Jourvie is improving the treatment of eating disorders by providing patients with discreet food and mood logs on their smartphones.
by Julia Migné
The National Eating Disorders Association (NEDA) defines eating disorders as “serious illnesses that involve extreme emotions, attitudes, and behaviours surrounding food, exercise, and body image”. Ekaterina Alipiev has experienced those symptoms first hand, having fought with an eating disorder in her teens.
The Bulgarian adolescent was in her final years of school when she started having a few body issues. Quite common in young women, these body issues in the case of Ekaterina, however, escalated quickly into a serious eating disorder, which resulted to her being sent to therapy.
During her year following therapy, Ekaterina struggled with the concept of having to keep a food and mood journal. The idea behind those logs is that it allows the therapist following the patient to get a better idea of what he/she is eating, the kind of mood triggers, and the urges the patient might have following the meal, such as the will to purge or to do excessive sport.
The young woman who had now moved to Germany found it extremely difficult to carry this journal with her all the time, making it challenging to precisely record what she ate and how she was feeling. She would not fill in the sheets of paper when she was out and about and would log her meals and mood out of the memory once back home instead.
Ekaterina noticed though that remembering exactly what she ate or felt was extremely difficult so she started recording it on her smartphone instead of on her paper sheets. Realising that other people were likely to feel the same way, she came up with an idea to improve this aspect of therapy: an app that would allow people to just use their smartphone to record the precious information and would then, in turn, send those data to their therapist. Jourvie was born.
Eating disorders are actually impacting a huge amount of people around the globe. In the UK alone, 1.25 million individuals are affected according to eating disorder charity Beat.
“Officially, 2.7 million people are affected by eating disorders in Germany,” adds Vivian Otto, director of Jourvie. “However, our personal belief is that actually, the hidden figure is a lot higher because the stigma around eating disorder is very high.”
The strong stigma surrounding the disease often leads people to think that eating disorders are a “silly little girls’ disease,” explains Vivian. This stereotype blended with a general lack of knowledge about the different conditions encompassed under the term eating disorders makes it hard for people to report it. “That’s why there is a big lag of people who are actually affected but who are not in therapy yet,” she says.
Seen as a typically feminine condition, the stigma becomes even stronger when men are the ones being affected by eating disorders. However, the pressure from popular culture and social media platforms such as Instagram are having a massive impact on men around the globe. According to NHS figures reported by the Guardian, eating disorders in men rose by 70 percent in the UK between 2010 and 2016.
“Studies show that the percentage of males affected [by eating disorders] is increasing,” adds Vivian. “However, for this group, it’s even worse because they don’t want to be associated with a ‘girls’ illness’ and that’s another major issue!”
“People are not taking it seriously, especially men, because it’s supposed to be the illness of ‘little silly girls’ and so I think there are a few issues with society as a whole that still needs to be tackled.”
By facilitating the therapy process, Jourvie is supporting and empowering over 39,000 users across Germany, Austria, and Switzerland. In addition to providing discreet logs, the app also gives pieces of advice to the patients to help them face difficult situations.
The app was made possible by a team of people who put their brains together to fix an issue that they knew many people were facing. “A beautiful thing was that from the very early stage on, a lot of people found their way to Jourvie,” Vivian says.
“They worked for free on the project because they were very inspired by the idea or they had been affected themselves or someone in their family had been. They invested a lot of time and effort in creating the product so right from the beginning, it was a great team effort that went into pulling it all together.”
One crucial aspect of the development of the app involved to make sure that it was based on strong scientific evidence and not “mumbo-jumb,” emphasises Vivian. Working closely with therapists, the team managed to get fundings from the European Commission and from the Google.org Impact Challenge, which according to its website, “asks local nonprofit innovators how they would make their community — and beyond— an even better place”.
“People are not taking it seriously especially men because its supposed to be the illness of ‘little silly girls’ and so I think there are a few issues with society as a whole that still needs to be tackled.”
This money helped the team to professionalise the whole company, increasing their global reach by partnering with the AOK Nordost, a German health fund and getting access to their infrastructure.
With many people developing eating disorders during their adolescence, the app is targeting a very young user base. Therefore, it was crucial for Ekaterina and Vivian to be able to offer this service for free as many teenagers might not have the financial means to pay to get access to the app or might not feel comfortable asking their parents to pay for it.
Therapists have also reported some positive feedback noticing that since the launch of the app, their patients are using Jourvie on the go, providing them with more accurate food and mood logs, which help facilitate their work.
“You can only give adequate therapy to someone if you know what you’re dealing with,” adds Vivian. “But if you’re not getting accurate food and mood journals, you don’t really know what you’re dealing with!”
Working with therapists and medical professionals, however, wasn’t easy at first. Vivian shares that the whole medical field in Germany is “still extremely old-fashioned and male-dominated”, making it difficult for the duo of women to be taken seriously.
“It’s very difficult to implement digital tools in therapy [in Germany],” she explains. “People are very much against it and very sceptical even if you have great studies from journals from the US or the UK [being published].”
With perseverance, the team managed to slowly build trust and now has solid relationships with therapists. Jourvie has since then expanded to a different target audience who are key to the treatment of eating disorders: the parents.
To complement the work accomplished by their first app, the team developed, in cooperation with AOK Nordost, a second app called Elamie. Aiming to reach out to parents, the app is recommended and monitored by paediatricians and supports the early detection of eating disorders in children.
Elamie gives parents crucial information about the symptoms of eating disorders and allows them to record the eating habits of their children to help doctors in their diagnosis.
Far from trying to reach every market possible, the approach taken by Jourvie is based on facts and time. “We maybe have a bit of a different approach than other startups,” says Vivian. Knowing that many great health apps already exist in the US, the startup has no interest in trying to expand there.
Instead, the team prefers to stay focused for now on the German, Swiss and Austrian market and to acquire a strong foothold and reputation there before moving to any other European countries.
“We believe that it is really important to have good references and to show that we actually know what we are doing. We really want to invest time and effort and then expand with a very firm knowledge of what works and what doesn’t.”