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What to do when your health and fitness goals turn against you

If you’re wearing a fitness tracker right now, chances are it’s packed full of sensors. These sensors can measure your sleep, record your steps and your workouts, take a heart-rate reading and keep tabs on how many calories you burn throughout the day.

If you’re lucky enough to have the newest Apple Watch Series 6 strapped to your wrist, you can also measure the oxygen saturation in your blood or take an electrocardiogram (ECG) reading to gauge the electrical activity of your heartbeat.

Tracking and accessing all of this data gives people interested in fitness more accurate measurement tools. It provides those living with health issues options to take monitoring into their own hands. And it’s also a dream come true for gadget lovers who are curious to find out more about their health and their bodies with the help of tech.

However, the wealth of data our tracking devices and monitoring apps present us with at the push of a button – often, you don’t even have to push a button, the screen comes on with the flick of your wrist – can feel overwhelming. This might lead to a not-so-healthy preoccupation with numbers, stats and optimisation.

The problem with health & fitness tracking

I’ve reviewed many different health and fitness tracking devices over the years, and, at times, I became overly concerned with hitting specific goals each day – to the point where I’d feel panicked or like a failure if my wearable told me I hadn’t burned enough calories or taken enough steps.

I’ve since learned this behaviour wasn’t motivated by fitness challenges or an interest in my health – which would have been my excuses at the time. Instead, this focus on everything my fitness tracker was telling me about my body, my health and my food intake had exacerbated problems I’d had with disordered eating in my teens. Except now I had a smart device strapped to my wrist making the worries about food and weight all that more difficult to escape from.

A growing pile of evidence suggests I’m not alone in finding that excessive tracking can worsen or, possibly, even cause an unhealthy preoccupation with health and fitness.

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One 2018 study from Loughborough University and the University of Warwick found that 65 per cent of young people in their sample reported using monitoring tools (this included both fitness trackers and calorie counting apps).

Those who used these tools exercised more compulsively and had more problems with dietary restraint, concerns about weight and shape, exercising for weight control and purging behaviours – which in this case meant exercising to work off calories – than those that didn’t.

The researchers explain this might be because many of the behaviours that categorise eating disorders, like obsessive behaviours towards food (i.e. calorie counting), perfectionistic tendencies and rigid attitudes to exercise, could all be heightened by fitness trackers.

This is important given estimations from eating disorder charity Beat, which currently puts the number of people with an eating disorder in the UK at 1.25 million.

Similar issues are present if we look at research that focuses specifically on calorie-counting apps. One 2017 study put MyFitnessPal under the spotlight, an app with a huge food database, which allows you to record everything you eat each day, giving you a breakdown of your calorie and nutrient intake.

The participants who took part in the study had recently been discharged from an eating disorder clinic. Seventy-five per cent of them reported having used MyFitnessPal in the past. Seventy-three per cent of those said that they believe the app had ‘at least somewhat’ contributed to their eating disorder. Thirty per cent said that it had ‘very much’ contributed to their eating disorder.

This research relied heavily on the participants retrospectively assessing their relationship with calorie counting, which means we can afford to be cynical about the results.

However, similar small scale studies have suggested a possible link between calorie tracking and disordered eating behaviours – with MyFitnessPal often being cited as the app of choice. There’s also plenty of anecdotal evidence online where people have linked their experience with calorie counting apps in the past to their disordered eating behaviours in the present.

Importantly, eating disorders are complex. These findings don’t necessarily mean apps and trackers designed to record calories, exercise or anything else to do with your health cause or trigger problems. Instead, people who already have issues with disordered eating or over-exercise tendencies might be more drawn to tracking what they do.

But although health and fitness monitoring tools might not be the cause of these problems, the teams behind them could still do more to provide screening tools or guidance for those who might be using them in less than healthy ways.

Sleep tracking: 40, 50 or 60 winks?

Researchers have found that a similar preoccupation with tracking could also affect those who use apps and devices to track their sleep, which is known as orthosomnia.

In research from 2017, this is described this as ‘a perfectionistic quest for the ideal sleep in order to optimise daytime function’.

This same research focuses on three different cases of people who had entered therapy for poor sleep. The researchers found each of them experienced unintended side effects of sleep tracking, and most of the time this was a preoccupation with sleeping and ways to improve it, including excessive amounts of time in bed.

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Research on orthosomnia and sleep-related anxiety caused by digital devices is still scarce – the study above only looked at three patients, after all – but it’s still important to talk about these potential problems with the tracking tech we introduce into our lives and our beds.

Under pressure

Health and fitness monitoring tools don’t need to lead to an eating or sleep disorder to raise alarm bells. A 2016 study carried out by CNN of 200 US women who all reported wearing a Fitbit regularly. It found 79 per cent of them felt “under pressure” to read their daily targets, 39 per cent felt their days were “controlled” by their fitness tracker and 30 per cent felt that it was an “enemy” that made them feel guilty.

Many of us know someone who runs on the spot in a bid to reach their daily step goal or who says they feel lost if they leave their Fitbit at home. Even if these feelings of pressure and control don’t become serious, they’re certainly not serving us.

What ‘healthy’ tracking looks like

What we can all take away from this isn’t that using tech to track your runs, heart rate, food intake or even your weight is necessarily going to harm you, but that we are all different. Our relationship with our bodies, minds and tech is complicated and tricky to pin down.

With that in mind, here are some of the key factors to consider before you begin tracking your runs, heart rate, calorie burn or sleep. If you already monitor those things and more, it might be time to re-evaluate your goals and you can start by asking yourself: why?

Get clear on your ‘why’

The study from Loughborough University and the University of Warwick provides us with insights into how the intentions behind using apps and trackers play a role in how they make us feel.

One useful finding was that participants who tracked their activity to change their weight and shape reported higher levels of disordered eating than those who did it for more general health reasons or just to feel good.

Adult mental health psychologist Tara Quinn-Cirillo says the reasons for tracking are what’s important. “You want to focus on value-based goal setting,” she says. “There is a fine line between what you ‘should’ do, i.e. ‘I need the data to say X or Y’ and value-based doing, such as ‘I feel good when I do my exercise’ or ‘my concentration and mood improves when I eat healthily.’”

She explains that getting clear on these values is fundamental to building a positive relationship with health and fitness tracking. But Quinn-Cirillo acknowledges it can be easy to lose perspective. “Value-based action can easily turn into obsession and anxiety-driven behaviour, such as exercising in unhealthy ways in terms of frequency, intensity or duration, purely for statistical gain.”

This could be a particular problem right now. “The more the world around us is destabilised and feels out of our control, the more we may over-focus on fitness and goals as a means of something we can have control over,” Quinn-Cirillo adds.

Watch out for telltale signs

Elizabeth Evans, a lecturer of psychology at Newcastle University who has researched weight management and body image, says that there are some behaviours she’d encourage everyone to look out for that could signal they’ve become preoccupied with tracking.

A few of these include feelings of guilt or dread when you’re using the device or just thinking about it; discomfort or panic when you’re not wearing the device; feelings of 'having to' make significant changes to food intake or physical activity patterns; or undertake repetitive or ritualistic behaviours to reach your goals.

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Quinn-Cirillo also provides us with a quick and useful gauge: “When the fun is replaced by anxiety and stress then a line has been crossed,” she says.

Give it a miss

Evans says that some people should probably avoid tracking altogether. “It takes many years for the cognitive and emotional aspects of previously disordered eating / disordered body-related behaviours to remit,” she says. “Devices can trigger it unexpectedly even after a period of use without incident.”

But it’s not just eating disorders we need to be wary of. Evans also recommends that anyone who struggles with perfectionism or compulsive thinking should think twice before using a device. “If in doubt, run it by a trusted friend or partner who knows your history, and/or a medical professional with expertise in this area,” she suggests.

Take it off

A device you strap on for a purpose, whether that’s to keep tabs on your sleep or track your runs, might be more helpful than wearing one 24/7 or recording every single bite of food you eat with an app.

One of the ways I’ve changed my relationship with wearable devices has been by allowing myself to take them off regularly. Now there are days when I’m interested in what my fitness tracker can tell me and days when I’m not.

Quinn-Cirillo recommends building tracking-free time into your schedule so you can be sure you’ll go without it. “Try and identify key times to regularly take off your tracker or put down your device with tracking apps on,” she explains. “Try and build this into a routine which will aid this behaviour to become more implicit or automatic.”

Keep checking in

Evans recommends frequently evaluating how tracking makes you feel. “Review limits after a couple of weeks or so with someone you trust to see whether there is a net positive benefit of device usage to affect thoughts and behaviours,” she suggests. She says that reflecting on the mood impact of a tracking device is important, too. “Do specific functions make you feel worse than others? Turn them off.”

Whenever I use a tracking device these days I make sure all calorie data is switched off. This isn’t possible with every brand of tracker, but some, like Fitbit, allow you to toggle off calorie information in the app’s main dashboard and focus on what you want to see every time you log-in instead.

We’re all different

It’s important to remember that for every person who finds health-focused tech can exacerbate disordered eating behaviours or lead to a preoccupation with sleep scores and step goals, another might find the same app or device to be a powerful accountability tool.

Research about behavioural change has suggested that keeping records – whether that’s in an app or a diary – about shifts you make to your health, fitness and lifestyle can be helpful, as can setting goals to motivate you.

For example, one review of 48 behavioural change studies found that some form of self-monitoring (the research didn’t specify all the different types) was often a strong predictor in participants making long-term, positive health and fitness changes.

Another study that looked specifically at health tracking apps (including Fitbit and MyFitnessPal) found that people who use them regularly reported a greater overall improvement in lifestyle and eating behaviour than those that did not. What’s more, one 2007 review found that even using the most rudimentary pedometer was associated with a significant increase in physical activity in participants.

Of course, we don’t know how these positive changes made the participants feel and whether worries about weight, sleepless nights or just a lot of pressure accompanied some of these positive outcomes. But what we can be more certain of is this: there’s no one-size-fits-all experience after you’ve strapped on a fitness tracker.

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This article was originally published by WIRED UK

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