I’m a reasonably fit person. I walk 4–6km per day, go to the gym several times a week, and occasionally marinate myself in the urine/chlorine mix of the local pool for a bunch of laps. In order to adequately prepare myself for this blog, I decided to download a fitness tracker and wallow in the truly unique experience of having my phone tell me that I was being lazy and should get off my goddam butt.
With the amazing advances in technology, I can now be a smug prick and tell you that I walk an average of 12,000 steps a day, and burn a bunch of calories lifting heavy things at the gym. My pump class, which is awesome, burns more calories than my weekly tussle with the urine of 1,000 toddlers.
However, I can also tell you that I didn’t lose any weight. I didn’t get any fitter. Now, a couple of months isn’t really a great length of time to see if the tracker was changing my health, but my experience is backed up by a decent amount of evidence that fitness tracking devices and apps tend to be ineffective when compared to other lifestyle modifications. To a certain extent, this makes sense; simply measuring your fitness levels doesn’t necessarily make you work harder, and fitness trackers are generally more cumbersome to wear/use than, say, nothing at all.
Generally, the research shows that there is little additional benefit to using a fitness tracking device above and beyond what you’d get from just undertaking the intervention in the first place. If you want to increase your walking, measuring out a careful 10,000 steps by shaking the pedometer whilst you watch Stranger Things on Netflix isn’t actually going to help.
This is particularly true when you consider that on average people only use their fitness trackers for a few months, and they aren’t always particularly accurate anyway. It’s hard to stay committed to using a device that’s awkward, irritating, and probably gets your step count wrong so you can’t show off to your friends.
There’s also another big hurdle to consider from a public health point of view; who uses fitness trackers? If you guessed problem groups who really need to exercise like diabetics, overweight men over the age of 50, low SES people who don’t get much exercise, and really lazy guys called Gid, you’d have fallen into the classic trap of being woefully wrong (let’s be honest, guys called Gid are the worst at fitness tracking). In fact, as you may now expect from my ongoing series about social determinants of health, the people who use fitness trackers are the very people who don’t need to use them at all. Reasonably young, rich, fit and healthy people who want to measure the calories in their workout love Fitbits, but poor diabetic smokers who have trouble with stairs couldn’t care less. As it stands, fitness tracking is yet another divide between the healthy wealthy and the unhealthy poor.
Who do you think we are more interested in targeting?
There’s also a cost aspect; as I mentioned, fitness trackers tend to be more expensive than nothing. If you can offer an intervention (like a free walking group), adding to the expense by providing some sort of fitness tracking is unlikely to have a significant impact but will almost certainly have some sort of cost. And I won’t even touch on the multitude of privacy issues; suffice to say that fitness data is of great interest to any numbers of groups who would profit from knowing how much you exercise and where/when you do it.
“But I lost weight with my fitness tracker/Fitbit!”
I’m not going to argue with you, random person intruding into my article. People lose weight, get fit and do really well using fitness tracking and measuring devices. However, it seems more and more likely that fitness tracking at best does very little, and may even impede the application of weight intervention programs. That’s not to say that you won’t lose weight using one, but that generally they don’t make a huge difference in how much weight people lose.
The light at the end of the tunnel
All of this seems a bit depressing; there’s a whole world of fitness devices that companies are busily getting you to throw money away on with very little real evidence that they do anything other than give you bragging rights. However, there is some evidence that fitness tracking can be useful when combined with certain types of interventions. There’s also new devices being invented every year; what we measure, and how, is changing every day.
By its very nature, research can’t keep up with an industry that changes overnight. A well-conducted study can take years to do, particularly in the arena of weight loss programs which often have 10–15 year follow-up cycles. Whilst there is very little evidence now that a Fitbit is anything other than a watch for people who own Activewear, given 5 years of development who knows what’s possible?
Imagine a fitness device that could give your doctor real-time alerts if you had a health event. Imagine having a dieting device implanted that could tell your dietitian exact foods and amounts eaten so that they could tailor a program perfectly for you.
(Try not to imagine how these devices could be used by private health insurers to determine your premiums. I wasn’t joking when I said there are some major privacy and ethics issues).
Right now, fitness tracking is a hobby for the wealthy. In 10 years, it could be an everyday part of health management.
I can’t wait to see what the future holds.