Weighing In Online

May 5th, 2014  |  Published in Business, Health, slider

Losing It With Reddit

By Kiley Bense

A post appeared recently on the social media site Reddit with a gripping headline: “I think I may have an eating disorder…and I really need help.” In the post, the user talked about dealing with anxiety and bulimia in the wake of a 60-pound weight loss. Within hours, other users were urging the writer to see a psychiatrist, offering advice, and typing out encouragement. “Get help,” one wrote. “It will get better and you can have your life back.”

Reddit is perhaps best known to the wider world for spreading cat memes and crowdsourcing breaking news investigations, but there are thousands of subreddits (forums divided by topic), each with its own rules, jargon, and spirit. LoseIt, founded in July 2010 as a community for motivation and advice about weight loss, is one of the most popular subreddits devoted to fitness and food. It has more than 200,000 subscribers, half of them gained since 2012. It’s not as popular as the biggest subreddits–like the pages devoted to funny posts or crowdsourcing questions, each with more than 5 million subscribers–but it ranks 91st out of the thousands of subreddits on the site.

Although the internet is full of confessional-style blogging, this forum seems to have a particularly large number of raw confessions and to be overwhelmingly positive. Users (called redditors) ask about calorie counting, exercise regimens, and supplements. They post progress pictures. They celebrate, wallow, and vent. “You don’t have to worry about the so-called ‘haters,’” says one 21-year-old LoseIt user, who recently joined the subreddit. She started a diet in early March and has been posting about her progress and setbacks. “Everyone is in that subreddit for the same reason.”

The LoseIt forum on Reddit.

The LoseIt forum on Reddit.

While some experts agree that online forums like LoseIt can be an invaluable source of emotional support, they also say that the unmonitored forums can be dangerous when they’re used for more than motivation. Some users, like the one who wrote about a severe eating disorder, turn to LoseIt for help with serious medical and psychological issues.

“Frankly, forums like that scare me,” says Dr. Mary Pritchard, a psychologist at Boise State University who has studied the psychology of eating for the past 16 years. Among her concerns is what she sees as a tendency to advocate extreme dieting, if indirectly. On LoseIt, the desire for extreme results is fueled by before and after photos and badges for your username stamped with the number of pounds you’ve lost.

Some users post complaints that the weight isn’t coming off fast enough. Because Reddit is ruled by “upvotes,” the most dramatic photos and stories often dominate the front page of the subreddit. (Every post on Reddit has up and down buttons; the posts with the most positive votes rise to the top; the bad ones sink out of sight.)

Pritchard’s clients are sometimes frustrated that their outcomes don’t measure up to the results they see online and on reality television series like The Biggest Loser. “They come to me and say, ‘Why have I not been able to do that?’” she says. For her part, Pritchard thinks we should do away with dieting altogether. “Diet is a four letter word,” she says. “If I had my way, we’d throw our scales out the window.” Diets can spawn what Pritchard and others call the “Last Supper effect,” which is a period of bingeing preceding the first day of a strict diet. The diet becomes a kind of punishment. Forums like LoseIt not only encourage you to diet (“Day One” posts are a popular category), but also, she believes, to compare yourself to others.

LoseIt is mostly numbers-driven, logging inches and pounds, but it also celebrates the intangible rewards of weight loss with “NSVs” or non-scale victories–that triumphant moment when your old jeans fall off your hips, or a friend doesn’t recognize you in the bar.

But LoseIt is filled with photos of scales and posts proclaiming that the user has reached “onederland” which is what LoseIt fans call the moment when their weight no longer starts with a two or three.

Heather Bainbridge, a registered dietitian who works at the Columbia University Medical Weight Loss Center, cautions that losing 30 percent of your body weight– a common goal among people hoping to lose weight–is very rare except among patients who have bariatric surgery. Bainbridge worries about people following fad diets without consulting a doctor or other professional.

Both Pritchard and Bainbridge say they’ve had clients who’ve gotten sick by trying advice or products they found online. Sometimes patients will come to see them after trying a supplement or pill they read about on the internet, complaining about indigestion and other stomach issues. Diets like Paleo (high protein) and Keto (high fat), can be effective, they say, but they are not one-size-fits-all, especially for people with pre-existing health conditions. Too much protein in the diet can cause liver and kidney problems, and Pritchard says that some versions of the Paleo diet contain more protein than is healthy for women.

Lisa Marie Rosati is a diet and nutrition coach, author, and entrepreneur who runs a number of weight loss related businesses, including the Smithtown Weight Loss, an online program for people who are addicted to sugar. “I don’t like extreme anything,” she says. A sudden switch to an extreme way of eating can have dangerous consequences. “Your internal organs can shut down,” she says. “You pass out. You lose energy.”

Pritchard sees forums like LoseIt as an example of a trend: people seeking love and approval online. At a time when so many are unhappy with their appearance (a 2007 study of university students, published in the journal Eating Behaviors, found that 90 percent of women and 60 percent of men expressed dissatisfaction with their bodies), and social interaction online has become normal, it makes sense to Pritchard that people would turn to the internet for 24/7, free support for weight loss.

“Anonymity helps people to feel more comfortable in sharing health information,” says Bainbridge. Progress pictures and success stories “can provide hope that it is possible to lose that weight.” Victoria Taylor, the Director of Communications for Reddit, says anonymity is the major draw for people using the site for weight loss advice. They feel more comfortable discussing something like the negative side effects of a new diet with strangers than they would with coworkers or friends. “People feel very empowered,” Taylor says. “There’s a huge diversity of perspectives,” from Paleo devotees to vegans to fitness fanatics, she says. “It’s incredibly exciting.”

When asked about the potential dangers of seeking medical advice online, Taylor says that many nutrition and fitness subreddits have guidelines warning that they are not meant to replace a physician’s advice. “People understand that results may vary,” Taylor says, and that a stranger’s words aren’t a substitute for a doctor’s. People understand that one user’s experience doesn’t necessarily translate to everyone else’s, she says. However, while LoseIt’s overview page recommends consulting a doctor about exercise regimens, it contains no similar warning about its dieting and nutrition advice.

Some LoseIt subscribers are women, but most seem to be men in their twenties and thirties, which is in line with Reddit’s demographics (a 2013 Pew Research Center study reported that 15 percent of men aged 18-29 used Reddit, compared with 5 percent of women), but not with most weight loss groups and programs. The National Weight Loss Registry, which tracks people who have lost weight, records that 80 percent of its respondents are women, and most are middle-aged. Women are also more likely to say that they want to lose weight and to sign up for weight loss programs.

One of the last commenters on the eating disorder post ended on a note of support. “You were very brave to write what you did,” he wrote. “Know that you are not alone and there are total strangers out there rooting for you.”

Sometime later, the author of the post responded, thanking everyone for their comments. But he did not seem to have changed his mind about seeking professional help. “I don’t think that would help me,” he wrote.

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