Nutrition apps can help build healthy habits. For some users, their gaming features carry risks

Green means go, red means stop. Trophies or confetti come with good performance, and people who fall behind get nudged to do better.

Those brightly colored engagement tactics long ago jumped from smartphone games to everything from online shopping to sports betting and classrooms. So it should come as no surprise that many nutrition-tracking apps like MyFitnessPal and Noom also use gaming features to keep users coming back.

But as nutrition apps proliferate, some researchers are raising alarms that gamification features may do more harm than good for some people.

Isabella Anderberg, a psychologist researching digital dieting behavior at Flinders University in Adelaide, Australia, said calorie tracking can reinforce behaviors associated with body dysmorphia and disordered eating.

“We do know that not everyone’s going to experience harm from using the apps, but there are certainly factors that might increase risk,” Anderberg said. “Approach with caution.”

Anderberg said there is certainly a place for the apps. Health professionals she interviewed during her research reported that apps can be especially helpful as meal-planning tools for people managing chronic conditions such as heart disease and diabetes. And physical activity apps remind people to move their bodies.

Many users report enjoying them, finding tactics like streak notifications to be motivating.

Angela Drury, an English professor in Woodstock, Georgia, began using MyFitnessPal more than 10 years ago to track protein, fat, carbohydrate and calorie intake when she started CrossFit. She has since cycled through several other apps, including Weight Watchers, Lose It and now Nourish, which is paid for by her insurance and includes blood work and weekly meetings with a dietitian.

Drury said the apps have helped her stay on track with fitness goals and have sometimes steered her away from high-calorie foods when she uploaded photos of meals she was considering eating. She feels a little boost when she gets a badge for continuing a streak for logging meals, but a notification that says she hasn’t entered lunch has the opposite effect.

“Then it felt like it was scolding me,” she said.

The way most apps work, users enter height, weight, age and other information and then set a goal. The app says how many calories or macronutrients are needed to reach that goal, using gamelike elements such as badges, streaks, rewards, points and notifications to encourage user engagement.

Many nutrition tracking apps are free but offer premium versions that users must pay for.

The Centers for Disease Control and others say that how many calories you need depends on factors including your age, sex and level of physical activity. The CDC provides a tool to calculate how many calories an individual needs.

Critics warn that food databases are often inaccurate, with estimated portion sizes and calorie counts that vary widely.

Courtney Simpson, a behavioral psychologist and director of eating disorders at the Evidence-Based Treatment Centers of Seattle, said some apps encourage people to set calorie goals that are far too low for any adult. That's not only unhealthy but can set people up for failure.

The gaming features keep people coming back to unrealistic goals, creating shame that may contribute to binge eating or other behaviors people are trying to change, Simpson said.

“It’s not that gamification itself is bad. It’s about what it is promoting,” she said. “Is that actually going to be beneficial?”

MyFitnessPal and Noom did not respond to several requests for comment.

Anderberg said people who already believe that thinner is better are more likely to misuse the apps. Calorie and macronutrient tracking can then become obsessional, which creates more negative feelings when daily goals aren’t met.

She urged users to be skeptical of what the apps tell them to do and instead rely on their own intuition. If you feel the need to rest, nurse an injury or treat yourself to something delicious, do so.

“We are sort of losing that ability to read our body cues,” she said.

Simpson noted that focusing on weight as a measure of overall health, besides being inaccurate, makes it more likely to lose and regain weight. Such cycling is linked to worse health outcomes over time.

“If you really want lasting change, then you need to be doing behaviors that are feasible and sustainable for you over time,” she said.

Drury could see how the apps could be harmful for people predisposed to disordered eating, but she said the most important consideration for her is to set realistic goals and listen to your body.

“I’ve ultimately learned that you cannot starve yourself into being in the shape you want to be in,” she said.

EDITOR’S NOTE: Albert Stumm writes about wellness, food and travel. Find his work at https://www.albertstumm.com