A qualitative analysis of psychological and behavioral outcomes of weight-related self-monitoring among a population-based sample of emerging adults

Abstract

Weight-related self-monitoring (WRSM) apps (e.g., MyFitnessPal) are used by millions of emerging adults. However, little is known about how WRSM app use impacts users outside of clinical contexts. This study examined how a non-clinical sample of emerging adults believed that using WRSM apps impacted them, both behaviorally and cognitively. Qualitative data come from semi-structured interviews from the Tracking-EAT study. Participants (n = 25) were emerging adults (M_age = 24.9 ± 1.8 years) who reported WRSM app use in the past year and were diverse in gender, ethnicity/race, and socioeconomic status. Inductive thematic analysis was used for qualitative data analysis. Participants reported changes in their dietary intake, increased physical activity, "obsessively" prioritizing meeting WRSM goals, and having cognitive and psychological effects from WRSM app use. Dietary implications included picking foods that were easy to track (e.g., prepackaged foods), prioritizing protein, and reducing carbohydrate intake. "Obsessive" prioritization including altering social behaviors to meet WRSM goals at the detriment of other aspects of their life, and further increasing intensity of goals. Cognitive and psychological affects included cognitive persistence of tracking and emotional persistence of tracking including feelings of pride, guilt, and shame. Results suggested that the psychological and behavioral implications of WRSM app use may be more negative than previously assumed, including having potentially harmful dietary implications and cognitive outcomes that extend even after WRSM app use stops. Clinicians should screen their patients who use WRSM apps for potential negative consequences associated with their use and provide additional education.