2120958: Urbanity and Wellbeing: 1949 words
The dark side of self-tracking: calorie counting app use in eating disorders
Introduction
As the proportion of the world’s population living in cities further increases, recent decades
have seen a burgeoning field of research into the link between urbanity and mental health.
The correlation between factors associated with urban living (eg. wealth disparity, lack of
green spaces and social isolation) and mood disorders such as depression and anxiety is
well-established (Berry, 2007; Van den Bosch and Meyer-Lindenberg, 2019). However, it is
only in recent years that researchers have begun to investigate the dangers that urban
environments pose to those at risk or suffering from eating disorders; disorders that were
historically thought to be exclusive to wealthy, Western women (Mulders-Jones et al., 2017).
Although, their prevalence is lower than depression and anxiety, eating disorders such as
anorexia nervosa and bulimia nervosa have the highest mortality rate of any mental disorder
due to the physical toll they take on a sufferer’s body and the long-term nature of the
conditions (Schaumberg et al., 2017). In this essay, I will discuss urban characteristics
contributing to eating disorders before examining the role that calorie tracking applications
(apps) play in the formation and maintenance of eating disorder behaviours. These apps (eg.
“My Fitness Pal”, “Lose It!” and “Fat Secret”) have become increasingly popular in recent
years with My Fitness Pal having over 100 million users. To conclude I will evaluate the UK’s
recent policy of adding calorie contents to menus and suggest better ways in which urban
planners, designers and policymakers can create healthy cities for those at risk of eating
disorders.
Context and Ideas
Berry’s (2007) model, which suggests that the combination of a harmful physical
environment, a harmful social environment and psychological stressors lead to mental
health problems, can be applied here to further understand urbanity’s impact on eating
disorders. Regarding the physical environment, living in cities poses certain risks to mental
wellbeing including polluted and unclean environments (Engemann et al., 2020), lack of a
sense of belonging (Frumkin, 2005) and impoverished, neglected, and degraded
neighbourhoods (Cohen, Spear, Scribner et al., 2000); all of which can be contributing factors
to mental disorders. Diverse studies (Dokhani et al., 2022) (Matthews et al., 2012) found that
life dissatisfaction and poor mental health are risk factors for disordered eating, with eating
disorders commonly co-occurring with depression and anxiety.
The social environment encompasses not only personal friends, family and acquaintances
but also the media, advertising and societal ideals. Hawkes, Harris and Gillespie (2017)
described urban environments as “increasingly obesogenic” with many individuals living in
“food deserts” (where there is a lack of access to affordable healthy food) and many more
living in “food swamps” (where there is a large range of fast food and unhealthy options)
, 2120958: Urbanity and Wellbeing: 1949 words
(Becker et al., 2017). Being overweight is highly correlated with body dissatisfaction and
subsequent disordered eating (Thompson and Shafer, 2018). Thus, people living in
impoverished urban environments find themselves at an increased risk for both obesity and
eating disorders.
In cities across the globe, urbanisation often occurs simultaneously with Westernisation.
Thus, populations that were not previously thought to be at risk of eating disorders are now
experiencing an increased prevalence of these conditions (Gorrell, Trainor and Le Grange,
2019). Westernisation brings with it a “thin ideal” (Thompson and Stice, 2001), a weight-
obsessed fitness industry (Gorrell, Trainor and Le Grange, 2019) and higher levels of
education (Borjorquez et al., 2018); all of which are thought to negatively impact body image
and weight perception, putting individuals at risk for eating disorders.
Eating disorders have typically been studied in Western contexts and research into cultural
diversity in eating disorders is only beginning to emerge. For example, Malaysian women are
more susceptible to family influence when developing disordered eating behaviours (Shagar
et al., 2019) and sudden dietary change from traditional staples to high fat Western food in
the 1970s saw a marked increase in eating disorders in Japanese women (Le Grange, 2016).
These two examples highlight the need to further study the rise of eating disorders in
individual cultural contexts.
Research
With obesity being such a concern in urban environments, those at risk are increasingly
being told to monitor and moderate their food intake. One innovative way of doing this that
has developed in recent years is calorie tracking phone apps that, when used properly, can
give users nutritional information about their food, suggest healthier alternatives and
provide tips to get to a desired weight goal. These apps are used by approximately one third
of smartphone users (Messer et al., 2021) and more concerningly, by approximately 75% of
eating disorder sufferers (both male and female) (Lindaron and Messer, 2019). Users of
these apps scored significantly higher on indicators of eating disorders (the Compulsive
Exercise Test and the Eating Disorders Examination-Questionnaire) than non-users and the
more frequent the use of the app, the more severe the symptoms (Simpson and Mazzeo,
2018; Plateau et al., 2018).
Eikey (2021) found eight negative consequences of using calorie tracking apps including
fixation on numbers, extreme negative emotions, competition and app dependency while
Messer et al. (2021) found that for the vast majority of sufferers use of these apps can
contribute to or exacerbate eating disorder symptoms including purging and obsession.
Social media and tech companies have historically been slow to respond to the problem of
pro-anorexia (“pro-ana”) content and just as the issue is adequately tackled by one platform,
The dark side of self-tracking: calorie counting app use in eating disorders
Introduction
As the proportion of the world’s population living in cities further increases, recent decades
have seen a burgeoning field of research into the link between urbanity and mental health.
The correlation between factors associated with urban living (eg. wealth disparity, lack of
green spaces and social isolation) and mood disorders such as depression and anxiety is
well-established (Berry, 2007; Van den Bosch and Meyer-Lindenberg, 2019). However, it is
only in recent years that researchers have begun to investigate the dangers that urban
environments pose to those at risk or suffering from eating disorders; disorders that were
historically thought to be exclusive to wealthy, Western women (Mulders-Jones et al., 2017).
Although, their prevalence is lower than depression and anxiety, eating disorders such as
anorexia nervosa and bulimia nervosa have the highest mortality rate of any mental disorder
due to the physical toll they take on a sufferer’s body and the long-term nature of the
conditions (Schaumberg et al., 2017). In this essay, I will discuss urban characteristics
contributing to eating disorders before examining the role that calorie tracking applications
(apps) play in the formation and maintenance of eating disorder behaviours. These apps (eg.
“My Fitness Pal”, “Lose It!” and “Fat Secret”) have become increasingly popular in recent
years with My Fitness Pal having over 100 million users. To conclude I will evaluate the UK’s
recent policy of adding calorie contents to menus and suggest better ways in which urban
planners, designers and policymakers can create healthy cities for those at risk of eating
disorders.
Context and Ideas
Berry’s (2007) model, which suggests that the combination of a harmful physical
environment, a harmful social environment and psychological stressors lead to mental
health problems, can be applied here to further understand urbanity’s impact on eating
disorders. Regarding the physical environment, living in cities poses certain risks to mental
wellbeing including polluted and unclean environments (Engemann et al., 2020), lack of a
sense of belonging (Frumkin, 2005) and impoverished, neglected, and degraded
neighbourhoods (Cohen, Spear, Scribner et al., 2000); all of which can be contributing factors
to mental disorders. Diverse studies (Dokhani et al., 2022) (Matthews et al., 2012) found that
life dissatisfaction and poor mental health are risk factors for disordered eating, with eating
disorders commonly co-occurring with depression and anxiety.
The social environment encompasses not only personal friends, family and acquaintances
but also the media, advertising and societal ideals. Hawkes, Harris and Gillespie (2017)
described urban environments as “increasingly obesogenic” with many individuals living in
“food deserts” (where there is a lack of access to affordable healthy food) and many more
living in “food swamps” (where there is a large range of fast food and unhealthy options)
, 2120958: Urbanity and Wellbeing: 1949 words
(Becker et al., 2017). Being overweight is highly correlated with body dissatisfaction and
subsequent disordered eating (Thompson and Shafer, 2018). Thus, people living in
impoverished urban environments find themselves at an increased risk for both obesity and
eating disorders.
In cities across the globe, urbanisation often occurs simultaneously with Westernisation.
Thus, populations that were not previously thought to be at risk of eating disorders are now
experiencing an increased prevalence of these conditions (Gorrell, Trainor and Le Grange,
2019). Westernisation brings with it a “thin ideal” (Thompson and Stice, 2001), a weight-
obsessed fitness industry (Gorrell, Trainor and Le Grange, 2019) and higher levels of
education (Borjorquez et al., 2018); all of which are thought to negatively impact body image
and weight perception, putting individuals at risk for eating disorders.
Eating disorders have typically been studied in Western contexts and research into cultural
diversity in eating disorders is only beginning to emerge. For example, Malaysian women are
more susceptible to family influence when developing disordered eating behaviours (Shagar
et al., 2019) and sudden dietary change from traditional staples to high fat Western food in
the 1970s saw a marked increase in eating disorders in Japanese women (Le Grange, 2016).
These two examples highlight the need to further study the rise of eating disorders in
individual cultural contexts.
Research
With obesity being such a concern in urban environments, those at risk are increasingly
being told to monitor and moderate their food intake. One innovative way of doing this that
has developed in recent years is calorie tracking phone apps that, when used properly, can
give users nutritional information about their food, suggest healthier alternatives and
provide tips to get to a desired weight goal. These apps are used by approximately one third
of smartphone users (Messer et al., 2021) and more concerningly, by approximately 75% of
eating disorder sufferers (both male and female) (Lindaron and Messer, 2019). Users of
these apps scored significantly higher on indicators of eating disorders (the Compulsive
Exercise Test and the Eating Disorders Examination-Questionnaire) than non-users and the
more frequent the use of the app, the more severe the symptoms (Simpson and Mazzeo,
2018; Plateau et al., 2018).
Eikey (2021) found eight negative consequences of using calorie tracking apps including
fixation on numbers, extreme negative emotions, competition and app dependency while
Messer et al. (2021) found that for the vast majority of sufferers use of these apps can
contribute to or exacerbate eating disorder symptoms including purging and obsession.
Social media and tech companies have historically been slow to respond to the problem of
pro-anorexia (“pro-ana”) content and just as the issue is adequately tackled by one platform,
