Moments That Matter: Co-designing Just-in-Time Support for Disordered Eating Behaviors

Paper Title

Moments That Matter: Co-designing Just-in-Time Support for Disordered Eating Behaviors

Publication Info

• Topic area: Designing just-in-time (JIT) interventions for disordered eating behaviors.
• Keywords: Eating disorders, just-in-time interventions, binge eating, restrictive eating, co-design, psychological support, wearable technology, adaptive learning, emotional regulation, health behavior change.

Background and Problem

• Problem / challenge: Existing interventions for eating disorders (EDs) focus primarily on retrospective reflection or general management, overlooking the critical moments during ED episodes when immediate support is needed.
• Significance: Disordered eating behaviors such as binge eating and restrictive eating have severe health consequences, including increased mortality rates, physical discomfort, and social strain. Timely interventions could mitigate these behaviors and improve recovery outcomes.
• Motivation and related work: Prior research has explored ED interventions such as cognitive behavioral therapy (CBT), nutritional counseling, and technology-based tools like food journaling apps and chatbots. However, these approaches lack dynamic, moment-specific support during ED episodes. Emerging sensing technologies offer opportunities for real-time monitoring, but effective communication and intervention strategies remain underexplored.

Solution

• Proposed approach: Co-designing just-in-time (JIT) interventions tailored to critical moments in disordered eating behaviors, informed by the lived experiences of individuals with ED and expert perspectives.
• Novelty:
  1. Identification of distinct roles eating plays in ED behaviors (e.g., emotional regulator, source of stress).
  2. Mapping ED episodes into micro timelines to pinpoint intervention moments.
  3. Development of JIT intervention designs with varied modalities, forms, and adaptive characteristics.
  4. Exploration of how JIT interventions can complement mainstream ED support for sustained impact.
• Procedure and key techniques:
  • Conducted individual co-design sessions with 22 young women experiencing EDs to create tailored intervention designs.
  • Interviewed five ED experts to evaluate the feasibility, risks, and clinical relevance of the designs.
  • Analyzed data using thematic coding to identify behavioral patterns, intervention moments, and design characteristics.

Results

• Concrete findings:
  • Participants conceptualized intervention moments across binge and restrictive eating episodes, including early impulses, ongoing behaviors, and post-episode recovery.
  • Proposed JIT designs included eating behavior warnings, appetite management, attention redirection, psychological support systems, food option redirection, and first aid systems.
  • Designs featured multi-sensory nudging (visual, haptic, auditory), parasocial and real-human support, and adaptive learning mechanisms.
• Advantage over baselines:
  • JIT interventions address immediate behavioral and emotional needs during ED episodes, unlike static or retrospective approaches.
  • Adaptive learning and reflection mechanisms extend the impact of interventions beyond momentary support.
• Experiments / evaluation:
  • Co-design sessions with 22 ED participants (ages 18–35, EAT-26 scores ≥ 20).
  • Expert interviews with five professionals specializing in ED treatment.
  • Data analysis included thematic coding and iterative refinement of design ideas.
• Limitations and future work:
  • Limited diversity in gender, age, and cultural background of participants.
  • Sampling constraints excluded atypical ED behaviors like night eating syndrome.
  • Future work includes developing and deploying JIT interventions in longitudinal field studies to evaluate their effectiveness over time.

Summary

This study explores the design of just-in-time (JIT) interventions for disordered eating behaviors through co-design sessions with 22 young women experiencing EDs and interviews with five experts. Participants identified critical moments for intervention across binge and restrictive eating episodes and proposed designs such as behavior warnings, appetite management, and psychological support systems. Experts provided insights into implementation feasibility and risks, emphasizing the importance of adaptive, non-punitive, and emotionally supportive approaches. The findings highlight how JIT interventions can complement mainstream ED support and serve as building blocks for sustained recovery. This work offers valuable design implications for future JIT systems targeting ED care.