Can Weight Stigma Be Perpetuated Through Weight Loss Apps?

Obesity rates in the Unites States are predicted to be at 50% by 2030, according to the World Health Organization. Obesity is linked to an increased risk of type 2 diabetes, cardiovascular complications, certain cancers, and chronic kidney disease [1, 2] and obesity increases the risk of mortality up to twenty three times [3].

However, regular consumption of foods high in fat and sugar cause adaptations in the reward centers of the brain, making impulse control extremely difficult [4] and metabolic adaptations cause the body to defend elevated weight once the weight is gained, influencing the likelihood of weight loss failure [1, 2].

Additionally, many individuals experiencing obesity report regularly encountering discrimination and weight bias from employers, health professionals, friends and family [5], and in exercise or sports-related settings [6]. When weight bias is internalized, it can increase feelings of hopelessness, depression, anxiety, and lead to reduced self-esteem, eating disorders, and body dissatisfaction [7]. Weight related stigma will interfere with achieving and maintaining a healthy weight [8].

Turning to Mobile Apps for Weight Loss

Weight loss is often cited as one of the major reasons an individual may seek to change their dietary habits. Though a variety of weight loss programs exist, according to numerous studies, long-term results are often difficult to maintain due to poor adherence to behavior change plans, lack of motivation, knowledge, coping skills, self-efficacy, and self-regulation. Individuals seeking to lose weight try to increase self-regulation through willpower alone or they try to reduce the effort needed for self-regulation through the use of weight-loss mobile apps [3].

Perpetuating Weight Stigma

Though mobile apps have been found to potentially improve adherence to weight loss plans, some apps may also be perpetuating weight stigma via app features, such as notifying an individual with feedback that they are “lazy” or “slacking off” if they report low physical activity. Promoting an unrealistic thin ideal or perpetuating the negative stereotypes associated with a larger body size are also features that are present in a variety of apps related to weight change behavior [8].

When recommending or using an app for weight loss, features in the app which may contribute to weight stigmatization need to be examined. For example, some features may consist of a grading scale for foods, implicitly stating there are “good” and “bad” foods, which may lead to a fixation on the “health attribute” of a food item and contribute to eating disorders, such as orthorexia [9].

A thorough review of app features and the manner in which they correspond to evidence-based strategies, as well as any possible perpetuation of negative stereotypes and weight biases, is the best way to ensure long-term weight loss success and a healthy mental status for the user. A chart, examining connecting evidence-based strategies, app features, and possible weight stigmatization features in an app can be found here.

If you are interested in learning more about combating weight stigma, check out this resource.

Resources

1. Whytock, K. L., Corbin, K. D., Parsons, S. A., Pachori, A., Bock, C. P., Jones, K. P., … Smith, S. R. (2021). Metabolic adaptation characterizes short-term resistance to weight loss induced by a low-calorie diet in overweight/obese individuals. The American Journal of Clinical Nutrition. https://doi.org/10.1093/ajcn/nqab027
2. Yan, Y., Zheng, W., Ma, Q., Chu, C., Hu, J., Wang, K., … Mu, J. (2021, February 19). Child-to-adult body mass index trajectories and the risk of subclinical renal damage in middle age. Nature News. https://www.nature.com/articles/s41366-021-00779-5?proof=t.
3. Chew, H. S., Ang, W. H., & Lau, Y. (2021). The potential of artificial intelligence in enhancing adult weight loss: A scoping review. Public Health Nutrition, 1–28. https://doi.org/10.1017/s1368980021000598
4. Serafine Katherine, M., O’Dell Laura, E., & Eric P, Z. (2021). Converging vulnerability factors for compulsive food and drug use. Neuropharmacology, 108556. Advance online publication. https://doi.org/10.1016/j.neuropharm.2021.108556
5. Weight bias & stigma in health care. Obesity Evidence Hub. (n.d.). https://www.obesityevidencehub.org.au/collections/treatment/weight-bias-and-stigma-in-health-care#:~:text=%20What%20can%20health%20care%20professionals%20do%20about,in%20documenting%20patient%E2%80%99s%20issues%20around%20weight…%20More%20.
6. Thedinga, H. K., Zehl, R., & Thiel, A. (2021). Weight stigma experiences and self-exclusion from sport and exercise settings among people with obesity. BMC public health, 21(1), 565. https://doi.org/10.1186/s12889-021-10565-7
7. Gmeiner, M. S., & Warschburger, P. (2021). Simply too much: the extent to which weight bias internalization results in a higher risk of eating disorders and psychosocial problems. Eating and weight disorders : EWD, 10.1007/s40519-021-01170-z. Advance online publication. https://doi.org/10.1007/s40519-021-01170-z
8. Olson, K. L., Goldstein, S. P., Lillis, J., & Panza, E. (2020). Weight stigma is overlooked in commercial-grade mobile applications for weight loss and weight-related behaviors. Obesity science & practice, 7(2), 244–248.https://doi.org/10.1002/osp4.457
9. Barthels, F., Meyer, F., Huber, T., & Pietrowsky, R. (2017). Orthorexic eating behaviour as a coping strategy in patients with anorexia nervosa. Eating and weight disorders : EWD, 22(2), 269–276. https://doi.org/10.1007/s40519-016-0329-x