Eating Disorders in the Digital Age: The Line Between Health Conscious and Obsessive By: Regan Radulski

Health and fitness have become trendy. Whether it means having various health apps on your phone or a FitBit on your wrist, the population is wholeheartedly embracing health and fitness in the digital age. In fact, studies estimate that at least 50% of smartphone users are expected to have a health app on their phone by 2018!1

Most health apps focus on areas where the individual feels like they themselves can make a change: mental health, behavioral disorders, and healthy eating.1 The apps include tools that enable the user to learn, self-evaluate, get advice and/or treatment, and self-monitor.1 The latter refers to a cognitive behavioral treatment, which allows an individual to gain self-understanding through the recognition of triggers of unhealthy behavior. To sum it up, health apps and fitness devices offer instant gratification: tracking made simple and in real-time.2

Naturally, this instant-gratification style of monitoring has some real benefits. Sedentary users are made much more aware of their energy expenditure and consumption.3 After all, it’s difficult to ignore an angrily beeping device from your wrist. This real-time self-monitoring and enhanced awareness aids in weight loss and can even prevent future weight gain.3

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Photo courtesy of Pixabay.com

However, there is a fine line between healthy and obsessive behaviors. The constant logging of exercise and calories demanded by many health apps and fitness devices challenges their users to walk this line daily. Professor of Psychology Mary Pritchard asserts that you might be crossing the line from health conscious to obsessive when you meet three of the following criteria:

 

  • Tolerance – either a need for increased reliance on the app/tracker or increasing amounts of exercise or decreased amounts of food because using the tracker makes you feel like you should be doing more and more
  • Withdrawal – you either get anxious when you can’t use your tracker or have to use the app to avoid the anxiety you know you will experience if you don’t use it
  • Intention Effect – spend more time using the tracker/app than you intended—get caught up in inputting everything in, sharing your results, checking your friend’s results, etc.
  • Lack of Control – a persistent desire or unsuccessful effort to cut down or control use of the tracker and/or exercise/calorie counting
  • Time – a great deal of time is spent in activities necessary to obtain the results your tracker tells you that you need to do (e.g., physical activity vacations, spending hours pouring over nutrition labels at the grocery store)
  • Reductions in Other Activities – social, occupational, or recreational activities are given up or reduced because of exercise or obsession with calories and calorie tracking
  • Continuance – continue to restrict calories or exercise despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the use of the tracker (e.g., continued running despite injury).4

Of course, there are already people in the population with a propensity for obsessive behavior who are more inclined to cross the line than others, such as people with an eating disorder. Unfortunately, a lot of the behaviors that health apps and devices encourage are even further multiplied in people who suffer from an eating disorder. Considering that at the end of 2015, an estimated ten million women and one million boys suffered from an eating disorder in the United States, it’s important to consider how the digital age will leave its mark on this disease. 5

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To put it bluntly, in the context of eating disorders, health apps and devices are enablers. A defining behavior of an eating disorder is the need to obsessively track calorie intake and expenditure, due to negative body image. This is exactly what many health apps and fitness devices are designed to do. The reality is that they simplify tracking by efficiently capturing data in real-time. Dr. Kimberly Dennis, who presides as medical director of a treatment facility, found that about 75% of her young adult patients used their phones in a way that encouraged their eating disorders.6

To make matters worse, health apps and fitness devices are trendy. While eating disorders are by no means a result of the digital age, technology has normalized tracking calories and behaviors and made other aspects even easier.1 So many people are engaged with at least one app or device that it doesn’t raise any suspicion when others get in over their heads.

Take a moment and think about it. You’ve essentially been provided with a mobile library of calorie counts right at your fingertips. Tempting, right? And it’s even more so for someone who already equates “better” with fewer calories and more exercise. After using MyFitnessPal, a woman with anorexia confessed, “I was never a calorie counter before using the app and now I’m so good, I don’t even need it.” 6

At the heart of the issue lies this: every body is unique. Health apps and fitness devices rely on averages, not individuals. They’re designed with your average Joe in mind. In the end, health apps and fitness devices are just tools. It’s up to us how we choose to use them.

With that said, we don’t allow children to play with sharp scissors; we have special kiddie scissors for them, for good reason. Perhaps all apps and devices could start incorporating fields for feelings and behaviors, a strategy already employed by some eating disorder recovery apps.1 At this point it’s clear that health apps and fitness devices are with us to stay so we might as well improve them for all audiences.

 

 

References

  1. Fairburn CG, Rothwell ER. Apps and eating disorders: A systematic clinical appraisal. International Journal of Eating Disorders. 2016;48(7):1338-1346.doi:13.1302/eat.22398.
  2. West JH, Hall PC, Hanson CL, Barnes MD, Giraud-Carrier C, Barrett J. There’s an App for That: Content Analysis of Paid Health and Fitness Apps. Journal of Medical Internet Research. 2012;14(3). doi:10.2196/jmir.1977.
  3. Zaidan S, Roehrer E. Popular Mobile Phone Apps for Diet and Weight Loss: A Content Analysis. JMIR mHealth and uHealth. 2016;4(3). doi:10.2196/mhealth.5406.
  4. Pritchard ME. Should You Use a Fitness Tracker? Psychology Today.https://www.psychologytoday.com/blog/diet-is-4-letter-word/201501/should-you-use-fitness-tracker. Published January 29, 2015. Accessed January 21, 2017.
  5. Dickson EJ. Fitness tech needs to stop fat-shaming us. The Daily Dot.http://www.dailydot.com/debug/fitness-tech-fat-shaming/. Published May 30, 2014. Accessed January 21, 2017.
  6. Gregory A. Hunger Games. New Republic. https://newrepublic.com/article/115969/smartphones-and-weight-loss-how-apps-can-make-eating-disorders-worse. Published December 18, 2013. Accessed January 21, 2017.

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