Do children need diet apps?

Weight Watchers recently unveiled a new app, Kurbo, which is aimed at children and teens. Is this the best way to tackle childhood obesity?

**Trigger warning for anyone who has or has had a disordered relationship with food.**

Ah, diet culture! Despite our growing awareness of how bad it is for us, and Instagram’s ban on certain weight loss promotions, it hasn’t gone away just yet.

So, what’s the latest addition to this toxic culture? It’s a diet app. For children.

That’s right. For children. It’s the latest release from Weight Watchers (or WW, according to their recent rebrand) that’s supposed to encourage healthy eating and weight loss in children. It can even help to “make your parents proud”.

And they make this every clear, it’s proven by science. Over 30 years of it! It uses a traffic light system, developed by Stanford University, to tell children what they should be eating.

Green foods (fruits and vegetables) are good to eat anytime. Yellow foods (e.g. lentils and pasta) are okay, as long as you watch your portions! And red foods (e.g. desserts and sugary drinks)? They say: “Just stop and think how to budget them in with everything else.”

What’s more, they have coaches who can do weekly check ins and help encourage healthy behavioural changes.

Obesity needs to be tackled, right?

Yes it does.

Here in the UK, it’s a serious medical issue. 1 in 10 children are obese before they’re 5 years old.¹ What’s more, obesity rates are highest in the most deprived areas of the UK,¹ making it a social and class issue as well.

So an app like this is a great idea, right?

No, not really. Not in my mind.

Let me start by saying that I understand the need. Obesity needs to be tackled, and we need to teach children and families about healthy eating and nutrition.

I can also understand WW’s thought process. First, it increases their range of customers – let’s not forget that WW is a business, not a charity. Second, they’re not the market leader in the weight loss business anymore – and they’re looking to diversify. This also explains their rebranding to WW, to try and incorporate ‘Wellness‘ into their business.

Apps may not live up to their promises

In the literature that I’ve found*, it looks like diet apps generally have a modest level of success.^2–4

One paper found apps that aim to improve diet, physical activity and sedentary behaviour were modestly successful – but that a multi-component approach with face-to-face contact and trained professionals appear to be more successful.²

Another said that the most popular apps available were ‘suboptimal’ in quality due to inadequate scientific coverage and inaccuracy of weight-related information.³ Ouch!

There was also a paper that specifically looked at popular apps aimed at children and adolescents.⁴ This found that the apps contained low quality information, but good with functionality.⁴

So… from the brief overview that I’ve seen, apps like Kurbo may not live up to the hype!

* Selected papers from my literature search, one of which was a systematic review of 25+ studies.²

We need to consider eating disorders

Eating disorders (ED) like anorexia nervosa and bulimia nervosa tend to develop during adolescence.⁵ They can also develop in young children.⁵

I found a couple of interesting papers about diet apps and disordered eating behaviours.^6,7

One study focused on college/university students (older than Kurbo kids) and found that those using calorie trackers were more concerned about calories.⁶ Then, when exercise tracking was added in, this was associated with ED behaviours.⁶ In the conclusion of the paper, the researchers said:

“Although preliminary, overall results suggest that for some individuals, these devices might do more harm than good.”

Simpson & Mazzeo. Eating Behaviours, 2017.

Another study was pretty damning, as it specifcally looked at My Fitness Pal – the big gun in the diet app market.⁷ They specifically looked at over 100 ED patients and found that 75% of patients had used the app.⁷ What’s more, 73% felt that the app contributed to their eating disorder.⁷

Now, these are just two papers. And, I know that there will be evidence (maybe anecdotal, maybe not) of how apps can be good for some people. I’m not going to deny that – I’m just concerned that we’re forcing behaviours on children that may do more long term harm than good.

If an app isn’t the answer, then what is?

As always, I’m going to preach balance. That’s because ED doesn’t just affect normal or underweight teens, it affects overweight and obese teens too!⁸

It’s something that we need to bear in mind. We need to try to move away from shame and blame when it comes to the obesity epidemic. It’s multifactoral, like a lot of conditions.

I found a great paper which had the following recommendations:⁸

• Inform teens that dieting, particularly unhealthy weight control behaviors, may be counterproductive. Encourage positive eating and physical behaviors that can be maintained on a regular basis 

• Don’t use body dissatisfaction as a motivator for change. Instead, help adolescents care for their bodies and nurture them through healthy eating, physical activity, and positive self-talk 

• Encourage families to have regular and enjoyable family meals 

• Encourage families to avoid weight talk; talk less about weight and do more to help them achieve a healthy weight 

• Assume overweight adolescents have experienced weight mistreatment and address it with both the patient and the family 

My final thoughts

This paper pretty much sums up what I was thinking, which is a relief! By saying that kids and teens can “make their parents proud”, it sounds likes Kurbo want their users to be ashamed of their bodies when they start their “journey”. Not cool.

We can’t just blame overweight/obese children. It’s lazy and counterproductive. Like I pointed out earlier, they may be from a deprived area. They may have a family members who are overweight/obese. They may bullied and pressured to be thin, and find comfort in food by binging.

Can this app know the full story? I don’t think so. Maybe their weekly counsellor sessions can dive into these issues. But, I’d like to add, I didn’t see a single paediactric, bariatric or dietetic specialist on their online list. Maybe the fully trained, medical professionals refused to put their name on the app?

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1. House of Commons Library. Obesity Statistics. Briefing Paper Number 3336: Aug 6 2019.
2. Schoeppe S et al. Int J Behav Nutr Phys Act. 2016;13:127.
3. Chen J et al. JMIR MHealth and UHealth. 2015;3(4):e104.
4. Schoeppe S et al. Int J Behav Nutr Phys Act. 2017;14:83.
5. Priory Group. Eating Disorder Statistics. Available at: https://www.priorygroup.com/eating-disorders/eating-disorder-statistics. Accessed October 2019.
6. Simpson CC and Mazzeo SE. Eat Behav. 2017;26:90–92.
7. Levinson CA et al. Eat Behav. 2017;27:14–16.
8. Alston Taylor S et al. Ped Annal. 2018;47(6):e232–e237.