Abstract
From weight loss to illness management, mHealth has the potential to help many people track and manage their health. Mobile health applications for weight loss or weight loss apps, in particular, are becoming increasingly popular. Through Google Play and the App Store, weight loss app developers paint a picture of a healthy lifestyle. While these apps may be a promising method to combat the obesity epidemic in places like the United States, what do we really know about the users of weight loss apps and how these apps affect them? The aim of this chapter is to explore these questions by focusing on the unintended users, uses, and consequences of weight loss apps by using eating disorders as a case study. There has been a recent push for understanding the role technology, such as social media, plays on eating disorders and related behaviors. Missing in this research are studies on the impact of weight loss apps on eating disorders even though they contain similar content. Additionally, weight loss apps enable and promote dieting, which is a risk factor for developing an eating disorder. This chapter first explores the unintended users of weight loss apps, then the unintended uses of these apps (i.e., eating disorder maintenance or recovery), and finally the unintended consequences of weight loss apps using qualitative data (from both forum posts and interviews), previous work, and popular media articles. This research has a number of implications for mHealth design, healthcare, and education.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Notes
- 1.
For adults 20 years+, underweight is <18.5, healthy weight is 18.5–24.9, overweight is 25.0–29.9, and obese is 30+. For younger users, BMI is calculated using percentiles. Anything <5th percentile is considered underweight.
- 2.
App name was change to protect users’ privacy.
- 3.
The referenced article was written and published after this book chapter. Therefore, some information reported has been updated.
- 4.
Due to lack of accurate age data for some users, all BMI calculations were performed using the standard BMI calculations (no percentiles). DropPounds requires users to be at least 18 years old. However, it is possible some users misreported their age in order to use the app.
References
Andsager JL (2014) Research directions in social media and body image. Sex Roles 71:407–413. https://doi.org/10.1007/s11199-014-0430-4
Bardone-Cone AM, Cass KM (2006) Investigating the impact of pro-anorexia websites: a pilot study. Eur Eat Disord Rev 14:256–262. https://doi.org/10.1002/erv.714
Bardone-Cone AM, Cass KM (2007) What does viewing a pro-anorexia website do? An experimental examination of website exposure and moderating effects. Int J Eat Disord 40:357–548. https://doi.org/10.1002/eat
Boero N, Pascoe CJ (2012) Pro-anorexia communities and online interaction: bringing the pro-ana body online. Body Soc 18:27–57. https://doi.org/10.1177/1357034X12440827
Bowler L, Oh JS, He D et al (2012) Eating disorder questions in Yahoo! Answers: information, conversation, or reflection? In: ASIST 2012. Baltimore
Campbell EM, Sittig DF, Ash JS, Guappone KP, Dykstra RH (2006) Types of unintended consequences related to computerized provider order entry. J Am Med Informatics Assoc 13:547–556. https://doi.org/10.1197/jamia.M2042
Castro TS, Osório AJ (2013) “Fat and happy?” I’d rather die!’ Online violence involving children: pro-anorexia communities and dangerous eating behaviours on the web. In: Skins visual culture and youth: a matter of belonging. Inter-disciplinary Press, Oxford, UK, pp 101–111
Chancellor S, Pater J, Clear T et al (2016) #thyghgapp: Instagram content moderation and lexical variation in pro-eating disorder communities. In: CSCW. ACM, San Francisco, pp 1–13
Choe EK, Lee B, Munson S et al (2013) Persuasive performance feedback: the effect of framing on self-efficacy. AMIA, Washington, DC, pp 1–9
Choe EK, Lee NB, Lee B et al (2014) Understanding quantified-selfers’ practices in collecting and exploring personal data. In: CHI’14. ACM, Toronto, pp 1143–1152
Cordeiro F, Bales E, Cherry E, Fogarty J (2015) Rethinking the mobile food journal: exploring opportunities for lightweight photo-based capture. In: CHI’15. ACM, Seoul, pp 1–10
Csipke E, Horne O (2007) Pro-eating disorder websites: users’ opinions. Eur Eat Disord Rev 15:196–206. https://doi.org/10.1002/erv
Custers K, Van den Bulck J (2009) Viewership of pro-anorexia websites in seventh, ninth and eleventh graders. Eur Eat Disord Rev 17:214–219. https://doi.org/10.1002/erv.910
Eikey EV (2016) Providers ’ perceptions of the impact of weight loss apps on users with eating disorders (poster). In: SIGMIS. ACM, Alexandria, pp 1–2
Eikey EV, Booth KM (2017) Recovery and maintenance: how women with eating disorders use Instagram. In: iConference. Wuhan, pp 1–12
Eikey EV, Reddy MC (2017) “It’s Definitely Been a Journey”: a qualitative study on how women with eating disorders use weight loss apps. In: ACM CHI Conference on human factors in computing systems (CHI’17). ACM, Denver, pp 1–13
Eikey EV, Reddy MC, Booth K, Kvasny L, Blair J, Li Victor, Poole ES (2017) Desire to be underweight: An exploratory study on a weight loss app community & user perceptions of the impact on disordered eating behaviors. JMIR Mhealth Uhealth 5(10):e150. https://doi.org/10.2196/mhealth.6683
Eisenberg D, Nicklett EJ, Roeder K, Kirz NE (2011) Eating disorder symptoms among college students: prevalence, persistence, correlates, and treatment-seeking. J Am Coll Heal 59:70–707. https://doi.org/10.1038/nature13314.A
Engel B, Reiss NS, Dombeck M (2007) Prevalence, onset and course of eating disorders. In: Ment. Help. https://www.mentalhelp.net/articles/prevalence-onset-and-course-of-eating-disorders/. Accessed 12 Nov 2015
Fairburn CG, Harrison PJ (2003) Eating disorders. Lancet 361:407–416. https://doi.org/10.1016/S0140-6736(03)12378-1
Fardouly J, Diedrichs PC, Vartanian LR, Halliwell E (2015) Social comparisons on social media: the impact of Facebook on young women’s body image concerns and mood. Body Image 13:38–45. https://doi.org/10.1016/j.bodyim.2014.12.002
Fox S, Duggan M (2012) Mobile health 2012
Grimes A, Harper R (2008) Celebratory technology: new directions for food research in HCI. In: CHI ‘08, p 467
Harper K, Sperry S, Thompson JK (2008) Viewership of pro-eating disorder websites: association with body image and eating disturbances. Int J Eat Disord 41:92–95. https://doi.org/10.1002/eat
Hoerr SL, Bokram R, Lugo B et al (2002) Risk for disordered eating relates to both gender and ethnicity for college students. J Am Coll Nutr 21:307–314. https://doi.org/10.1080/07315724.2002.10719228
Jett S, La Porte DJ, Wanchisn J (2010) Impact of exposure to pro-eating disorder websites on eating behaviour in college women. Eur Eat Disord Rev 18:410–416. https://doi.org/10.1002/erv.1009
Juarascio AS, Manasse SM, Goldstein SP et al (2015) Review of smartphone applications for the treatment of eating disorders. Eur Eat Disord Rev 23:1–11. https://doi.org/10.1002/erv.2327
Keski-Rahkonen A, Tozzi F (2005) The process of recovery in eating disorder sufferers’ own words: an internet-based study. Int J Eat Disord 37:580–586. https://doi.org/10.1002/eat.20123
Kim JW, Chock TM (2015) Body image 2.0: associations between social grooming on Facebook and body image concerns. Comput Human Behav 48:331–339. https://doi.org/10.1016/j.chb.2015.01.009
Kummervold PE, Gammon D, Bergvik S et al (2002) Social support in a wired world: use of online mental health forums in Norway. Nord J Psychiatry 56:59–65. https://doi.org/10.1080/08039480252803945
Livingston JD, Boyd JE (2010) Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med 71:2150–2161. https://doi.org/10.1016/j.socscimed.2010.09.030
Mabe AG, Forney KJ, Keel PK (2014) Do you “like” my photo? Facebook use maintains eating disorder risk. Int J Eat Disord 47:516–523. https://doi.org/10.1002/eat.22254
Mahdawi A (2014) The unhealthy side of wearable fitness devices. Guard
Marshall MN (1996) Sampling for qualitative research. Fam Pract 13:522–526
Meier EP, Gray J (2014) Facebook photo activity associated with body image disturbance in adolescent girls. Cyberpsychology, Behav Soc Netw 17:199–206. https://doi.org/10.1089/cyber.2013.0305
Miller AM (2015) The dark side of activity trackers. In: U.S. News World Rep. http://health.usnews.com/health-news/health-wellness/articles/2015/01/06/the-dark-side-of-activity-trackers. Accessed 15 Sep 2015
Mueller F, Marshall J, Khot RA et al (2014) Jogging with technology: Interaction design supportging sport activities. CHI ’14 Ext Abstr 1131–1134. https://doi.org/10.1145/2559206.2559209
Mulveen R, Hepworth J (2006) An interpretative phenomenological analysis of participation in a pro-anorexia internet site and its relationship with disordered eating. J Health Psychol 11:283–296. https://doi.org/10.1177/1359105306061187
Neumark-Sztainer D (2005) “I’m, Like, SO Fat!”: helping your teen make healthy choices about eating and exercise in a weight-obsessed world. The Guilford Press, New York
Neumark-Sztainer D, Wall M, Guo J et al (2006) Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? J Am Diet Assoc 106:559–568. https://doi.org/10.1016/j.jada.2006.01.003
Pater J, Haimson O, Andalibi N, Mynatt ED (2016) “Hunger hurts but starving works:” characterzing the presentation of eating disorders online. In: CSCW. ACM, San Francisco, pp 1–16
Peebles R, Wilson JL, Litt IF et al (2012) Disordered eating in a digital age: eating behaviors, health, and quality of life in users of websites with pro-eating disorder content. J Med Internet Res. https://doi.org/10.2196/jmir.2023
Peñas-Lledó E, Bulik CM, Lichtenstein P et al (2015) Risk for self-reported anorexia or bulimia nervosa based on drive for thinness and negative affect clusters/dimensions during adolescence: a three-year prospective study of the TChAD cohort. Int J Eat Disord 48:692–699. https://doi.org/10.1002/eat.22431
Physician’s Committee for Responsible Medicine (2012) Survey finds americans lack basic nutrition information. A report from the physicians committee for responsible medicine. http://www.pcrm.org/health/reports/survey-americans-lack-basic-nutrition-info. Accessed 1 Sept 2016
Ransom DC, La Guardia JG, Woody EZ, Boyd JL (2010) Interpersonal interactions on online forums addressing eating concerns. Int J Eat Disord 43:161–170. https://doi.org/10.1002/eat.20629
Reba-Harrelson L, Von Holle A, Hamer RM et al (2009) Patterns and prevalence of disordered eating and weight control behaviors in women ages 25–45. Eat Weight Disord. https://doi.org/10.1007/BF03325116
Reinking MF, Alexander LE, Louis S (2005) Prevalence of disordered-eating behaviors athletes and nonathletes. J Athl Train 40:47–51
Rooksby J, Rost M, Morrison A, Chalmers M (2015) Pass the ball: enforced turn-taking in activity tracking. In: CHI’15. ACM, Seoul, pp 2417–2426
Rouleau CR, Von Ranson KM (2011) Potential risks of pro-eating disorder websites. Clin Psychol Rev 31:525–531. https://doi.org/10.1016/j.cpr.2010.12.005
Sharpe H, Musiat P, Knapton O, Schmidt U (2011) Pro-eating disorder websites: facts, fictions and fixes. J Public Ment Health 10:34–44. https://doi.org/10.1108/17465721111134538
Shisslak CM, Crago M, Estes LS (1995) The spectrum of eating disturbances. Int J Eat Disord 18:209–219. https://doi.org/10.1002/1098-108x(199511)18:3<209::aid-eat2260180303>3.0.co;2-e
Smith A (2015) U.S. smartphone use in 2015. In: Pew Res. Cent. http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/. Accessed 11 Nov 2015
Stawarz K, Cox AL, Blandford A (2015) Beyond self-tracking and reminders: designing smartphone apps that support habit formation. In: CHI’15. ACM, Seoul, pp 2653–2662
Stover CM (2014) Elements of a sensibility: fitness blogs and postfeminist media culture. The University of Texas, Austin
Stronge S, Greaves LM, Milojev P et al (2015) Facebook is linked to body dissatisfaction: comparing users and non-users. Sex Roles 73:200–213. https://doi.org/10.1007/s11199-015-0517-6
Strother E, Lemberg R, Stanford SC, Turberville D (2012) Eating disorders in men: underdiagnosed, undertreated, and misunderstood. Eat Disord 20:346–355. https://doi.org/10.1080/10640266.2012.715512
Tan T, Kuek A, Goh SE et al (2016) Internet and smartphone application usage in eating disorders: a descriptive study in Singapore. Asian J Psychiatr 19:50–55. https://doi.org/10.1016/j.ajp.2015.11.007
Teufel M, Hofer E, Junne F et al (2013) A comparative analysis of anorexia nervosa groups on Facebook. Eat Weight Disord 18:413–420. https://doi.org/10.1007/s40519-013-0050-y
Tiggemann M, Zaccardo M (2015) “Exercise to be fit, not skinny”: the effect of fitspiration imagery on women’s body image. Body Image 15:61–67. https://doi.org/10.1016/j.bodyim.2015.06.003
Toscos T, Faber A, An S, Gandhi MP (2006) Chick clique: Persuasive technology to motivate teenage girls to exercise. In: CHI ‘06 extended abstracts, pp 1873–1878
Wade TD, Keski-Rahkonen A, Hudson J (2011) Epidemiology of eating disorders. In: Tsuang M (ed) Textbook in psychiatric epidemiology, 3rd edn. Wiley, New York, pp 343–360
Walsh G, Golbeck J (2014) StepCity: a preliminary investigation of a personal informatics-based social game on behavior change. In: CHI’14 extended abstracts. ACM, Toronto, pp 2371–2376
Whitlock JL, Powers JL, Eckenrode J (2006) The virtual cutting edge: the internet and adolescent self-injury. Dev Psychol 42:407–417. https://doi.org/10.1037/0012-1649.42.3.407
Yom-Tov E, Fernandez-Luque L, Weber I, Crain SP (2012) Pro-anorexia and pro-recovery photo sharing: a tale of two warring tribes. J Med Internet Res 14:1–16. https://doi.org/10.2196/jmir.2239
Acknowledgments
This material is based upon work supported by the National Science Foundation under Grant No. DGE1255832. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Eikey, E.V. (2018). Unintended Users, Uses, and Consequences of Mobile Weight Loss Apps: Using Eating Disorders as a Case Study. In: Sezgin, E., Yildirim, S., Özkan-Yildirim, S., Sumuer, E. (eds) Current and Emerging mHealth Technologies. Springer, Cham. https://doi.org/10.1007/978-3-319-73135-3_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-73135-3_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-73134-6
Online ISBN: 978-3-319-73135-3
eBook Packages: MedicineMedicine (R0)