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Eating disorder chatbots: Current status, challenges, and future directions
- 1 Laurel Heights Secondary School, Waterloo, Canada
* Author to whom correspondence should be addressed.
Abstract
Eating disorders (ED) have the highest case mortality rate among all mental health issues, and their prevalence has increased significantly in recent years. However, fewer than 20% of sufferers receive treatment. Chatbots, or conversational agents, that target EDs are a promising way to bridge this gap and supplement existing support by being cost-effective, accessible, and non-human. The technical compositions behind these chatbots vary, each with their own strengths and weaknesses. Generally, the field of ED chatbots is emerging and only a handful of platforms have come out, including one designed to replace ED helpline support and one to support youth body image. While many ethical and practical challenges affect ED chatbots, there are ways to make progress, and the collaboration between developers, clinicians, ethicists, and the public will be vital in this pursuit. Integrating ED chatbots into healthcare and social media platforms are future directions that could significantly advance ED healing.
Keywords
eating disorders, chatbot, mental health, body image, artificial intelligence
[1]. Balasundaram, P., & Santhanam, P. (2023). Eating disorders. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK567717/
[2]. Deloitte Access Economics. (2020). The social and economic cost of eating disorders in the United States of America. Harvard T.H. Chan School of Public Health. https://www.hsph.harvard.edu/striped/wp-content/uploads/sites/1267/2020/07/Social-Economic-Cost-of-Eating-Disorders-in-US.pdf
[3]. López-Gil, J. F., García-Hermoso, A., Smith, L., Firth, J., Trott, M., Mesas, A. E., Jiménez-López, E., Gutiérrez-Espinoza, H., Tárraga-López, P. J., & Victoria-Montesinos, D. (2023a). Global proportion of disordered eating in children and adolescents. JAMA Pediatrics, 177(4), 363. https://doi.org/10.1001/jamapediatrics.2022.5848
[4]. Chan, W. W., Fitzsimmons-Craft, E. E., Smith, A. C., Firebaugh, M.-L., Fowler, L. A., DePietro, B., Topooco, N., Wilfley, D. E., Taylor, C. B., & Jacobson, N. C. (2022). The challenges in designing a prevention chatbot for eating disorders: Observational study. JMIR Formative Research, 6(1). https://doi.org/10.2196/28003
[5]. Coghlan, S., Leins, K., Sheldrick, S., Cheong, M., Gooding, P., & D’Alfonso, S. (2023). To chat or bot to chat: Ethical issues with using Chatbots in mental health. DIGITAL HEALTH, 9. https://doi.org/10.1177/20552076231183542
[6]. Shah, J., DePietro, B., D’Adamo, L., Firebaugh, M., Laing, O., Fowler, L. A., Smolar, L., Sadeh‐Sharvit, S., Taylor, C. B., Wilfley, D. E., & Fitzsimmons‐Craft, E. E. (2022). Development and usability testing of a chatbot to promote mental health services use among individuals with eating disorders following screening. International Journal of Eating Disorders, 55(9), 1229–1244. https://doi.org/10.1002/eat.23798
[7]. Haque, M. D., & Rubya, S. (2023). An overview of chatbot-based mobile mental health apps: Insights from app description and user reviews. JMIR mHealth and uHealth, 11. https://doi.org/10.2196/44838
[8]. Fardouly, J., Crosby, R. D., & Sukunesan, S. (2022). Potential benefits and limitations of machine learning in the field of eating disorders: Current research and Future Directions. Journal of Eating Disorders, 10(1). https://doi.org/10.1186/s40337-022-00581-2
[9]. Matheson, E. L., Smith, H. G., Amaral, A. C., Meireles, J. F., Almeida, M. C., Mora, G., Leon, C., Gertner, G., Ferrario, N., Suarez Battan, L., Linardon, J., Fuller-Tyszkiewicz, M., & Diedrichs, P. C. (2021). Improving body image at scale among Brazilian adolescents: Study protocol for the co-creation and randomised trial evaluation of a chatbot intervention. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-12129-1
[10]. Lee, Y.-C., Yamashita, N., Huang, Y., & Fu, W. (2020). “I hear you, I feel you”: Encouraging deep self-disclosure through a chatbot. Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems. https://doi.org/10.1145/3313831.3376175
[11]. Torous, J., Bucci, S., Bell, I. H., Kessing, L. V., Faurholt‐Jepsen, M., Whelan, P., Carvalho, A. F., Keshavan, M., Linardon, J., & Firth, J. (2021). The growing field of digital psychiatry: Current evidence and the future of apps, social media, Chatbots, and virtual reality. World Psychiatry, 20(3), 318–335. https://doi.org/10.1002/wps.20883
[12]. Abd-alrazaq, A. A., Alajlani, M., Alalwan, A. A., Bewick, B. M., Gardner, P., & Househ, M. (2019a). An overview of the features of Chatbots in Mental Health: A scoping review. International Journal of Medical Informatics, 132, 103978. https://doi.org/10.1016/j.ijmedinf.2019.103978
[13]. Sharp, G., Dwyer, B., Xie, J., McNaney, R., Shrestha, P., Prawira, C., Fernando, A. N., de Boer, K., & Hu, H. (2024). Co-Design of a Single Session Intervention Chatbot for People on Waitlists for Eating Disorder Treatment: A Qualitative Interview and Workshop Study. ms, Melbourne.
[14]. Adamopoulou, E., & Moussiades, L. (2020). An overview of chatbot technology. In I. Maglogiannis, L. Iliadis, & E. Pimenidis (Eds.), Artificial intelligence applications and innovations (AIAI 2020, IFIP Advances in Information and Communication Technology, Vol. 584). Springer, Cham. https://doi.org/10.1007/978-3-030-49186-4_31
[15]. Barnes, E., & Hutson, J. (2024a). Natural language processing and neurosymbolic ai: The role of neural networks with knowledge-guided symbolic approaches. DS Journal of Artificial Intelligence and Robotics, 2(1), 1–13. https://doi.org/10.59232/air-v2i1p101
[16]. Beilharz, F., Sukunesan, S., Rossell, S. L., Kulkarni, J., & Sharp, G. (2021). Development of a positive body image chatbot (KIT) with young people and parents/carers: Qualitative Focus Group Study. Journal of Medical Internet Research, 23(6). https://doi.org/10.2196/27807
[17]. Sharp, G., Torous, J., & West, M. L. (2023). Ethical challenges in AI approaches to eating disorders. Journal of Medical Internet Research, 25. https://doi.org/10.2196/50696
[18]. Ta, V., Griffith, C., Boatfield, C., Wang, X., Civitello, M., Bader, H., DeCero, E., & Loggarakis, A. (2020a). User experiences of social support from companion chatbots in everyday contexts: Thematic analysis. Journal of Medical Internet Research, 22(3). https://doi.org/10.2196/16235
[19]. Bendig, E., Erb, B., Schulze-Thuesing, L., & Baumeister, H. (2019). The next generation: Chatbots in clinical psychology and psychotherapy to Foster Mental Health – a scoping review. Verhaltenstherapie, 32(Suppl. 1), 64–76. https://doi.org/10.1159/000501812
[20]. Bowie-DaBreo, D., Sas, C., Iles-Smith, H., & Sünram-Lea, S. (2022a). User perspectives and ethical experiences of apps for Depression: A qualitative analysis of user reviews. CHI Conference on Human Factors in Computing Systems. https://doi.org/10.1145/3491102.3517498
[21]. Juli, R., Juli, M. R., Juli, G., & Juli, L. (2023). Eating Disorders and Psychiatric Comorbidity. Psychiatria Danubina, 35(Suppl. 2), 217–220.
[22]. Batterham, P. J., Calear, A. L., Farrer, L., McCallum, S. M., & Cheng, V. W. (2017). FitMindKit : Randomised controlled trial of an automatically tailored online program for mood, anxiety, substance use and suicidality. Internet Interventions, 12, 91–99. https://doi.org/10.1016/j.invent.2017.08.002
[23]. Dingler, T., Kwasnicka, D., Wei, J., Gong, E., & Oldenburg, B. (2021). The use and promise of conversational agents in Digital Health. Yearbook of Medical Informatics, 30(01), 191–199. https://doi.org/10.1055/s-0041-1726510
[24]. Nimavat, K., & Champaneria, T. (2017). Chatbots: An overview types, architecture, tools and future possibilities. Int. J. Sci. Res. Dev, 5(7), 1019-1024.
[25]. Prucher, J. (2007). The Oxford Dictionary of Science Fiction by Jeffrey Prucher. Oxford Univ. Press.
Cite this article
Xiao,E. (2024).Eating disorder chatbots: Current status, challenges, and future directions.Applied and Computational Engineering,92,68-74.
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