Your Fitbit and Apple Watch may wind up hurting you
Over the past seven or eight years, I've developed a habit. Whenever I have a brief moment of calm or boredom during my day, without really thinking about it, I'll pull up my smartphone's health-tracking app to check my step count. If it's late in the day and the number is low, I might decide to go out and walk a few blocks or take the long way home. If it's low at the end of a busy month, I might try to squeeze in a few extra long walks to pull up the average. And if it's low at the end of a busy year, I'll almost certainly fall into a spiral of self-recrimination: What was I doing with my time, exactly, that was more important than getting a bare minimum of daily steps?
My step-counter guilt has been enabled by the growing ubiquity of health-tracking tech. Over the past decade, a dizzying array of smartwatches, activity-monitoring apps, and even high-tech activewear has flooded the marketplace, each promising to support their users' quests toward living their best and fittest lives. These tools count a person's heartbeat, hours of sleep, and even the length of your gait (and whether or not you should be worried about it). They are programmed into our phones, worn on our wrists, and even forced onto us by creepy employers. Entire fitness regimes replete with complex point systems and digital rewards are designed around the data they amass. What used to be just a helpful tool for health nuts has bloomed into a multibillion-dollar market. But is this deluge of data making Americans healthier?
While some people are certainly motivated to move more because their phone or watch reminds them to, for others the proverbial carrot of self-optimization can become a source of dangerous preoccupation. Far from a silver-bullet solution to healthy living, these always-on tools and the culture of self-optimization they foster can stand in the way of our well-being.
When numbers take over
The 10,000-step benchmark has generally been the baseline goal for smartphone apps and fitness trackers. Despite the cultural cache, the 10,000-step benchmark was not developed by scientists. Instead, it grew out of a marketing campaign by the Japanese company Yamasa to promote its new step-counting gadget during the 1964 Tokyo Olympics. Actual peer-reviewed studies have subsequently found that it takes far fewer steps a day to significantly lower the risk of mortality — and yet 10,000 steps remains the gold standard. The allure of 10,000 steps kind of makes sense: It's a nice, round number that's easy to remember, and in East Asia, it symbolizes the idea of plenty. Most critically, it provides a health target that's reassuringly direct — one easier to focus on than a messier holistic picture of well-being.
When the Fitbit tracker launched in 2009, 45 years after Yamasa's gadget cemented the 10,000-steps ideal in the public consciousness, it kick-started a boom in fitness wearables and spawned a frenzy for health data. Between 2010 and 2015, the company's sales grew from 58,000 to nearly 21.4 million devices each year. Much like the iPhone revolutionized the mobile-phone market, the Apple Watch's debut eight years ago cemented the fitness wearable as a desirable lifestyle product that could unlock a path to self-optimization. This flood of easily accessible health data has certainly had some positive effects. Numerous studies have shown that fitness trackers can provide users with a jolt of motivation to exercise — at least in the short term. Given that an overwhelming majority of Americans don't meet the US Department of Health and Human Services' recommended weekly exercise quotas, even a small boost in movement can have meaningfully positive health implications. Research indicates that for every 2,000 steps a person takes each day, their risk of premature death may fall by as much as 8% to 11%.
Amanda Paluch, a physical activity epidemiologist and kinesiologist at the University of Massachusetts Amherst who studies the health benefits of fitness-tracking technology, said that for "moderately active" individuals like me, apps and wearables can be "a great tool." Quantifying our movement makes it easier to incrementally ramp up daily exercise incentives, which helps prevent injury and generally makes being more active more achievable. Many fitness-tracking products also incorporate social-sharing features, which can give us a better perspective on how our exercise habits stack up against our friends', providing a little healthy competition as motivation.
While the guilt and anxiety I feel staring down the final hours of a 300-step workday aren't necessarily great, if that number prods me into racking up a couple thousand steps before the total resets at midnight — which it sometimes does — then the data is ultimately making me healthier. It's an intermittently effective Band-Aid for all the sitting that's baked into my daily life. But for all the upsides, that deluge of data can also spur unhealthy fixations and negative consequences down the road.
There's no one-size-fits-all health metric
Despite her pro-tracking position, Paluch concedes that there are downsides to living by the numbers on a scale or screen. "The thing with physical activity, or any type of health behavior, is that it's based on the individual," she told me. "How much activity you need in order to see various health benefits — like lowering your blood pressure or improving your mental health or lowering your risk of cardiovascular disease — is going to be different depending on the person."
The optimal fitness regimen for a person depends on a wide variety of factors: their age, whether or not they have a chronic health condition, and even their genetic makeup. This inherent variability means that striving to outdo someone else's fitness metrics or meet the static targets laid out by an app can be a double-edged sword. Research suggests a number-crunching approach to well-being actively undermines the formation of sustainable, healthy habits. It gamifies fitness goals without factoring in the bigger picture of what a particular body might need on any given day and effectively reduces the care of our complex systems to arbitrary targets. This route can be handy for those of us who need to-do lists stacked with itemized tasks to get anything done, but it does little to support healthy choices beyond the limited scope of achieving select daily benchmarks. If I'm meeting my caloric requirements with a diet of pilsner and french fries, for instance, it doesn't really matter that I'm consuming as much energy as I can burn.
"If I see my physical activity solely as a numerical output, then I end up with little choice but to think of my body as a quantity of something," John Toner, a health sciences professor at University of Hull in the UK, cautioned in a 2018 paper published in the journal Performance Enhancement & Health. "Perhaps I am merely a quantity of fat or only capable of a certain quantity of power." Toner went on to explain that although measurement might spur a person to increase how much of an activity they do, it can also decrease their intrinsic motivation to do those activities in the long run. It may even make those activities less enjoyable, turning what should be recreation into yet another chore of productivity.
Then there's the pinging and pestering. Many health- and fitness-tracking apps and wearables issue notifications throughout the day to urge their users toward their movement goals. While these little reminders can be helpful to some, they also play on users' insecurities about personal achievement and can cause people to fixate too much on the numbers. In some cases, users rearrange their entire lives in harmful ways to achieve their daily goals. Studies have found that exercise tracking can be linked to patterns of restrictive behavior in eating-disorder patients, and there's a growing body of research into whether the use of wearable fitness trackers contributes to the development of eating disorders.
"When you are number-obsessed, it can really — pardon my French — fuck with your brain," Cathleen Kronemer, a personal trainer based in St. Louis, told me. During her more than 30 years on the job, she's seen many clients fixate on calories, miles, steps, and pounds, beginning well before the advent of today's tech-enhanced trackers. But the rise in new gadgets has driven what Kronemer has called techorexia, a term for people who use of fitness wearables to fuel food restriction and overexercise. It was that same tendency, Kronemer said, that landed her in a residential treatment program in 2000 for anorexia, where she was fitted with a feeding tube.
Today, Kronemer sees both sides of the fitness-tracking debate. Although these apps and wearables are not the source of eating disorders and overexercise, they pose a real risk to people who struggle to separate the pursuit of health from the rigid rules that fitness metrics may apply. At the same time, she recognizes that many people benefit from the extra push that numbers, goals, and a little competition can provide. Her own husband credits his Apple Watch with making him a better athlete.
"In a perfect world, people would say, 'Let me use this data as a guide' as opposed to 'Let me believe in this like the Bible,'" Kronemer said. "People treat it like GPS. If it says, 'Go straight for three blocks and then turn right,' they think, 'I better not do anything but that. And if I did, I'm a failure.' I just think that there's got to be a happy medium, but Americans don't function on a happy medium."
Endless optimizing
While the allure of fitness-tracking apps has a lot to do with the psychological tricks they play on individual users, they also appeal to people because they fit so easily into our fast-paced lives. Overloaded work schedules, car-dependent commutes, and the nefarious convenience of food-delivery services make it harder than ever to take care of ourselves. A study by researchers at the Washington University School of Medicine in St. Louis found that in 2016, the average American adult spent 6.5 hours a day sitting down — an entire hour longer than in 2007. Considering the ongoing rise of app-based conveniences, today's number may be even higher.
These modern pressures — combined with an obsession with optimizing for efficiency — has caused Americans to squeeze healthy habits into the margins. And fitness tech is there to help make it easier for us to squash it all in. In fact, the original Japanese step counter is said to have been created after an exchange between Yamasa's founder and a doctor who suggested that the nation's newfound prosperity had given rise to new conveniences which, in turn, discouraged physical activity.
The pursuit of fitness has become absorbed into the American (over)work ethic. Instead of valuing wellness as worthy of pursuing in its own right, fitness is pursued as a means to an end: People work out in order to be more focused and productive at work, or to be more confident in order to be a better worker, or to be more attractive in order to — you guessed it — succeed in their career.
When the step counter on my health app reminds me how little I've moved my body, I feel like a failure. But in truth, those disappointing numbers usually mean I lived my days exactly as most Americans are taught to: by prioritizing the completion of more and more tasks, then doing whatever I can to decompress enough to repeat the whole process tomorrow. When my steps are low, it's because I'm dutifully working hard and putting my well-being last.
Fitness tracking is no silver bullet, but it's not inherently antithetical to the cause. Despite my ambivalence, I suspect I will always turn to certain technological tools to keep me honest and active, hopefully for many years to come. For others, the tools may hurt more than they help. Everybody, and every body, is different.
Kelli María Korducki is a journalist whose work focuses on work, tech, and culture. She's based in New York City.
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