Table 3.

Summary of suggestions to address diet and fitness app issues

Area	Problem	Related unintended negative consequences	Suggestions
Quantified self movement	Overabundance of quantification despite the fact that not all aspects of health can easily be quantified Some quantifications are not good health indicators Too much of a number focus can trigger and exacerbate eating disorder behaviours	Fixation on numbers Rigid diet Obsession App dependency High sense of achievement Extreme negative emotions Motivation from negative messages Excess competition	Work meaningfully with people with eating disorders during all phases of designing these tools Find new ways to acquire user needs and non-numeric yet quick and easy methods for tracking behaviours Consult expert recommendations about healthy eating and exercise during design process Support healthy eating patterns, food variety, portion control, shifting to better food choices and various eating contexts Change exercise tracking to focus on performance and enjoyment rather than calorie expenditure Incorporate qualitative components to assess other aspects of health
Conception of appropriate usage	Push users to log consistently over long periods of time Tend to view breaks and abandonment as negative Encouraging overuse can trigger and exacerbate eating disorder behaviours	Obsession App dependency	Reduce reminders to log daily Encourage breaks Rethink what app engagement is and reward users for engagement that is not actively logging or viewing numbers
Visual cues and feedback	Try to use visualisations to motivate users but do not fully understand their effects Visual cues do not always match users’ goals Warnings have opposite of intended effect or are avoided Visualisations and messages can trigger and exacerbate eating disorder behaviours	High sense of achievement Extreme negative emotions Motivation from negative messages Excess competition	Study effects of design and warnings more thoroughly and on different users at different times Develop more nuanced design visualisations that better coincide with intended messages and users’ goals Rethink unhealthy eating and exercise pattern thresholds for showing feedback