Calorie Counting and Fitness Tracking Technology: Associations with Eating Disorder Symptomology

 This article is authored by Wendy York and Danny Rahal as part of the 2018 pre-graduate spotlight week.

           With the growing popularity of health-tracking technology, teaching students of all ages about nutrition and overall health has the potential to become a more interactive learning experience than ever before. Health-tracking technology, commonly in the form of a mobile app or website, can be broken down into two categories: calorie-tracking technology and fitness-tracking technology. Calorie-tracking technology typically adds up calories and nutrients based on the meals and snacks that the user has consumed throughout the day. These apps incorporate recommendations for how much users should eat (specifically grams of fat, protein, sugar, etc.), typically based on each individual user’s weight loss goals. Fitness-tracking technology similarly encourages users to track their physical activity with the ultimate goal of losing weight. These apps usually track heart rate, daily steps taken, and more.  

            Health-tracking apps may seem harmless. On the surface, they appear to be a convenient and accessible way for people to become more aware of what they put into their bodies and how much exercise they engage in on a regular basis. Furthermore, there is strong evidence that this kind of self-regulation is associated with behavioral change. However, what happens when that behavioral change takes a drastic and even dangerous turn? When it comes to tracking food and exercise, some individuals tend to exhibit obsessive behaviors to the point at which their mental and physical health are jeopardized. In assessing the overall benefits and costs of using health-tracking technology, we must consider how they have the capacity to trigger, enable, or exacerbate eating disorder behaviors.

            Although research has indicated that eating disorders have the highest mortality rate of any mental illness, they are often tremendously misunderstood by the general public. 1 Unfortunately, media portrayals do not adequately represent the scope or the complexity of these disorders, leaving most people with a lack of awareness about the wide range of eating disorders (as well as the symptoms they entail). Beyond the two most commonly known disorders (anorexia nervosa and bulimia nervosa), the National Eating Disorders Association classifies nine others, including orthorexia and compulsive exercise.2 Orthorexia is characterized by the obsessive concern with exclusively eating foods that are considered “healthy.” 3 Compulsive exercise involves an intense impulse to adhere to a rigid exercise routine, often engaging in physical activity as a means of reducing guilt associated with eating.4 Over time, these eating disorders become so unyielding that they interfere with individuals’ daily functioning. Equipped with an understanding of these eating disorders, the convenience and accessibility of health-tracking technology can potentially be considered more aversive than it is beneficial. These apps provide tools for those suffering to continue (or even increase) engagement in detrimental behaviors or may prompt users with no prior eating disorder symptoms to become concerned about their weight to an unhealthy extent. 

            In an effort to explore whether use of health-tracking technology predicts eating disorder symptomology, researchers Courtney Simpson and Suzanne Mazzeo conducted a study of undergraduate students.5 Although the study included both women and men, undergraduate women were the primary focus because they represent the most common demographic that uses health-tracking technology (women between the ages of 18 and 29). Furthermore, young adult women account for the largest demographic of individuals with eating disorders. Participants completed an anonymous survey regarding their eating disorder symptoms, such as binging episodes, purging behavior, eating concerns, shape concern, weight concern, and dietary restraint, over the past month. Participants also reported whether they use calorie-tracking technology (such as MyFitnessPal) and/or fitness-tracking technology (such as FitBit) on a regular basis.

            Rather than improving healthy behaviors, regular use of calorie-tracking technology was associated with anxious attitudes toward food and a greater likelihood of engaging in restrictive dieting. However, despite these abnormal attitudes regarding food, those who reported use of calorie-tracking technology did not express body image concerns; this finding suggests that the use of calorie-tracking technology may not be related to overall body satisfaction after all. On the other hand, participants who reported regular use of fitness-tracking technology did indicate tendencies to engage in behaviors and attitudes associated with eating disorder symptomology. These results suggest that fitness-tracking apps may not always be used for health purposes, but rather to achieve potentially harmful weight-loss goals. Moreover, in spite of these negative implications, 13.8% of participants reported regular use of calorie-tracking technology and 19.6% reported regular use of fitness-tracking technology.

            It is important to acknowledge that health-tracking technology may not actually be causing eating disorder symptoms; more research is needed to identify whether that is the case. An alternative hypothesis is that people who already show symptoms are merely more likely to track their food and exercise patterns. Of those individuals who are already at risk for eating disorders, it is possible that their symptoms become worse through the regular use of health-tracking technology. In other words, the use of calorie-tracking and/or fitness-tracking technology may be problematic for those who are susceptible to eating disorder symptomology. However, it is not always apparent whether an individual is at risk or not, and more work is needed before schools endorse such technology or require students to use it.

            Despite claims that health-tracking technology has the potential to provide benefits for those who need to incorporate a more balanced diet and exercise routine for health purposes, the dangerous consequences these apps tend to set in motion cannot be ignored. In recommending the use of these apps to individuals (particularly students), health providers and teachers should be extremely cautious. Representing a demographic that is at greater risk for the development of eating disorders, adolescents and young adults may not be the most appropriate population for health-tracking apps to be targeted at. Unfortunately, however, it seems that young people already represent the largest user-base. Hopefully, with continued research, changes can be made to health-tracking technology with sensitivity to populations who are vulnerable to the onset and exacerbation of eating disorders.

Wendy York is a third year undergraduate student at UCLA pursuing a major in Psychology and a minor in Applied Developmental Psychology. She is primarily interested in developmental and abnormal psychology. 

References

1. Statistics and Research on Eating Disorders. (2018, April 5). Retrieved from https://nationaleatingdisorders.org/statistics-research-eating-disorders

2. Information by Eating Disorder. (2018, February 21). Retrieved from https://www.nationaleatingdisorders.org/information-eating-disorder

3. Orthorexia. (2018, February 22). Retrieved from https://nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

4. Compulsive Exercise. (2018, February 22). Retrieved from https://nationaleatingdisorders.org/learn/general-information/compulsive-exercise

5. Simpson, C. C., & Mazzeo, S. E. (2017). Calorie counting and fitness tracking technology: Associations with eating disorder symptomology. Eating Behaviors, 26. doi: 10.1016/j.eatbeh.2017.02.002