New research has linked the use of diet and fitness apps to problematic eating habits and body image issues, particularly in young people. It highlights the fine line that exists between using these apps for motivation and using them to perpetuate potentially dangerous behaviors.

These days, smartphone and wearable apps can track pretty much every aspect of our health and wellness. And they’re popular. In 2023, 311 million people were health app users, whether they used Apple Health, MyFitnessPal, Fitbit, Noom, BetterMe, WeightWatchers, or something else. The apps make users accountable for their diet and fitness – which is a good thing – but do they have unintended consequences?

In a recently published study, researchers from Flinders University in South Australia undertook a systematic review of studies to examine the darker side of using diet and fitness monitoring apps, looking at the relationship between them and disordered eating, body image, and compulsive exercise.

“Diet and fitness apps are marketed as tools to improve health, however, they may also have unintended negative consequences, such as creating pressure to meet goals, concerns about body image as well as provoking feelings of guilt if goals aren’t achieved,” said Isabella Anderberg, from the University’s College of Education, Psychology and Social Work, and the study’s lead and corresponding author. “Whilst there is evidence that these tools can be effective in increasing physical activity, we’re interested in understanding whether these apps might actually be harmful for some users.”

After searching for post-2007 international research on four main concepts – diet and fitness apps, disordered eating, body image, and compulsive exercise – the researchers identified 38 studies that were eligible for review. Twenty-six used quantitative methodology; the remainder used qualitative or mixed methods. Thirty-five of the 38 studies recruited participants (either adults, adolescents, or a mix of both), and three conducted a qualitative analysis of app data.

Studies were conducted in the US and Canada, the UK, Australia and New Zealand, China, the Czech Republic, France, Norway, and Switzerland. Some examined diet and fitness monitoring apps together as a single variable; some examined the two app types as separate variables. Some studied diet or fitness apps separately, and others looked at specific apps.

The researchers first looked at the relationship between the use of diet and fitness apps and disordered eating, body image, and compulsive exercise. While both diet and fitness apps were associated with symptoms of disordered eating, there were only a few studies that separated app types, making it hard to compare their individual effects. Diet monitoring apps were linked to intentionally self-regulating caloric intake (dietary restraint), a preoccupation with food, and eating concerns. However, fitness monitoring apps were more strongly linked to compulsive exercise, likely because of their ability to track exercise frequency, duration, and intensity. There were mixed results when it came to body image. Some studies found that diet app users had higher body dissatisfaction. And some fitness apps had a positive effect on body image, while others showed increased weight concerns.

Next, the researchers looked at the relationship between the frequency of use of these apps and disordered eating, body image, and compulsive exercise. They found that frequent users of diet and fitness apps were more likely to have symptoms of disordered eating, body image concerns, and compulsive exercise habits. Some studies suggested that disordered eating symptoms predicted later diet app use rather than the other way around.

Finally, they analyzed the key factors contributing to the relationships between diet and fitness app use, disordered eating, body image, and compulsive exercise. People who used diet and fitness apps for weight and body-shape-related reasons were more likely to experience disordered eating. In contrast, people who used these apps to achieve health or fitness goals tended to have fewer negative effects.

The researchers found the qualitative research useful for gauging the perspectives and experiences of app users. Users perceived the benefits of app use to include motivation to engage in physical activity and access to health-related information. On the other hand, their concerns included the promotion of thinness as an ideal, the pressure to meet diet- or fitness-related goals and feelings of guilt associated with that, and the problematic use of apps to maintain disordered eating behaviors.

“We found that young adults who use diet and fitness apps have greater disordered eating symptoms, such as harmful or restrictive diets, and have negative thoughts about body image when compared to those that don’t use them,” Anderberg said. “The focus on dietary restriction and weight loss in these apps may feed into restrictive or excessive behaviors raising concerns for those people who have pre-existing concerns about their weight or body image. While some users reported positive experiences such as increased awareness and motivation, the broader implications for mental health need careful consideration, especially among vulnerable populations like adolescents.”

It’s important to note that no conclusions about causation could be reached from the study’s findings. However, the researchers suggest that, based on their findings, there is a need to include in-app screening that screens users for eating concerns and provides them with support resources.

“Our findings highlight the importance of promoting healthy body image and exercise behaviors among young adults, and of being aware of the potential risks associated with the use of diet and fitness apps and for users to approach them with a focus on improving their health,” said senior author Professor Ivanka Prichard, a specialist in health psychology and Director of the Embrace Impact Lab at Flinders University. “In a growing world of technology, studies like this are important in shaping future research to provide the best health and self-management information via apps to the wider population.”

Future research is needed to untangle the complex relationship that exists between diet and fitness apps and how each one contributes to disordered behaviors, as well as investigate individual risk and protective factors such as gender, eating disorder history, and the concept of perfectionism. More adolescents, as an under-researched population, should also be included in further studies.

The study was published in the journal Body Image.

Source: Flinders University