Weight stigma is overlooked in commercial‐grade mobile applications for weight loss and weight‐related behaviors

INTRODUCTION Behavioral treatments for weight loss and weight‐related behaviors increasingly leverage commercially available health‐focused mobile applications (i.e., “apps”) to assist participants in changing weight‐related behaviors (e.g., monitoring caloric intake, body weight, and physical activity). 1,2 This includes weight loss treatments in which the content and behavior change tools are delivered entirely through a single mobile application (e.g., Noom or WW) as well as mobile applications that can act as adjuncts to existing programs to assist participants with making changes to specific weight‐related behaviors (i.e., monitoring caloric intake, body weight, and physical activity). Table content includes a description and explanation of potentially weight stigmatizing content (which can be found in the second and third columns), citations supporting the stigmatizing nature of this content, and each example is labeled with a corresponding evidence‐based strategy(ies) to demonstrate how this content can occur within the context of utilizing evidence‐based practice. 1 TABLEIllustrative examples of content within currently existing smartphone applications that could be perceived as weight stigmatizing Evidence‐based strategy a Example of weight stigmatizing content within App Explanation of why this could be stigmatizing conceptually Self‐monitoring and feedback Based on physical activity level, step count, or duration of activity, individual receives feedback that they have been “lazy” or “slacking off” The assumption that individuals of higher body weight are “lazy” is a quintessential example of weight stigmatization, especially given that most apps make this attribution without assessing alternative contextual factors that may drive low activity (e.g., illness and work/home responsibilities). [...]this language reinforces fallacious stereotypes about obesity particularly related to their capacity and engagement with exercise/physical activity. 11,17‐19 Self‐monitoring and feedback Based on quality of food intake or calories reported, individual receives feedback that they can have “better control” of their health/choices tomorrow. Lack of inclusive visual representation in body size (i.e., using only thin and/or very fit individuals) suggests that individuals of higher body weight are not represented among those who eat healthfully and exercise. 29 Goal setting and planning Planning features of the App encourage individual to “imagine getting rid