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Objectives
Although monitoring is considered a key component of effective behaviour change, the development of apps has allowed consumers to constantly evaluate their own diet, with little examination of what this might mean for eating behavior. The aim of this study was to investigate whether self‐monitoring of diet using the app MyFitnessPal or d...
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Objectives
In children with mild to moderate Crohn's disease (CD), exclusive enteral nutrition (EEN) is the first‐line treatment. However, adherence to this therapeutic strategy remains challenging because of numerous psychosocial factors. This study aimed to evaluate the short‐term acceptability and long‐term tolerance of EEN.
Methods
A single‐ce...
Adolescence is a sensitive stage of life that is particularly vulnerable to nutritional problems, including DEBs. This cross-sectional study aims to explore the prevalence of DEBs among adolescent female school students in four intermediate and secondary schools in the city of Riyadh and to examine predictors associated with DEBs, including age, BM...
Citations
... 11 One study, however, found evidence suggesting that calorie counting and fitness-tracking applications do not pose risk for worsening eating disorder symptomatology and disordered exercise behaviors. 31 Students noted positive aspects of using a calorie and/or fitness tracker such as helping the client be aware of food intake and what to improve, which can motivate the client to eat healthier and/or increase physical activity. Mobile health apps can assist individuals in changing eating behavior and diet-related health risk factors, 30 and can facilitate healthy diets. ...
Intuitive eating (IE), an evidence-based, weight-inclusive, hunger-based, and mind-body health approach, is critical for dietitians to know and practice when working with clients to manage their health. Yet, many dietitians are not familiar with the practice of IE, stemming from a lack of training in their dietetics curriculum. The purpose of this mixed-methods study was to investigate the outcomes of creating pedagogical activities incorporating IE education into a senior-level Professional Skills in Dietetics course (Intervention Group [IG]) on students’ eating behaviors, body esteem, and self-efficacy to provide effective nutrition counseling and compare it to junior-level dietetics students in a course not receiving the IE education (Control Group [CG]). Sixty-seven students completed the pre-and post-survey including the Intuitive Eating Scale-2 and Body-Esteem Scale for Adolescents and Adults. Students in the IG showed significant improvements in IE scores pre-to post-course, and there was a significant difference in IE post scores between IG and CG; however, the post-pre-IG versus post-pre-CG scores for IE and body esteem showed no significance. High IE scores among IG were associated with higher levels of body esteem, and no correlation was found within the CG. This study also noted the IG embraced IE principles, which led them to have a more positive relationship with food and increased their self-efficacy to be more effective nutrition counselors. Dietetics programs have a unique opportunity to include the topic of IE in any number of existing courses in the dietetics curriculum. As such, teaching about IE in the undergraduate dietetics curriculum and providing community-engaged learning for students to apply this skill prepares students to be effective nutrition counselors as future dietitians.
... One key component of BWL includes self-monitoring of weight during treatment, and prior work suggests that more frequent or consistent self-weighing is associated with improved weight-loss outcomes [18][19][20][21]. Several prospective studies examining adults during weight-loss treatment found that greater frequency of self-weighing was not associated with adverse psychological outcomes such as binge-eating [22], depression [20,21,23] or other forms of disordered eating, such as compensatory strategies [20,22]. Importantly, however, many of these studies excluded individuals with current or history of eating disorders, and we are unaware of any studies examining self-weighing among those with food addiction. ...
... One key component of BWL includes self-monitoring of weight during treatment, and prior work suggests that more frequent or consistent self-weighing is associated with improved weight-loss outcomes [18][19][20][21]. Several prospective studies examining adults during weight-loss treatment found that greater frequency of self-weighing was not associated with adverse psychological outcomes such as binge-eating [22], depression [20,21,23] or other forms of disordered eating, such as compensatory strategies [20,22]. Importantly, however, many of these studies excluded individuals with current or history of eating disorders, and we are unaware of any studies examining self-weighing among those with food addiction. ...
Food addiction (FA) has been linked to clinical features in binge-eating disorder (BED) and obesity. A feature of behavioral weight loss (BWL) treatment involves frequent weighing. However, little is known regarding how frequency of self-weighing and related perceptions are associated with BWL outcomes among individuals with BED and obesity stratified by FA status. Participants (n = 186) were assessed with the Eating Disorder Examination before and after BWL treatment. Mixed effects models examined FA (presence/absence) before and after (post-treatment and 6- and 12-month follow-up) treatment and associations with frequency of weighing and related perceptions (reactions to weighing, sensitivity to weight gain and shape/weight acceptance). Participants with FA reported more negative reactions to weighing and less acceptance of shape/weight throughout treatment and follow-ups, and both variables were associated with greater disordered eating at follow-ups among participants with FA. Sensitivity to weight gain decreased over time independent of FA status. Frequency of weighing was associated with a greater likelihood of achieving 5% weight loss only among those without FA. Reactions to weighing and sensitivity to weight gain are associated with FA and poorer treatment outcomes in individuals with BED and obesity. Targeting these features may improve BWL outcomes among individuals with BED, obesity and FA.
... Furthermore, causal links between shape checking and body dissatisfaction exist in some (Shafran et al., 2007), but not all (Bailey and Waller, 2017) experimental work. However, authors of two recent weight loss studies reported no significant differences in eating and body image disorder symptoms between those implementing self-monitoring or those not (Jospe et al., 2018;Steinberg et al., 2014). To explain this discrepancy, it may be these monitoring behaviors are detrimental only when performed rigidly (Fairburn, 2008), or by individuals likely to implement them rigidly, such as those with clinical or subclinical eating disorders. ...
The popularity of physique sports is increasing, yet there are currently few comprehensive nutritional guidelines for these athletes. Physique sport now encompasses more than just a short phase before competition and offseason guidelines have recently been published. Therefore, the goal of this review is to provide an extensive guide for male and female physique athletes in the contest preparation and recovery period. As optimal protein intake is largely related to one’s skeletal muscle mass, current evidence supports a range of 1.8-2.7 g/kg. Furthermore, as a benefit from having adequate carbohydrate to fuel performance and activity, low-end fat intake during contest preparation of 10-25% of calories allows for what calories remain in the “energy budget” to come from carbohydrate to mitigate the negative impact of energy restriction and weight loss on training performance. For nutrient timing, we recommend consuming four or five protein boluses per day with one consumed near training and one prior to sleep. During competition periods, slower rates of weight loss (≤0.5% of body mass per week) are preferable for attenuating the loss of fat-free mass with the use of intermittent energy restriction strategies, such as diet breaks and refeeds, being possibly beneficial. Additionally, physiological and psychological factors are covered, and potential best-practice guidelines are provided for disordered eating and body image concerns since physique athletes present with higher incidences of these issues, which may be potentially exacerbated by certain traditional physique practices. We also review common peaking practices, and the critical transition to the post-competition period.
... Reducing this complexity, three studies have focused on the use of one application, MyFitnessPal, in relation to eating psychopathology (Jospe et al., 2018;Levinson, Fewell, & Brosof, 2017;Linardon & Messer, 2019). The main functions of MyFitnessPal enable users to set goals concerning weight, and calorie intake and macronutrient intake, and assess their goal progress by (a) estimating and tracking their calorie intake and nutrient intake (e.g., consulting a food database, scanning barcodes, creating their own entries for foods); (b) estimating and tracking calorie expenditure (e.g., logging exercises, tracking steps); and (c) recording their weight with optional photos of their body (Under Armour Inc., 2019). ...
... A smaller proportion (47%, 26/55) of male users recruited from health and fitness websites described it as, at least, somewhat contributing to disordered eating (Linardon & Messer, 2019). However, in contrast to these cross-sectional studies, an experimental study found no evidence for a causal effect of using MyFitnessPal on eating disorder symptomatology (Jospe et al., 2017(Jospe et al., , 2018. Given the inconsistent results, it is important to explore factors that could influence the nature of these relationships. ...
... The risk of such narrow assessment of engagement is that patterns of use that are particularly indicative of eating disorders might remain undetected. Similarly, while no causal effect of MyFitnessPal use on eating disorder symptomatology was detected in the experimental study (Jospe et al., 2018), this finding could be due to the duration (or consistency) of engagement being insufficiently manipulated. Specifically, the participants in the "MyFitnessPal" condition used the application daily for the first month, but for only 1 week of each remaining month in the 12-month period (approximately 15 weeks in total; Jospe et al., 2017). ...
Objective
Using calorie‐counting and fitness‐tracking technologies is concerning in relation to eating disorders. While studies in this area typically assess one aspect of use (e.g., frequency), engagement with a device or application is more complex. Consequently, important relationships between the use of these technologies and the eating disorder symptomatology might remain undetected. The current study therefore used comments from online eating disorder‐related forums to generate comprehensive qualitative insights into engagement with a popular calorie‐counting and fitness‐tracking application, MyFitnessPal.
Method
First, we extracted every comment mentioning MyFitnessPal made on three eating disorder‐related forums between May 2015 and January 2018 (1,695 comments from 920 commenters). Then, we conducted an inductive thematic analysis using these comments to identify important aspects of engagement with MyFitnessPal.
Results
The analyses resulted in three themes: Preventing misuse, describing ways in which MyFitnessPal attempts to prevent pathological use and actions taken by users to circumvent its interventions; Accuracy, outlining distrust of MyFitnessPal's accuracy and ways in which perceived inaccuracy is reduced or compensated for; and Psychosocial factors, comprising cognitive, behavioral, and social factors that influence, or are influenced by, engagement with MyFitnessPal.
Discussion
The qualitative insights provide a detailed overview of how people with high levels of eating disorder symptomatology likely engage with MyFitnessPal. The insights can be used as a basis to develop valid, quantitative assessment of pathological patterns of engagement with calorie‐counting and fitness‐tracking technologies. The findings can also provide clinicians with insight into how their patients likely engage with, and are affected by, these devices and applications.
... For example, Steinberg et al. [106] found no significant post-treatment differences in anorectic cognitions, disinhibited eating, binge eating, and depressive symptoms between individuals with overweight/obesity randomized to either a daily self-weighing group or a delayed-intervention control group. Similarly, Jospe et al. [107] found no increase and differences in eating disorder symptoms among individuals with obesity randomized to either a daily weighing intervention, an energy intake tracking mobile intervention, a brief support intervention, hunger training strategies, or a wait-list control. ...
Physique athletes strive for low body fat with high lean mass and have higher body image and eating disorder rates than the general population, and even other weightlifting populations. Whether athletes with a background or tendency to develop these issues are drawn to the sport, or whether it drives these higher incidences, is unknown. However, the biological drive of cyclical energy restriction may contribute to binge-eating behavior. Additionally, requisite monitoring, manipulation, comparison, and judgement of one’s physique may contribute to body image concerns. Contest preparation necessitates manipulating body composition through energy restriction and increased expenditure, requiring dietary restraint and nutrition, exercise, and physique assessment. Thus, competitors are at mental health risk due to (1) pre-existing or predispositions to develop body image or eating disorders; (2) biological effects of energy restriction on eating psychology; and (3) dietary restraint attitudes and resultant physique, exercise, and nutrition monitoring behavior. In our narrative review we cover each factor, concluding with tentative best-practice recommendations, including dietary flexibility, slower weight loss, structured monitoring, gradual returns to offseason energy intakes, internal eating cues, appropriate offseason body compositions, and support from nutrition and mental health professionals. A mental health focus is a needed paradigm shift in bodybuilding nutrition practice and research.
... Moreover, some have also speculated that MFP may become a way for users to quantify their selfworth, thereby exacerbating the over-evaluation of weight and shape (Levinson et al., 2017). Initial findings suggest that MFP use is associated with eating disorder symptoms in undergraduate students (70% were female; Simpson & Mazzeo, 2017) and in females with an eating disorder (Levinson et al., 2017) differences in overweight individuals (65% females) who used MFP relative to other self-monitoring methods (Jospe et al., 2018). Importantly, Levinson et al. (2017) reported that more than one-third of participants (35%) felt that their MFP usage was largely contributing to their eating disorder. ...
Background
While body image dissatisfaction (BID) and eating disorders (EDs) are relatively common in athletes (ranging from 11% to 67% of athletes, depending on the sport) [1], they are also prevalent in weight-class restricted sports (a common format in strength sports), and among physique athletes [2]. These athletes manipulate their nutrition to reach aesthetic or body weight standards and, in that process, may undergo prolonged periods of low energy availability. Low energy availability, defined as consuming insufficient energy for one’s lean mass and exercise activity, can lead to Relative Energy Deficiency in sport (REDs), a syndrome that can impact menstrual cycle (MC) symptoms (and many other aspects of physiology and psychology) [3]. There has not been an investigation into the relationships between these resistance-trained (RT) athletes’ nutritional habits, MC-related symptoms, BIDs, and EDs.
Methods
A survey was implemented to explore the dieting habits, MC characteristics, BID, and EDs in RT females.
Results
64.6% (n = 469) of participants reported tracking calories, with a slightly higher percentage of competitive athletes tracking calories 71.8% (n = 181) than recreational-level athletes. Competitive athletes were significantly more likely to track calories than recreational-level athletes (p = 0.003). When asked what the primary purpose of calorie restriction was, most participants selected weight loss for aesthetic purposes 58.8% (n = 356). Competitive athletes were less likely to select weight loss for aesthetic purposes 35.7% (n = 77), but weight loss for the purpose of a weight class-based sport was higher at 43.5% (n = 94). There were no significant associations between BID and MC characteristics or most MC symptoms and limited associations between EDs and MC characteristics and symptoms.
Conclusion
RT athletes exhibited a higher prevalence of calorie tracking than the general population. Competitive RT athletes were less likely to calorie restrict for aesthetic purposes than non-athletes, but more likely to calorie restrict for the purpose of weight-class-based sports. There were limited significant associations between BID and MC characteristics or MC symptoms, as well as between EDs and MC characteristics. However, there was a significant association between amenorrhea and EDs, which aligns with previous research in this area. Both BID and EDs were significantly associated with MC-based mental health effects; this is likely due to the interconnected nature of mental health concerns, such as EDs with depression and anxiety.
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.
