Engagement with MyFitnessPal in eating disorders: Qualitative insights from online forums

Abstract

Objective Using calorie‐counting and fitness‐tracking technologies is concerning in relation to eating disorders. While studies in this area typically assess one aspect of use (e.g., frequency), engagement with a device or application is more complex. Consequently, important relationships between the use of these technologies and the eating disorder symptomatology might remain undetected. The current study therefore used comments from online eating disorder‐related forums to generate comprehensive qualitative insights into engagement with a popular calorie‐counting and fitness‐tracking application, MyFitnessPal. Method First, we extracted every comment mentioning MyFitnessPal made on three eating disorder‐related forums between May 2015 and January 2018 (1,695 comments from 920 commenters). Then, we conducted an inductive thematic analysis using these comments to identify important aspects of engagement with MyFitnessPal. Results The analyses resulted in three themes: Preventing misuse, describing ways in which MyFitnessPal attempts to prevent pathological use and actions taken by users to circumvent its interventions; Accuracy, outlining distrust of MyFitnessPal's accuracy and ways in which perceived inaccuracy is reduced or compensated for; and Psychosocial factors, comprising cognitive, behavioral, and social factors that influence, or are influenced by, engagement with MyFitnessPal. Discussion The qualitative insights provide a detailed overview of how people with high levels of eating disorder symptomatology likely engage with MyFitnessPal. The insights can be used as a basis to develop valid, quantitative assessment of pathological patterns of engagement with calorie‐counting and fitness‐tracking technologies. The findings can also provide clinicians with insight into how their patients likely engage with, and are affected by, these devices and applications.

Usage of Mobile Applications or Mobile Health Technology to Improve Diet Quality in Adults

“…There is also the issue of overdependence on M-health applications while being used for something positive such as improving diet quality which can have the caveat of being also be used to assist disordered eating patterns such as orthorexia, anorexia, or calorie restriction [58,59]. Recent research has highlighted that the use of calorie-counting and fitness-tracking technologies is worrying in relation to eating disorders [60]. According to research on disordered eating, body discontent and unease about weight and body shape tend to be high in users of pro-eating disorder websites, leading users to pay closer attention to their current weight and weight shifts and use M-health apps and web-based instruments to track their body weight and food intake [61].…”

Detrimental Effects of Online Pro–Eating Disorder Communities on Weight Loss and Desired Weight: Longitudinal Observational Study

“…Body dissatisfaction and concerns about body shape and weight tend to be high in users of pro-ED websites, which could lead them to pay close attention to their current weight and weight changes [ 12 , 19 ]. Many users of pro-ED communities use apps and web-based tools to track their body weight and food intake [ 21 - 23 ]. Pro-ED communities provide similar functions as weight tracking apps with check-ins or status updates , allowing users to share personal information, such as their current body weight, height, age, or gender, with the online community [ 4 , 12 , 24 ].…”

“…Reddit users can write posts or comment on other users’ posts in these communities. The r/proed community, similar to other pro-ED communities, featured tips and tricks such as circumventing minimums for weight and daily intake in a fitness tracker app [ 23 ], thinspiration, and discussions about topics such as low-calorie foods or binge eating as well as social support and treatment [ 17 ]. Besides being one of the largest and most active communities related to EDs on Reddit [ 17 ], r/proed also had one feature that was relevant for this study—users could display a text field called flair next to their username on all their posts and comments in r/proed.…”

Detrimental Effects of Online Pro–Eating Disorder Communities on Weight Loss and Desired Weight: Longitudinal Observational Study (Preprint)

“…Body dissatisfaction and concerns about body shape and weight tend to be high in users of pro-ED websites, which could lead them to pay close attention to their current weight and weight changes [12,19]. Many users of pro-ED communities use apps and web-based tools to track their body weight and food intake [21][22][23]. Pro-ED communities provide similar functions as weight tracking apps with check-ins or status updates, allowing users to share personal information, such as their current body weight, height, age, or gender, with the online community [4,12,24].…”