BackgroundMobile health (mHealth) apps for weight loss (weight loss apps) can be useful diet and exercise tools for individuals in need of losing weight. Most studies view weight loss app users as these types of individuals, but not all users have the same needs. In fact, users with disordered eating behaviors who desire to be underweight are also utilizing weight loss apps; however, few studies give a sense of the prevalence of these users in weight loss app communities and their perceptions of weight loss apps in relation to disordered eating behaviors.ObjectiveThe aim of this study was to provide an analysis of users’ body mass indices (BMIs) in a weight loss app community and examples of how users with underweight BMI goals perceive the impact of the app on disordered eating behaviors.MethodsWe focused on two aspects of a weight loss app (DropPounds): profile data and forum posts, and we moved from a broader picture of the community to a narrower focus on users’ perceptions. We analyzed profile data to better understand the goal BMIs of all users, highlighting the prevalence of users with underweight BMI goals. Then we explored how users with a desire to be underweight discussed the weight loss app’s impact on disordered eating behaviors.ResultsWe found three main results: (1) no user (regardless of start BMI) starts with a weight gain goal, and most users want to lose weight; (2) 6.78% (1261/18,601) of the community want to be underweight, and most identify as female; (3) users with underweight BMI goals tend to view the app as positive, especially for reducing bingeing; however, some acknowledge its role in exacerbating disordered eating behaviors.ConclusionsThese findings are important for our understanding of the different types of users who utilize weight loss apps, the perceptions of weight loss apps related to disordered eating, and how weight loss apps may impact users with a desire to be underweight. Whereas these users had underweight goals, they often view the app as helpful in reducing disordered eating behaviors, which led to additional questions. Therefore, future research is needed.

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How do deaf and hard of hearing (DHH) individuals use smart assistants (SAs)? Does the prominent use of voice interfaces in most SAs pose unique challenges for DHH users? In this work, we aim to answer these questions by conducting 4 in-depth interviews, as well as collecting survey data from 73 DHH individuals. Our findings show that individuals, even with profound deafness, can leverage SAs to accomplish complex daily tasks. However, we also identified a number of common challenges DHH individuals face when interacting with SAs (e.g., high pitch used in the default SA voice interfaces can be incompatible with hearing aids, difficulty using mobile SAs in public places with loud background noise). Based on these insights, we provide a set of suggestions for designing SAs that can better accommodate a wide range of hearing abilities. Specifically, SAs should provide more customization options to allow the user to tailor their SA to meet their hearing needs over time. For example, using a pitch-frequency test feature, much like audiograms conducted by audiologists, could allow users to calibrate their SA's voice to fit within their optimal range. We also see a need to provide more clear and actionable error messages conveyed beyond audio notifications, such as more meaningful light notifications. These recommendations and findings provide the first step forward toward a more inclusive SA by addressing accessibility needs unique to this group.