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Do Chatbots for Dieting Work?

Natalie
Stein
April 29, 2019
Do Chatbots for Dieting Work? - Lark Health
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I Tried Dieting with a Chatbot – I Loved it!

I'm always on the look-out for a way to lose weight. At 5'4" and 180 lb., I don't really stand out (the average woman in the U.S. is 5'4" and 169 lb.), but I could stand to lose a few lbs. My weight puts me into the "obese" category and at risk for health problems like diabetes, and I'd have a lot more clothing options if I could drop a few sizes.

I've been worrying about my weight and dieting for decades. The first time that I am sure that I was embarrassed about my weight was when I was 7 years old. I didn't eat ice cream that whole summer because the saleswoman at the department store where I was looking for a bathing suit said I was "thick." (By the way, no way did I have a weight problem at that time, or deserve to feel bad about myself. I was strong, active, healthy, and, judging from photos of myself from that time, a standard cute 7-year-old).

I haven't stopped being weight-conscious or searching for the perfect diet since. I've tried pretty much every type of diet: replacing meals with shakes, cookies, or soups, low-carb, low-fat when it was popular, raw food, vegan, paleo, and clean eating (whatever that is). I've done Weight Watchers (who hasn't?) and joined weight loss challenges, and used MyFitnessPal.

They all worked, but only when I followed them. I went off each diet after weeks to months. Excuse me if I got sick of drinking chocolate shakes while everyone else ate a real dinner, or couldn't face going to a Weight Watchers meeting after a hard day at work and knowing I had not lost weight recently.

Next up: the Lark diet.

My personal health coach.

Okay, Lark isn't a diet. Lark is a health app that describes itself as a 24/7 Health Coach. It promises "a holistic, customized plan," delivered by high-tech AI (artificial intelligence), with a chatbot that acts as a virtual, personal trainer and nutritionist coach. The program was developed by health and behavior researchers at Stanford University and Harvard Medical School, with input from experts on nutrition, fitness, sleep, and chronic disease prevention and management. Apple voted it one of the "Top 10 Apps of 2015," and Vogue described it as a cheerleader that "ultimately feels like a friend." A reviewer who got attached to Lark described the app as, "kind of like my own little life coach."

Various versions of Lark are for wellness, diabetes prevention if you have prediabetes, and managing diabetes and hypertension. The app I am downloading is the one focused on weight loss. Lark Pro offers a "personalized health plan, nutrition coaching, and unlimited check-ins."

I like the idea of a personal weight loss coach with "unlimited personal guidance and support, anytime, anywhere," and there is no way I could afford one in real life. The promise of being ready to chat whenever I am sounds good — who hasn't had the midnight munchies? Maybe those behavior change experts behind Lark have looking into my brain and know what to tell me at midnight when the ice cream calls me.

I must be approaching the "average" 130th diet.

I wasn't surprised to read that over half of women are trying to lose weight, and that the average woman tries 130 diets in her lifetime. I don't know how many I've tried, or even how to count. Did my refusal to eat ice cream the summer I was 7 count as my first diet? Surely my attempt with Weight Watchers counts, as does the semester that my college roommates and I vowed to lose weight by eating only fruit and vegetables from the cafeteria's salad bar (that lasted only 2.5 weeks, which was when we decided as a group that we needed to take full advantage of the all-you-can-eat ice cream bar).

Regardless of how you count, I must be close to my lifetime quota of 130 attempts. Maybe Lark will be my magic 130th diet, the last one I ever try. Just call me Pollyanna.

What's not to hate about dieting?

You'll have to forgive me if I sound less than excited about starting another diet. In my experience, diets mean cutting out chocolate, pasta, and pizza. They mean staying home instead of going out with friends. They mean chugging shakes, nibbling on protein cookies, or preparing complicated meals according to the diet du jour's rules. They mean scrupulously counting calories or grams of carbs or fat.

The prospect of more diet misery accounts for only part of my dread. Making me even less excited is that I feel certain that I will fail, just like I have every other time. I feel as though I am already doomed to realize in a few months that I am still unhappy with my body and that I am a failure.

Maybe I'm grasping at straws, but maybe this time will be different. I've never had a personal coach before, and certainly not one that is available for me all the time. There is no calorie counting involved, and Lark promises to be compassionate. That must mean that Lark will understand that I need chocolate in my life, right?

Day 1: Here we go again.

It is Day 1 of my new diet with Lark. It feels a lot like Day 1 of any other diet, or anything else, for that matter. I have never minded the first day of a new term at school, or at a new job, probably it is too soon for me to fail. You can be confident that you will not forget your homework or fail a quiz on the first day of school, and you cannot let your new boss down on the first day at work. By the same token, I have not yet cheated on Lark…err…on my new diet.

I log into Lark and am asked permission for the app to access my Apple Health data. I hesitate for a second at the thought of sharing such personal information, but give in quickly. I'd probably put up more of a fight if it wanted to share my receipts from my most recent trip to the mall with my husband.

The set-up process continues as my personal coach asks me for my current and goal weight and suggests losing weight at 1 pound per week. I'm given the option to choose dietary preferences such as gluten-free, low-carb, vegan, vegetarian, paleo, or dairy-free, but I do not select one. I have no dietary rules and prefer to see what Lark has in store for my weight loss plan. I notice in the app settings that my physical activity goal is an hour a day. Sure, Lark, if you can get me there, you'll be doing better than I expected!

Lark starts right in with the sleep coaching, asking me to confirm the times that I went to sleep last night and got up this morning, and then informing me tha
t last night, I got 7 hours and 32 minutes. "That's less than you usually get on weekdays!" says Lark. I guess Lark picked up my previous sleep data from Apple Health to be able to generate that insight, since I only started using Lark about half an hour ago.

Day 3: What's the plan?

I'm kind of in a mental holding pattern. I started the program a few days ago, but still have no idea what the diet plan is. I haven't been given a list of allowed and forbidden foods, or a meal plan to follow. How is Lark planning for me to lose weight?

I may not be an expert in weight loss, but I am certainly an experienced dieter. I know that you must change something if you want to lose weight. I start to think about what it is that Lark is trying to change in me because if I can pinpoint a few differences between my normal patterns and what Lark suggests, maybe I'll understand how this "diet" is supposed to work.

  • Good foods, bad foods. Recognizing various positive and negative foods or aspects of foods are the closest thing to dietary guidelines that I can see in Lark. Vegetables are good, soft drinks are bad. I've been praised for eating oatmeal (a whole grain), and have been told to consider fruit for dessert next time instead of cake. As obvious as it is to eat more fruit and less cake to lose weight, maybe I need to actually implement it!
  • One thing at a time. I'm used to my diets regulating each detail of each meal, but Lark doesn't seem to do that. When I log a meal, Lark only seems to tell me about one part of the meal, such as a vegetable or healthy protein, or (oops!) a slice of pizza. I don't know if that's the best approach (shouldn't my health coach have been concerned about my roll with butter in addition to praising me for the salmon I had for dinner?), but maybe my conscience will carry me through (yes, I feel bad about the roll and butter, and I know Lark could have focused on that instead of my salmon!).
  • Awareness. The 24/7 availability of my personal weight loss coach extends to my ability to start a chat or log my feelings anytime. Lark tends to praise me for that, informing me that it's good to recognize my feelings. Why? I don't know, but telling the bot that I'm proud, stressed, or hungry certainly seems a small price to pay for weight loss.
  • Acceptance. Lark seems to want me to accept myself, which is arguably a little cheesy, but kind of refreshing all the same. It seems worth a try to for once forgive myself instead of getting angry when I inevitably skip a workout or eat a doughnut. Maybe my Lark experts will prove to be right that it will be easier to get back on track if I accept myself.
  • Moving. There is nothing new about moving more to burn more calories and lose more weight, but Lark really prioritizes activity with reminders, tracking, and encouragement to hit my 60-minute goal each day. Lark also uses reminders to break up long periods of motionless sitting time with activity, which apparently helps with metabolism.

I have a ways to go before my actions match up with what Lark says and, frankly, what I know. So, before I worry that Lark hasn't given me a stringent meal plan, I will first try to make the changes that I know Lark wants and that I know are best, one of the perks of dieting with a chatbot.

Day 8: A bit of progress — coincidence?

It's been a week since Lark and I introduced ourselves to each other, and I have decided that it is time for a weigh-in. I know, a week is but a blip on the weight loss radar map, but I would still like to peek in on how my personalized program is working.

Weigh-in: 178 lb.

From Lark: "I saw you logged your weight. Would you like to talk about it?" The Lark chatbot asks me. My answer can be one of two options: "Sure" or "Nah."

Nice. I'll take it. I don't know if I can chalk it up to my fancy schmancy Harvard and Stanford-backed personal weight loss coach, but I have a policy of taking any weight loss as a positive sign. Apparently, Lark does, too. It's good to know that we're on the same page here!

So, why did I lose weight this week? It could be the Lark diet, but I'm still not sure what that is. It could be a coincidence. It could that I didn't have any excessive binges or nights out. It could be a result of my extra time at the gym, or due to my extra sleep because of an extra day off work. Maybe all of those are the Lark diet — sneaky moderation that fits into your life!

So far, I've opened the app one or more times a day. Sometimes, it's because I remember to log a meal or I want to make sure that the walk I just took got counted in my daily activity total. Sometimes, I enter the app because I get a notification on my phone, asking if I want to chat about lunch, or congratulating me on some extra exercise.

Whatever caused the weight loss this week, I am satisfied — at least enough to follow through with my second planned week of using a dieting chatbot. Here goes!

Day 10: Weird. I'm trying to please an imaginary mentor.

I would say that I've been regular, but not fanatical, about using Lark. I've logged most meals, confirmed or corrected each night's sleep totals when prompted, and logged or confirmed activity.

The strangest thing so far is that I'm starting to care what Lark "thinks." That is strange because Lark is a chatbot. The most accurate descriptor of Lark's intelligence is, "artificial." That's not me being cynical. Lark is an example of artificial intelligence. My health coach, personal weight loss assistance, and a compassionate new friend is nothing but a programmed series of responses. Lark co-founder and CEO Julia Hu said about designing Lark: "We basically cloned tens of thousands of conversations and interventions that these health experts knew would be effective in helping people get more active and eat healthier and sleep better."

Despite the simulated compassion and responsiveness, the masterminds behind my personal coach have done a good enough job faking a human mind for me to fall prey — or, to be honest, to benefit. No matter that Lark isn't a real person, or that Lark doesn't know if I lie, or that Lark doesn't care if I lose weight. No matter that the Lark chatbot doesn't care about anything because Lark is an imaginary entity. I want to make Lark proud! So I take the skin off my chicken, walk up the escalator instead of standing on it motionless, and notice the flavors in my food.

Day 13: Hey…I can do this!

I'm still waiting to find out if my Lark friend is going to turn ugly and present me with a strict meal plan soon. In the meantime, my personal cheerleader seems to think I'm doing okay, so I'll go with that.

Do I really deserve to lose weight now? What am I doing "differently" compared to being on no diet? There are a lot of little changes, with many of the
m resulting from my desire to receive praise or avoid critique from Lark.

  • Ordering a baked potato instead of fries for a side because I don't want to tell my Lark coach that I had fried food.
  • Putting lettuce and tomato on my sandwich in hopes that Lark will praise me for the vegetables and "not notice" the ham (again).
  • Making sure to walk for at least five minutes when I can, even if it means looking like I'm planning to steal a car when I walk around the parking lot a few times before getting back into my own parked car.
  • Having a fruit salad instead of smoothie because Lark doesn't want me to drink my calories when I can have whole foods.
  • Including a glass of water at each meal to give Lark a chance to praise me.

These changes may be as small as they sound, but I hope they will add up.

Day 11: getting into the mindset.

Perhaps it's a sign that I'm spending too much time with my new bot friend, but I not only wonder what Lark will "think," but I'm starting to think like Lark. I tell myself that taking a brisk walk is worth it, even if it is short, because every little step adds to my activity total. I try to put more vegetables, proteins, and whole grains on my plate because I've learned that they are more filling, and minimize the refined carbs and added sugars because they'll give me cravings later. I even try to get to bed earlier because, well, a little bird told me that it helps with weight loss.

Oddest of all: I talk to myself just like Lark talks to me. "You're making some great choices, there," I tell myself. "Give yourself props for that plate of colorful veggies!" Or, "You've been sitting for a while. Maybe the chair needs a little break while you get moving for a bit!" Hey, if you can't beat 'em, join ‘em! I told myself I'd give it two weeks, and I'm going whole hog, including talking to myself.

Another motivator to do right is that I am now sure that Lark notices and remembers. I may get a comment only about one part of the dinner I just logged (yay, Lark applauded my grilled chicken breast), but the rest of my meals are stored and counted. Earlier, Lark noted that I had logged processed meat (specifically, it was ham) "again," although Lark had not mentioned it the first time I logged it. It is the same with sleep and activity. I was told that Lark "hasn't seen much activity from me yet, but that's OK because it's typical of me for a Saturday." Oh, so you noticed that I'm a bit sluggish on weekends? Maybe I'll add in a walk just to see if you notice, Lark!

Knowing that Lark sees and remembers all makes me want to be sure that I won't be reminded later about some cringeworthy choice I made.

So, keeping on keeping on. It's certainly not burdensome to stick with Lark; I just log in every so often. I'm still not sure what the "diet" is if I'm not counting carbs or calories, skipping meals or using meal replacements, or limiting myself to certain foods.

Day 15: Weigh-in 2 and decision day.

Today marks two weeks of using Lark. That means it's weigh-in day and it's decision day — do I stick with Lark? First things first: weigh-in.

176 lb.

That's fine by me! I've lost 4 lb. in two weeks without any formal diet rules. I've not cut out any foods entirely, nor skipped meals, nor had to eat foods I don't like. If I can lose weight with that lack of rules, I'm happy.

That leads me to making my decision about whether to continue using Lark. I do wonder about following a plan that's so vague. I also have occasional moments when I want to give my health coach a certain response, but I have to choose one of the response options that I am offered.

The positives about Lark are:

  • The reminders to log food and get moving. They let me know that Lark is always watching me and thinking about me (with its imaginary eyes and brain, of course).
  • The program is pretty painless so far. I have gone out to eat and eaten some treats in the past two weeks, which means this diet doesn't make me feel deprived of food and life.
  • I like my new friend. Lark is there all the time, and I'm getting used to the company. I also like knowing that great minds are behind my new buddy, so I can trust the advice I get.
  • I thought the lifestyle focus was silly at first (do I really need to see, "8 hours, 18 minutes, that's more than you usually get on weekdays!" or, find out that my sleep is "not quite at its usual weekday level. But that's alright, each day's a bit different?"), but I'm starting to like it. I can't swear that it helps me lose weight, but lowering stress and increasing sleep can't be a bad thing.
  • It seems to work. I lost weight.

That final point is the clincher. I signed up to lose weight. I lost weight. I will stick with the program! Chatbot for weight loss: here I am!

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