Self‐monitoring has no adverse effect on disordered eating in adults seeking treatment for obesity

Abstract

SummaryObjectivesAlthough monitoring is considered a key component of effective behaviour change, the development of apps has allowed consumers to constantly evaluate their own diet, with little examination of what this might mean for eating behaviour. The aim of this study was to investigate whether self‐monitoring of diet using the app MyFitnessPal or daily self‐weighing increases the reported occurrence of eating disorders in adults with overweight/obesity following a weight loss programme.MethodsTwo hundred fifty adults with body mass index ≥ 27 kg/m2 received diet and exercise advice and were randomized to one of four monitoring strategies (daily self‐weighing, MyFitnessPal, brief monthly consults or self‐monitoring hunger) or control for 12 months. The Eating Disorder Examination Questionnaire 6.0 was used to assess eating disorder symptoms and behaviours for the previous 28 d at 0 and 12 months.ResultsThere were no significant differences in the global Eating Disorder Examination Questionnaire score or the subscales between those in the four monitoring groups and the control at 12 months (all p ≥ 0.164), nor were there differences in binge eating, self‐induced vomiting, laxative misuse or excessive exercise at 12 months (p ≥ 0.202). The overall prevalence of one or more episodes of binge eating was 53.6% at baseline and 50.6% at 12 months, with no change over time (p = 0.662).ConclusionsThere was no evidence that self‐monitoring, including using diet apps like MyFitnessPal or daily self‐weighing, increases the reported occurrence of eating disorder behaviours in adults with overweight/obesity who are trying to lose weight.

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

“…The risk of such narrow assessment of engagement is that patterns of use that are particularly indicative of eating disorders might remain undetected. Similarly, while no causal effect of MyFitnessPal use on eating disorder symptomatology was detected in the experimental study (Jospe et al, ), this finding could be due to the duration (or consistency) of engagement being insufficiently manipulated. Specifically, the participants in the “ MyFitnessPal ” condition used the application daily for the first month, but for only 1 week of each remaining month in the 12‐month period (approximately 15 weeks in total; Jospe et al, ).…”

“…A smaller proportion (47%, 26/55) of male users recruited from health and fitness websites described it as, at least, somewhat contributing to disordered eating (Linardon & Messer, 2019). However, in contrast to these cross-sectional studies, an experimental study found no evidence for a causal effect of using MyFitnessPal on eating disorder symptomatology (Jospe et al, 2017(Jospe et al, , 2018. Given the inconsistent results, it is important to explore factors that could influence the nature of these relationships.…”

“…A complicating factor for research concerning calorie‐counting and fitness‐tracking technologies is that they vary in their functionality, such as providing different information (e.g., calorie intake, steps), or influencing behavior in different ways (e.g., facilitating self‐monitoring, rewarding behavior; Lyons, Lewis, Mayrsohn, & Rowland, ). Reducing this complexity, three studies have focused on the use of one application, MyFitnessPal , in relation to eating psychopathology (Jospe et al, ; Levinson, Fewell, & Brosof, ; Linardon & Messer, ). The main functions of MyFitnessPal enable users to set goals concerning weight, and calorie intake and macronutrient intake, and assess their goal progress by (a) estimating and tracking their calorie intake and nutrient intake (e.g., consulting a food database, scanning barcodes, creating their own entries for foods); (b) estimating and tracking calorie expenditure (e.g., logging exercises, tracking steps); and (c) recording their weight with optional photos of their body (Under Armour Inc., ).…”

“…The aim of our current study was therefore to generate more comprehensive substantive evidence (i.e., qualitative insights) for the patterns of engagement with MyFitnessPal , as discussed by a large sample of commenters on online eating disorder‐related forums. MyFitnessPal represented a particularly important calorie‐counting and fitness‐tracking technologies to consider, as, of these types of technology, it has been found to be the most downloaded (Ferrara, Kim, Lin, Hua, & Seto, ) and the most commonly discussed in eating disorder‐related online forums (McCaig, Bhatia, Elliott, Walasek, & Meyer, ), and is the focus of three previously discussed studies in the area of eating psychopathology (Jospe et al, ; Levinson et al, ; Linardon & Messer, ). Furthermore, as MyFitnessPal facilitates both calorie‐counting and fitness‐tracking technologies, it is more representative of the varied functionality of these technologies than devices or applications dedicated to only one of these functions.…”

“…Reducing this complexity, three studies have focused on the use of one application, MyFitnessPal, in relation to eating psychopathology (Jospe et al, 2018;Levinson, Fewell, & Brosof, 2017;Linardon & Messer, 2019). The main functions of MyFitnessPal enable users to set goals concerning weight, and calorie intake and macronutrient intake, and assess their goal progress by (a) estimating and tracking their calorie intake and nutrient intake (e.g., consulting a food database, scanning barcodes, creating their own entries for foods); (b) estimating and tracking calorie expenditure (e.g., logging exercises, tracking steps); and (c) recording their weight with optional photos of their body (Under Armour Inc., 2019).…”