Finished-plate photos
An optional per-patient setting that pairs the plate as served with the plate when finished, so you can see how much was actually eaten. The patient never sees the finished photo and is never shown an amount.
Between appointments you get "I ate dinner" and no way to know what that meant. Completion is already something you track — thresholds around 80–90% are used as step-down criteria from residential to partial hospitalisation — and photography measures it better than anything else available. Against weighed plate waste, before-and-after photography correlates at r = 0.995, against r = 0.810 for a trained clinician estimating by eye.
So the clinical case is strong. The reason this setting is off by default and not for every patient is equally strong, and worth reading before you turn it on.
Asking someone to measure their own leftovers is a checking behaviour. In a study of 108 people with diagnosed eating disorders, situations where the person performed an eating-disorder safety behaviour were rated more threatening than the identical situation without one, regardless of actual danger — performing the check is itself read as evidence there was something to check.
For a patient who is checking-prone, or who is highly distressed after meals, leave this off. The safest version of this feature is a parent taking the photo, not the patient.
How it is built around that
Every mechanism of harm needs the patient either to perform a measurement or to see the result. Both are avoidable while keeping all of the clinical signal, so:
- The patient never sees the finished photo. Not in the day view, the calendar, meal detail, or anywhere else, in any mode. This is stricter than Blind Mode, which is a display preference with exemptions — here there is simply no patient-facing route to the image, and the app never even writes it to the phone.
- No amount is ever shown to them. No percentage, fraction, "left", or comparison.
- No question is attached. One tap, one photo, no follow-up. There is deliberately no "how much did you leave?".
- Nothing nags. No notification, no badge, no incomplete-meal state. The button appears on a just-logged meal for two hours and then quietly disappears — a prompt to photograph a plate from hours ago is an invitation to ruminate about it.
- The words "before" and "after" never appear in the patient's app. That framing has its own harmful history in recovery. They see a small "finished" camera button and nothing else.
Who should hold the camera
A family supporter, where you have one, and this is the better option rather than a fallback.
In the first phase of family-based treatment the parent already plates the meal, supervises it, and supervises the post-meal period — being firm about completion is explicitly their job. A parent photographing the finished plate is therefore already what happens, just undocumented, and it moves the measurement off the patient entirely, which removes every mechanism above.
Family supporters can upload it from their own login. See Family access.
What you see
The two photos side by side in the meal detail, the served plate and the finished one, with the log's timestamps. Most meals will not have a finished photo, and that absence is shown plainly with no styling.
Two photographs are self-evidently evidence. A number reads as measurement — and the validity figures above are for trained raters and purpose-built software against weighed waste, not for a model's estimate. A wrong number you act on is worse than no number.
Absence is not refusal. A missing finished photo usually means somebody was busy. Treating it as a signal would invent the compliance measure this feature is specifically designed not to be.
Interactions
| Setting | Behaviour |
|---|---|
| Intuitive eating | Forced off. Intuitive eating exists to stop quantifying intake; a completion measure is the opposite frame. |
| ARFID mode | Allowed, off by default. Worth thinking twice: a plate photo of a feared food may add exactly the pressure ARFID mode removes. |
| Treatment mode | Allowed, off by default. Straightforwardly useful there — intake is the medical question and the ED harm mechanisms do not apply. |
Deleting
If a patient deletes the photo for a meal, both halves go. Deleting "the photo of this meal" means the meal, not one image of it.
Android currently syncs the setting; the capture button is on iOS first.