Users' Perspectives: A Thematic Analysis Exploring the Feasibility and Accessibility of Intuitive Eating Features Prototypes
As part of our SBRI-funded project, we spoke with Holly Health users about their relationship with food and explored their thoughts on new app prototype features based on intuitive and mindful eating. Through these in-depth interviews, we aimed to better understand the lived experience of people experiencing problematic eating behaviours, such as loss of control around food, and how digital tools can be designed to support them more effectively.
Introduction
Problematic eating behaviours, such as loss of control around eating, affect millions of women in the UK. One common but often overlooked condition is Binge Eating Disorder (BED), which is characterised by regularly eating large amounts of food in a short period of time, often to the point of discomfort (NHS). BED is closely linked to weight and health outcomes. Research shows that around 30% of individuals with obesity who are trying to lose weight show symptoms of BED (McCuen-Wurst et al., 2018) and people with BED are three to six times more likely to be overweight or obese than those without an eating disorder (Giel, 2017). The condition is also significantly more common in women, with NICE reporting that BED is six times more prevalent in women than in men. Restrictive, calorie-focused dieting approaches are thought to be a significant contributing factor that can intensify cycles of deprivation and overeating. Based on these figures, more than three million women in the UK may be at risk of developing BED, yet most do not have access to timely or appropriate support.
In recent years, alternative methods such as intuitive eating and mindfulness have emerged as evidence-based strategies that support more sustainable eating behaviours (Friedel et al., 2015; Mercado et al., 2021). Rather than relying on external rules, intuitive eating encourages individuals to reconnect with internal hunger and fullness cues, eat in response to physical rather than emotional needs, and let go of guilt or rigid food rules. This flexible, non-judgmental approach aims to rebuild trust in the body and support a more balanced relationship with food (Linardon et al., 2018). When delivered digitally, these approaches offer a promising way to reach large numbers of people in a scalable and accessible format, with the potential to reduce the prevalence of BED and ease pressure on healthcare services.
This study was part of an SBRI-funded project aimed at expanding access to support for women experiencing problematic eating behaviours by integrating an intuitive eating features into the Holly Health app. Using a user-centred approach, we conducted a thematic analysis of qualitative interviews to explore how users experienced and interpreted potential feature concepts, including a Food and Mood Diary, a self-guided pathway introducing intuitive eating principles (called the ‘Insights Path’) and a community space within the app. The objective was to understand the feasibility and acceptability of intuitive and mindful eating content, including visual prototypes and content outlines that were designed to support individuals with problematic eating behaviours, such as loss of control around eating.
Methods
Design
This report used a qualitative design to explore the use of a digital coaching service as a tool for supporting women experiencing problematic eating behaviours and a perceived loss of control around eating, with a focus on identifying key facilitators and barriers to their effectiveness. Participants were recruited through purposive sampling of Holly Health female users who self-reported a poor relationship with food, and were subsequently invited to take part via email. Participants received a £10 Amazon voucher as remuneration on completion of their interview.
Participants
The sample consisted of 12 participants. The most prevalent age group was 55–64 years (50%), followed by both the 25-34 and 65-74 age groups, each representing 16.7%. All participants identified as White (100%).
Data Collection
Data was collected through semi-structured interviews conducted remotely via Zoom. The interviews followed an interview guide and lasted approximately 30 minutes. All interviews were audio recorded and transcribed with the participant’s consent.
Data Analysis
The interview data were analysed using thematic analysis, following Braun and Clarke’s (2006) framework.
Results
We identified five themes, which are: 1. Frustration with diet culture and a desire for a gentler approach, 2. Emotional factors are deeply entwined with eating, 3. Accessible design and diverse formats enhance user experience, 4. Food & Mood Diary as a tool for self-reflection, 5. Community space as a source of motivation and connection.
Theme 1: Frustration with Diet Culture and a Desire for a Gentler Approach
Across the interviews, participants expressed a clear sense of frustration and fatigue with conventional dieting strategies. Many shared experiences of repeated attempts at weight loss through calorie counting, restrictive eating, and external rule-following, often accompanied by guilt, shame, and a sense of failure. The intuitive eating approach was frequently described as refreshing or even liberating, offering a more compassionate way to reconnect with food. Several participants commented on how the broader cultural narrative around food, particularly in media, reinforces unhelpful black-and-white thinking, which they found both confusing and overwhelming. In contrast, intuitive eating and its emphasis on listening to the body and promoting self-trust and compassion resonated strongly. While a few participants acknowledged that it may take time to adjust to such a different mindset, there was a widespread openness and even relief at the idea of moving away from diet culture.
“I’ve done all (calorie-focused diets), lost all the weight and put it on 10 times harder.”
“Everything seems to be so focused on what today is now good, what is bad, you know, the best ways to lose weight, the healthiest foods, what we need to have less of, what to look for in what foods you're eating. And sometimes all of that information is just too much information.”
“I think it (intuitive eating) is the way forward. We have to have a better way of managing the difficulties people have with their relationship with food. I mean, there's no question about it.”
“The idea of trying to reconnect with food, to think about your body, to not brutalise yourself for what you're struggling with, I think, is absolutely crucial, isn't it?”
Theme 2: Emotional Factors Are Deeply Entwined with Eating
A prominent thread across the dataset was the emotional and psychological context of participants’ eating behaviours. Many described eating in response to difficult emotions such as stress, boredom, sadness, or a general sense of low mood. Several noted that eating often happens automatically, with little conscious awareness of hunger or fullness, and some shared that they rarely pause to consider how they feel before or during eating. There was a strong recognition that eating is not only a physical act, but also an emotional one. Participants welcomed the idea of being more reflective and tuning into emotional states as part of developing healthier relationships with food. Some expressed interest in learning more about the link between emotions and eating, particularly in relation to tools or content that could help make these connections clearer.
“I do find that if I'm really, really stressed, I do tend to eat an awful lot, and I usually tend to go more for salty and sugary foods, and I can just practically stuff my face until I can't eat no more.”
“Sometimes I don't even know what my own hunger feels like. So actually learning that would be a really positive thing, yeah.”
“I realised that emotions really trigger my wish to eat. If I'm hungry, it's probably more chance that I won't eat anything.”
Theme 3: Accessible Design and Diverse Formats Enhance User Experience
Feedback gathered on the Insights Path, a feature prototype for a self-guided pathway introducing intuitive eating principles, demonstrated that users perceived the feature as helpful for consuming content in a clear and logical way. Participants appreciated the ability to move step by step, with each section building naturally on the last, which made the experience feel manageable rather than overwhelming. Many described the content as well organised, with topics introduced in a way that was easy to follow and understand. Participants also consistently valued the range of formats offered, including articles, audio-visual content, and interactive experiments. This variety made the experience more engaging and enjoyable, rather than text alone. The diversity of formats was seen as a particular strength, as it allowed users to engage in ways that matched their individual preferences and learning styles. For some, this also addressed accessibility needs, such as difficulty concentrating or neurodivergence. One participant noted that being able to combine text and audio when revisiting content would improve usability. Overall, participants felt that the combination of step-by-step flow and varied content formats made the feature more enjoyable and inclusive.
“Because it's a mix, it's not just the one thing, it's not just articles. You've got the video, you've got an experiment, things like that. It’s engaging you wanting to do it.”
“I also like the fact that there's a mix between audio, visual and reading. That's, that's lovely, yeah…. Although it's a pathway, it's not a strict pathway. So it's more of an adult education style, which is great.”
“I really like that content. I like it that it talks about, you know, not listening to the food police and things like that, because otherwise it's just, you know, really stressful.”
“It is making me hopeful that I could re-educate my body when I thought I was stuck with never being able to be in tune again. So that's really exciting.”
Theme 4: Food and Mood Diary as a Tool for Self-Reflection
Participants generally responded positively to the idea of a Food and Mood Diary and often described it as non-judgmental and reflective. Rather than viewing it as a tool for control or monitoring, many saw it as a way to pause and better understand the relationship between how they feel and what or how they eat. Several participants appreciated that the diary focused on emotional and physical cues rather than calorie tracking. Participants also shared a range of ideas to improve its usability, such as simplifying the layout and including pre-filled options to make it easier to complete. Notifications or reminders throughout the day were also suggested to help prompt use without making it feel intrusive. These practical suggestions reflected a desire for the diary to be flexible and easy to integrate into daily routines.
“Because it's not judgmental, not only that, if I've written it down, I can go back to it and reflect on that day's mood, because it's there in black and white, and I try and compare it with another day, if it's the same trigger or whatever. Yeah, I think that would be easy for me.”
“I’m quite busy, so things like that, if it was a notification, I’d be like, ‘Alright, got to do it’.”
“And also, I think sometimes people find it really hard to describe the feelings if you've got options of actually, I was anxious, I was distracted, I was bored, I was those options, with the option to write something else in obviously, I think that would be far easier for people to complete on a regular basis.”
“What I would also do is, if it is possible to do it, that people can do it more than once, like get a notification for, like, in the morning or even at lunchtime … because if you've got your phone, it takes two minutes to do it really.”
Theme 5: Community Space as a Source of Connection and Support
The concept of having a community space in the app that included a collection of user testimonials or shared experiences was viewed as a potential source of positive connection and support. Reading about others who had faced similar challenges was seen as a way to reduce feelings of isolation, make personal experiences feel more understood, and help to normalise difficulties around eating. Several participants preferred reading over interacting in real time, and they suggested that they would feel more comfortable with a space that featured selected stories rather than a live chat or forum. Some saw particular value in being able to ask questions and receive responses from the experts in the Holly Health team. To make the user-stories more relevant and engaging, participants suggested including a variety of experiences and allowing users to search or filter content based on themes they relate to. One participant also expressed interest in contributing their reflection on their experience around loss of control around eating, seeing it as a way to support others navigating similar journeys.
“I think it's a brilliant idea, because we are human, and let's be honest, we like to hear other people's stories.”
“I was gonna say that I have read some people's short stories and looked at how they've coped with it, how they've worked it out, and how they feel after so, yeah, it's nice to know that you're not the only one that's going through it, sort of thing.”
“I think that it is really important, but I think it would be an absolute mistake to have a live community. You get some people who become very vocal and possibly negative, maybe not helpful. So I think the idea of just having a collection of experiences that can be put on to that is a better way.”
“I mean, often, you know those kind of things, especially when you're talking about weight, people don't like to talk about it, especially if they're struggling, you know, so actually having an opportunity to maybe look at when other people have felt the same, it would be maybe something that would be useful, certainly.”
Conclusion
This qualitative work set out to explore the feasibility and acceptability of intuitive and mindful eating features designed to support people with problematic eating behaviours, such as experiences of loss of control around food. Participants shared thoughtful reflections on three early-stage features: the self-guided content Insights Path, the Food and Mood Diary, and the community pace. Participants expressed a clear preference for moving away from restrictive diet culture and towards a more flexible and compassionate approach. Many also reflected on how their mood and emotional state influenced their eating habits, and expressed a desire to better understand the connection between the two.
The design and presentation of the content played a key role in shaping participants’ engagement with the Insight Path feature. Participants appreciated the clear structure, visual layout, and range of formats, which made the experience feel manageable and accessible to different learning preferences. The Food and Mood Diary was particularly well received when framed as a tool for reflection rather than control. Participants valued being able to check in with how they were feeling and notice patterns between food and mood. Several participants also offered practical ideas on how to enhance usability, such as incorporating pre-filled response options to streamline the logging process. The concept of a community space also resonated with many participants, not as a live chat or forum, but as a way to read shared experiences.
Overall, participants responded positively to the concept of intuitive eating and the early-stage designs, and contributed a range of thoughtful, practical suggestions to further improve the tools. This user research is especially valuable, not only for shaping person-centred features but for strengthening the overall relevance and usability of the service. Looking ahead, Holly Health is continuing to develop and refine the features explored in this study, including the Insights Path, Food and Mood Diary and community space. When thoughtfully researched and co-designed with users, digital tools like these have the potential to boost engagement and offer meaningful, accessible support for the many aiming to build a healthier relationship with food.
