness apps on individuals at risk of maladaptive eating and exercise behavior, including (1) guilt formation because of the nature of persuasive models, (2) social isolation as a result of personal regimens around diet and fitness goals, (3) fear of receiving negative responses when targets are not achieved, and (4) feelings of being controlled by the app. The app review identified logging functionalities available across the apps that are used to promote the sustained use of the app. However, a significant number of these functionalities were seen to have the potential to cause negative experiences and behaviors.ConclusionsIn this study, we offer a set of responsibility guidelines for future researchers, designers, and developers of digital technologies aiming to support healthy eating and fitness behaviors. Our study highlights the necessity for careful considerations around the design of apps that promote weight loss or body modification through fitness training, especially when they are used by young people who are vulnerable to the development of poor body image and maladaptive eating and exercise behaviors.

Highlights

  • WorkBody dissatisfaction, the subjective experience of negative thoughts and feelings toward one’s own body [1], is so prevalent among young people in modern Western societies that it is regarded as normative discontent [3,4]

  • Our findings indicate a wide range of concerns around the wider impact of healthy eating and fitness apps on individuals at risk of maladaptive eating and exercise behavior, including (1) guilt formation because of the nature of persuasive models, (2) social isolation as a result of personal regimens around diet and fitness goals, (3) fear of receiving negative responses when targets are not achieved, and (4) feelings of being controlled by the app

  • Our study highlights the necessity for careful considerations around the design of apps that promote weight loss or body modification through fitness training, especially when they are used by young people who are vulnerable to the development of poor body image and maladaptive eating and exercise behaviors. (JMIR Mhealth Uhealth 2019;7(6):e14239) doi:10.2196/14239

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Summary

Introduction

Background and Related WorkBody dissatisfaction, the subjective experience of negative thoughts and feelings toward one’s own body [1], is so prevalent among young people (defined by the United Nations as those aged 15 to 24 years [2]) in modern Western societies that it is regarded as normative discontent [3,4]. Sociocultural theories emphasize the role of specific agents, such as parents, peers, and the media, in shaping negative attitudes toward the body [12], with body dissatisfaction arising because of perceived pressure from sociocultural agents to conform to an unrealistic, culturally defined body and beauty ideal. This has been described as thin and toned, yet curvaceous with pert breasts and buttocks, whereas for men it is muscular yet lean with little body fat [13]. Such apps are designed to promote continuous engagement, potentially fostering compulsive behaviors

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