Body trackers: period, bowel, and movement
Three optional per-patient trackers, all off by default: a period log, a bowel log with Bristol stool form and laxative use, and a movement log that asks why someone exercised, never how much.
Three things that matter in eating-disorder care never show up in a food log: whether menses have returned, what is happening in the gut during refeeding, and whether exercise is being used to compensate for food. Pippa has an optional tracker for each.
All three are off by default. Turn on only the ones that fit the clinical picture.
| Tracker | Who can turn it on | What the patient logs |
|---|---|---|
| Period | You, or the patient in their app's Settings | Days with flow (spotting, light, medium, heavy), and whether they use hormonal contraception |
| Bowel | You only | A bathroom visit: Bristol stool form, how it felt, and whether they took anything to help |
| Movement | You only | What they did, how hard it felt, a rough length band, and why |
Turning them on
Expand the Body trackers card.
Each switch saves on its own and reaches the patient's app on its next sync.
You can also switch any of them on in a saved invite preset, so a new patient starts with them.
Tracking your own cycle is a reasonable thing to want without waiting for a clinician, so the patient can switch the period tracker on or off in Settings → Check-ins. The card shows who changed it last. The latest change wins, in either direction.
What the patient sees
When any tracker is on, a Body entry appears on Pippa's menu on the home screen. It opens one sheet with a tab per tracker that is on. The top of the sheet always says:
your care team can see what you log here. nothing is required, and skipping is always fine.
What the patient never sees: a cycle-day counter, a "late" warning or any prediction, a weekly bowel count, minutes, steps, distance or calories, a streak, or any total. The period tab shows a plain month grid of the days they marked, because editing past days is the point of a period log. There are no reminders for any of the three. Logging is always patient-initiated.
Logged exercise is never praised or rewarded. If a patient picks a compensatory or driven reason, the app answers with warmth and points them to you:
thank you for being honest 💛 when moving feels like it has to make up for something, that's a heavy thing to carry. it's worth bringing to your care team.
What you see
A Body signals card on the Overview, shown when a tracker is on or has data. It is clinician-only and hidden in patient view.
Cycle. A status, a 180-day timeline of marked days shaded by flow, recent periods with their lengths and cycle lengths, when tracking started, and the contraception answer. The status is one of:
- Within 21 to 35 days: recent cycles are in the typical range.
- Irregular: two or more recent cycles were longer than 35 days, or outside 21 to 35.
- No recent period: 90+ days since the last logged period, or 90+ days of tracking with none logged.
- Period returned: the latest period came after a gap of 90+ days.
- One period logged / Nothing logged yet: not enough to say anything.
Spotting on its own doesn't count as a period, and one forgotten day in the middle of a period doesn't split it in two.
Bowel. Visits logged, days with a visit, how many were hard (Bristol 1 to 2), whether anything was taken to help (split into care team suggested and something else), a 14-day strip colored by stool form, and how it felt.
Movement. Sessions logged, how many were to compensate (make up for food, burn something off, earn food), how many had driven features (felt they had to, guilt if skipped, kept going past the plan, exercised while sick or sore, kept it hidden), the reasons tally, and recent sessions.
Clinical alerts these add
Each alert is gated on its tracker being on. A missing entry is never read as "none".
| Alert | Fires when | Tier |
|---|---|---|
| No period logged in N days | 90+ days since the last logged period, or 90+ days tracking with none | Watch |
| Irregular cycles logged | Two or more recent cycles over 35 days | Watch |
| Visits with "something else" taken to help | Any in the window | Watch; At risk at 3+, or with purging logged |
| Mostly hard stools logged | 4+ described visits and half or more Bristol 1 to 2 | Watch |
| Sessions logged to compensate for food | Any in the window | Watch; At risk at 3+, or with a high skip rate, purging, or exercise while sick or sore |
| Sessions with driven features | 2+ in the window | Watch |
Every alert carries its reasoning, the evidence behind it, and a reminder that these are self-reported. None of them sends an email or push. A single laxative or compensatory session is something for the next review, not a page.
Export
Export → Body trackers downloads one CSV with a row per period day, bathroom visit, and movement session, with a Tracker column to filter on. Downloads are recorded in the access log like every other export.
Privacy
Period data is sensitive, and the app says who can see it on the tracker sheet and on the Settings switch. It is stored with the rest of the patient's record, never shared with third parties, and the patient can clear any day or remove any entry. In a family-led setup with no clinician, the family supporter who manages care sees the same as a clinician would.
Why it's built this way
- Spontaneous return of menses is a treatment goal (AED Guide to Medical Care, 4th ed.) and can lag weight restoration by months, so you need the timeline, not a yes/no. Oral contraceptives aren't indicated to restore menses or protect bone, and a withdrawal bleed isn't recovery, which is why the tracker asks about hormonal contraception.
- Constipation is expected early in refeeding. In one inpatient cohort, 84% had it at admission, and it was predicted to normalize over roughly four months. Laxatives barely change calorie absorption, and stimulant misuse drives hypokalemia and rebound constipation. That's why the tracker separates a laxative you suggested from anything else.
- The motive is the construct, not the volume. Driven exercise is an EDE-Q compensatory behavior, and the Compulsive Exercise Test measures rule-driven, weight-control, and rigidity facets. Minutes would become a target, so the tracker asks why. SEES favors supervised, non-abstinent movement, so nothing in the app frames moving as bad either.
For how to use these in a session, see Reading the body trackers.