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May 18, 2017

Fitness Trackers and Disordered Eating

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We previously discussed research on "fitspiration" and the association between disordered eating and social media use, which suggests there is a relationship between social media and eating disorder behaviors. In a similar line of inquiry, a recent study looked specifically at fitness trackers (those trendy apps people use to record things like steps, calories, and heart rate) and eating disorder thoughts and behaviors.

The purpose of the study was to gain detailed insight into how some women with a history of disordered eating used fitness trackers and how their attitudes toward the technology changed over time. A series of interviews revealed that many of the participants had used the apps in an unhealthy way, which the researchers broke down into the following categories:

  • Obsessive logging - One participant described her experience as "an obsession with tracking my food and how low I could get the number...When I was in the middle of my eating disorder, I would definitely use it [the app] every day."
  • Need to be exact - Participants reported feeling the need to track every piece of food and hit calorie goals precisely. One participant reported feeling anxiety about her parents switching the restaurant they were going to, saying "I didn't want to go to dinner. I was like 'No I already had everything perfectly planned for my day.' "
  • Acute awareness of numbers - Some participants noted that the apps changed their relationship with food, essentially equating food with numbers. "I think it's definitely very triggering because you become obsessed with food, you look at food differently...That's protein, that's fat, that's carbs instead of like that's a chicken breast, that's peanut butter, that's a piece of bread."
  • Restricting - Some participants reported that the app encouraged them to maintain control by restricting calories. "It was kind of like a game to beat the calories." 
  • Manipulating the app to lose weight - Some participants described "tricking" the app and not logging all of their activity to motivate them to lose weight even more quickly. "I don't think I ever reported it [my exercise] simply because I knew I was doing so much."
  • Compensatory behaviors - Many participants talked about how they restricted calories to compensate for being "over their calorie budget" other days. "If I see the red, it's pretty much a bad day, and I feel like I have to start all over again."
  • Manipulating the app to avoid negative emotions - Some participants said seeing the foods or calories on the app made it seem more real, so they didn't report correctly. "Normally on my cheat days, I try not to even enter it in the app because I didn't want to see it on the app."

Interestingly, many of the participants said that when they began to recognize their unhealthy thoughts about food, exercise and body image, they changed how they used the app or stopped using it altogether. Some participants said that during eating disorder recovery, it helped them to slowly add calories and track macros, like protein carbs, and fat for healthy weight gain. Others said it helped to take a break from the technology and learn how to recognize food as food again. Others said the idea of deleting the app altogether caused anxiety.

The study authors are clear that they don't see fitness tracking as either "good" or "bad," pointing out that their findings showed benefits and drawbacks. However, they suggest that some users, especially those struggling with eating disorder behaviors or body image issues, may find the apps triggering or possibly detrimental.

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