Correlates of weight-related self-monitoring application use during emerging adulthood in a population-based sample

Tracking every bite and step: Associations between diet and fitness app use, disordered eating, body image concern and compulsive exercise

BACKGROUND

Diet and fitness applications (apps) aim to enhance users' physical health. Many of these apps allow users to monitor their diet or fitness-related data, such as the number of calories consumed or burnt. However, they may not be suitable for all individuals due to their focus on dietary restriction and weight loss.

OBJECTIVES

and Methods: The present study sought to determine whether the use of specific app types (e.g., diet versus fitness) differ in their associations with disordered eating, body dissatisfaction, and compulsive exercise. Fit-ideal internalisation and exercise motivations were examined as moderating and mediating factors, respectively. An online questionnaire was administered to 386 Australian women (17-35 years).

RESULTS

Diet monitoring app users and those who used both fitness and diet apps had greater disordered eating, body dissatisfaction, and compulsive exercise compared to fitness monitoring app users and non-users. Fit-ideal internalisation moderated the relationship between diet and fitness monitoring app use and disordered eating. Exercise motivations mediated the relationships between diet and fitness monitoring app use and disordered eating symptomology.

CONCLUSIONS

Despite diet and fitness apps' intentions to promote health and wellbeing, their use is linked to disordered eating symptomology. Educating app users, screening for unhealthy behaviours within apps, and advising professionals how to monitor app use could provide suitable interventions to encourage more positive app use. In addition, more research is needed to determine associations in other understudied and at-risk populations such as adolescents, as well as longitudinal and experimental studies to establish directions of effects.

Emerging Adults Report Internal, External, and Social/Environmental Motivations for Weight-Related Self-Monitoring Application Use

OBJECTIVE

To describe the factors that motivate emerging adults to engage in weight-related self-monitoring (WRSM) and to determine the age of initiating WRSM.

DESIGN

Mixed-methods cross-sectional study, including quantitative survey and semi-structured interviews.

PARTICIPANTS

Tracking-EAT participants came from the population-based sample of Project EAT (Eating and Activity over Time); 138 participants (mean age=26.5 years; range 22-29) completed a survey, 25 of which also completed a semi-structured interview.

MAIN OUTCOME MEASURE

Internal and external motivations for WRSM and the age when participants began WRSM were assessed quantitatively. Semi-structured interviews assessed how participants were introduced to and why they used WRSM.

ANALYSIS

Descriptive statistics for quantitative measures. Inductive thematic analysis for qualitative analyses.

RESULTS

Participants reported internal (e.g., trying to lose weight, change body shape), external (e.g., advice from health professionals, friends/or family), and social/environmental motivations (e.g., WRSM being ubiquitous in our culture). A sense of moral obligation to strive for health contributed to participants' motivation to engage in WRSM. Participants reported self-monitoring dietary intake and weight as young as 8 years old and exercise as young as 9 years old.

CONCLUSIONS AND IMPLICATIONS

Numerous factors converge to normalize and encourage WRSM, including internal, external, and social/environmental motivations. Future research could explore how the age of introduction and motivation for use affect the health impacts of WRSM.

Longitudinal Associations Between Adolescents' mHealth App Use, Body Dissatisfaction, and Physical Self-Worth: Random Intercept Cross-Lagged Panel Study

BACKGROUND

Longitudinal investigation of the association between mobile health (mHealth) app use and attitudes toward one's body during adolescence is scarce. mHealth apps might shape adolescents' body image perceptions by influencing their attitudes toward their bodies. Adolescents might also use mHealth apps based on how they feel and think about their bodies.

OBJECTIVE

This prospective study examined the longitudinal within-person associations between mHealth app use, body dissatisfaction, and physical self-worth during adolescence.

METHODS

The data were gathered from a nationally representative sample of Czech adolescents aged between 11 and 16 years (N=2500; n=1250, 50% girls; mean age 13.43, SD 1.69 years) in 3 waves with 6-month intervals. Participants completed online questionnaires assessing their mHealth app use, physical self-worth, and body dissatisfaction at each wave. The mHealth app use was determined by the frequency of using sports, weight management, and nutritional intake apps. Physical self-worth was assessed using the physical self-worth subscale of the Physical Self Inventory-Short Form. Body dissatisfaction was measured with the items from the body dissatisfaction subscale of the Eating Disorder Inventory-3. The random intercept cross-lagged panel model examined longitudinal within-person associations between the variables. A multigroup design was used to compare genders. Due to the missing values, the final analyses used data from 2232 adolescents (n=1089, 48.8% girls; mean age 13.43, SD 1.69 years).

RESULTS

The results revealed a positive within-person effect of mHealth app use on the physical self-worth of girls: increased mHealth app use predicted higher physical self-worth 6 months later (β=.199, P=.04). However, this effect was not consistent from the 6th to the 12th month: a within-person increase in using apps in the 6th month did not predict changes in girls' physical self-worth in the 12th month (β=.161, P=.07). Regardless of gender, the within-person changes in the frequency of using apps did not influence adolescents' body dissatisfaction. In addition, neither body dissatisfaction nor physical self-worth predicted app use frequency at the within-person level.

CONCLUSIONS

This study highlighted that within-person changes in using mHealth apps were differentially associated with adolescents' body-related attitudes. While increased use of mHealth apps did not influence body dissatisfaction across genders, it significantly predicted higher physical self-worth in adolescent girls 6 months later. A similar association was not observed among boys after 6 months. These findings indicate that using mHealth apps is unlikely to have a detrimental impact on adolescents' body dissatisfaction and physical self-worth; instead, they may have a positive influence, particularly in boosting the physical self-worth of adolescent girls.

The link between the use of diet and fitness monitoring apps, body image and disordered eating symptomology: A systematic review

Diet and fitness applications (apps) are marketed as health tools. Emerging research suggests that these apps may be linked to disordered eating symptomology. This systematic review aimed to collate and synthesise research examining the relationship between diet and fitness app use and disordered eating, including body image concerns and compulsive exercise. Additionally, it sought to identify how app type, frequency of use, and other contributing factors may influence the relationships investigated. A systematic search of peer-reviewed and published journal articles was undertaken using five electronic databases (Medline, PsycINFO, ProQuest, Scopus, and Web of Science). Thirty-eight articles were included. Disordered eating symptomology was higher in young adults who use diet and fitness apps and among those who use them more frequently, than non-users. Qualitative research indicated unintended consequences of this type of app use (e.g., pressure to meet goals and guilt). No causal conclusions could be drawn. Cross-sectional evidence suggests that the use of diet and fitness apps is associated with disordered eating, body image concerns and compulsive exercise. Future research should attempt to disentangle potential differences between app types and features, investigate potential risk and protective factors, and extend work to under researched populations (e.g., adolescents).

A mixed-methods longitudinal examination of weight-related self-monitoring and disordered eating among a population-based sample of emerging adults

BACKGROUND

Weight-related self-monitoring (WRSM) apps are used by millions, but the effects of their use remain unclear. This study examined longitudinal relationships between WRSM and disordered eating among a population-based sample of emerging adults.

METHODS

Participants (n = 138) were recruited from EAT 2010-2018 (Eating and Activity over Time study) to participate in a mixed-methods (quantitative and qualitative) longitudinal study to understand the impacts of WRSM. In 2018, participants (Mage=21.7 ± 1.9 years) reported motivations for use and types of WRSM apps used. Dependent variables collected in 2022 (Mage=25.7 ± 1.9 years) included past year total number of disordered weight control behaviors, disordered muscle building behaviors, compulsive exercise, and binge eating. Linear and logistic regressions were used adjusting for sociodemographics, body mass index, and baseline disordered eating. Semi-structured interviews (n = 25) were analyzed using inductive thematic analysis.

RESULTS

Participants using WRSM apps for weight management demonstrated an increase in disordered weight control behaviors over time (β = 0.894, p = .012). Using WRSM apps for "healthy" eating was marginally associated with an increase in disordered weight control behaviors. (β = 0.673, p = .052). Qualitatively, participants reported varied temporality between WRSM and disordered eating, but believed that app use encouraged restriction/binge cycles and normalized disordered eating.

CONCLUSIONS

Findings suggest there may be individual variation in the relationships between WRSM and disordered eating, but that using WRSM apps with the motivation of managing eating or weight may increase disordered eating in some. Additionally, WRSM apps may normalize or encourage disordered eating. Therefore, safeguards, including screening and monitoring, are needed to ensure WRSM does not cause or escalate harm among WRSM users.

Exploring longitudinal relationships between fitness tracking and disordered eating outcomes in college-aged women

OBJECTIVE

A growing body of research, primarily cross-sectional, suggests a relationship between the practice of tracking one's food intake and exercise behaviors using fitness-tracking smartphone applications ("apps") or wearable devices ("wearables") and disordered eating symptomatology. The aim of the present study was to explore longitudinal relationships between fitness tracking and disordered eating outcomes among college-aged women, as well as to determine whether the individual-level risk factors of pre-existing eating concerns, perfectionism, and rumination about food moderated the relationship.

METHOD

N = 68 female undergraduates used the MyFitnessPal app for 8 weeks while completing a series of self-report measures.

RESULTS

At the trait level, fitness tracking frequency was positively associated with weight/shape concerns, but not with the other outcome measures. Daily levels of fitness tracking did not predict next-day levels for any of the outcome measures. Within-day fitness tracking at one timepoint was associated with lower reports of dietary restraint efforts at the next timepoint. None of the proposed moderators significantly interacted with the relationships over time.

DISCUSSION

These results suggest that while those who engage in fitness tracking may experience higher weight/shape concerns as a trait, over time fitness tracking was not associated with an increase in concerns. Further work exploring whether fitness tracking may affect particular subgroups in different ways is warranted.

Mobile Food Tracking Apps: Do They Provoke Disordered Eating Behavior? Results of a Longitudinal Study

Background

Some studies connect the popularity of food-tracking apps to an increase in restrictive eating and other disordered eating behaviors and find those apps harmful for psychological well-being, but there is a lack of empirical studies, especially of Russian samples.

Objective

To examine the connection between disordered eating symptoms, psychological well-being, and the use of a mobile food-tracking application.

Design

The participants were 26 women aged 18-30 (M = 21.96; SD = 3.33); 24 completed the study. During the pre-test, the participants completed the Dutch Eating Behavior Questionnaire (Van Strien et al., 1985), the Eating Attitude Test (Skugarevskii, 2007), the Hospital Anxiety and Depression Scale (Ma et al., 2023), the Situation Inventory of Body-Image Dysphoria (Baranskaia & Tataurova, 2011), and a socio-demographic survey with additional questions related to food tracking, weight, and disordered eating. The experimental group was then tasked with tracking their food consumption with a mobile app for a month. The test battery was completed again immediately after the experiment ended, and for a third time one month later.

Results

The comparative analysis showed a decrease in anxiety throughout the study, with a tendency-level increase in depressive symptoms by the end of the experiment. Contrary to expectations, emotional and external eating decreased during the experiment, while restrictive eating did not change. However, the risk of general disordered eating behavior increased one month after the experiment. The correlations between psychological well-being and eating behavior changed during the study. Immediately after the experiment, more correlations between eating behavior, body dissatisfaction, anxiety, and depression emerged, while at the later cutoff, correlations with depression and anxiety became insignificant.

Conclusion

The study had mixed results, contradicting some previous research. Both emotional and external eating decreased along with anxiety levels; however, general disordered eating symptoms increased after food tracking.

Predictors of Food and Physical Activity Tracking Among Young Adults

BACKGROUND

Monitoring food intake and physical activity (PA) using tracking applications may support behavior change. However, few longitudinal studies identify the characteristics of young adults who track their behavior, findings that could be useful in designing tracking-related interventions. Our objective was to identify predictors of past-year food and PA tracking among young adults.

METHODS

Data were available for 676 young adults participating in the ongoing longitudinal Nicotine Dependence in Teens Study. Potential predictors were measured in 2017-2020 at age 31, and past-year food and PA tracking were measured in 2021-2022 at age 34. Each potential predictor was studied in a separate multivariable logistic regression model controlling for age, sex, and educational attainment.

RESULTS

One third (37%) of participants reported past-year PA tracking; 14% reported past-year food, and 10% reported both. Nine and 11 of 41 potential predictors were associated with food and PA tracking, respectively. Compensatory behaviors after overeating, trying to lose weight, self-report overweight, reporting a wide variety of exercise behaviors, and pressure to lose weight predicted both food and PA tracking.

CONCLUSION

Food and PA tracking are relatively common among young adults. If the associations observed herein between compensatory behavior after overeating and tracking (among other observed associations) are replicated and found to be causal, caution may need to be exercised in making "blanket" recommendations to track food intake and/or PA to all young adults seeking behavior change.

Weight-related Self-monitoring App Use Among Emerging Adults is Cross-sectionally Associated With Amount and Type of Physical Activity and Screen Time

Weight-related self-monitoring (WRSM) apps are often used by emerging adults to assist in behavior change. However, little is known about the relationship between WRSM among the general population of emerging adults and various physical activity and screen time behaviors. This paper examines associations between WRSM app use and various forms of physical activity and screen time among a population-based sample of emerging adults. Data come from EAT 2018 (N = 1,568, mean age = 22.0 ± 2.0 years), a population-based sample of emerging adults from Minneapolis/St. Paul, Minnesota. Participants reported on the types of WRSM apps used (physical activity and/or dietary focused), in addition to how much time they spent doing physical activity, whether they practiced yoga, compulsive exercise, recreational screen time, social media use, and whether they viewed dieting/weight loss materials. Linear and logistic regressions were used to assess adjusted means and prevalences of outcomes. We found that physical activity-focused WRSM app users engaged in more hours of total (8.7 vs 7.2, P < .001), and moderate-to-vigorous (5.1 vs 4.3, P = .002) physical activity compared to non-users. Similar results were found for dietary WRSM app users compared to non-users. However, WRSM app users had higher levels of compulsive exercise and were more likely to view dieting/weight loss materials (Ps < .001). Findings suggest that although physical activity is higher among WRSM users, the types of physical activity and screen time behaviors WRSM users are engaging in may be harmful.