Desire to Be Underweight: Exploratory Study on a Weight Loss App Community and User Perceptions of the Impact on Disordered Eating Behaviors

Abstract

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.

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

“…Last, we identified psychosocial factors that reportedly influence, or are influenced by, engagement with MyFitnessPal . As with previous findings (Eikey et al, ; Eikey & Reddy, ), there was variability in whether commenters viewed engagement as facilitating or worsening psychosocial factors, such as negative feelings (e.g., “stress”), and eating disorder‐related behaviors and outcomes (e.g., restricting, weight loss). Such heterogeneity suggests moderators in the relationship between engagement with calorie‐counting and fitness‐tracking technologies, and eating disorder‐related symptomatology, which could explain the inconsistencies in previous research (Embacher Martin et al, ; Hefner et al, ; Plateau et al, ; Simpson & Mazzeo, ).…”

“…Two studies offer a degree of substantive evidence for engagement with calorie‐counting and fitness‐tracking technologies in relation to eating disorders (Eikey et al, ; Eikey & Reddy, ). Both studies developed qualitative insights from 13 users who posted comments including eating disorder‐related terms (e.g., “anorexia”) on an unspecified weight‐loss application's forum (Eikey et al, ), and from 16 young women who self‐reported eating disorder symptoms (Eikey & Reddy, ). The insights from both studies mainly identified cognitions and emotions (e.g., obsessiveness, perfectionism, guilt), and behaviors (e.g., restricting, binge eating, purging) related to use of these technologies.…”

Analyzing big data in social media: Text and network analyses of an eating disorder forum

“…By comparing the ED sample to two other samples, they showed that ED users have fewer interactions, are active for a shorter time, and express more negative emotions than the comparison samples (Wang et al, ). Other studies have analyzed the usage of weight loss apps by users with underweight BMI goals (Eikey et al, ), tags on Instagram posts to infer mental illness severity (Chancellor, Lin, Goodman, Zerwas, & De Choudhury, ) or modeled networks of Pro‐ED websites (Casilli, Pailler, & Tubaro, ).…”

“…Other studies have analyzed the usage of weight loss apps by users with underweight BMI goals (Eikey et al, 2017), tags on Instagram posts to infer mental illness severity (Chancellor, Lin, Goodman, Zerwas, & De Choudhury, 2016) or modeled networks of Pro-ED websites (Casilli, Pailler, & Tubaro, 2013).…”

Study on Differences between Patients with Physiological and Psychological Diseases in Online Health Communities: Topic Analysis and Sentiment Analysis

“…In the field of healthcare, the booming development of online social platforms has promoted the improvement of relevant platforms themed on healthcare and has given rise to the term "online health community" (OHC). Based on Internet technology, online health communities are a platform to discuss disease-related problems, share medical experiences, provide remote medical service and organize member activities [4][5][6][7]. The main participants of online health communities are generally patients, relatives or people with health management needs.…”