title: Development of a smartphone application for eating disorder self-monitoring.
abstract: OBJECTIVE
  This case report aims to (1) describe the development and refinement of a smartphone application for eating disorder self-monitoring; (2) characterize its users in terms of demographic and clinical characteristics; and (3) explore its feasibility and utilization as a self-monitoring tool.
  
  
  METHODS
  We developed a mobile phone application through which people with eating disorders can self-monitor meals, emotions, behaviors, and thoughts. The application also included positive reinforcement, coping skill suggestions, social support, and feedback components. The app was made available on two Internet app stores. Data include number of downloads and subsequent usage statistics, consumer ratings on app-stores are used as indicators of satisfaction, anonymous aggregate demographic data and Eating Disorder Examination Questionnaire scores from 57,940 individuals collected over a two-year period.
  
  
  RESULTS
  The app demonstrated population-level utilization with over 100,000 users over a two-year period. Almost 50% percent of users stated that they are not currently receiving clinical treatment and 33% reported they had not told anyone about their eating disorder. A surprising number of people with severe problems are using the app.
  
  
  CONCLUSIONS
  Smartphone apps have the capacity to reach and engage traditionally underserved individuals with eating disorders at a large scale. Additional work is indicated for the evaluation of the clinical effectiveness of applications for specific user groups and in clinical treatment contexts.
authors.affiliation: Recovery Record Inc., 1121 Clark Way, Palo Alto, California.
authors.forename: Jenna P
authors.initials: JP
authors.lastname: Tregarthen
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Stanford University School of Medicine, Stanford, California.
authors.forename: James
authors.initials: J
authors.lastname: Lock
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Stanford University School of Medicine, Stanford, California.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Darcy
mesh_terms: D001068:Feeding and Eating Disorders / Q000628:therapy*; D006801:Humans; D008297:Male; D063731:Mobile Applications / Q000706:statistics & numerical data*; D000068997:Smartphone / Q000295:instrumentation / Q000706:statistics & numerical data*
keywords: app; cognitive behavioral therapy; eating disorders; mobile health; smartphone