Wearable Tracking Devices - Are they worth it?

‘I’m wearing an Oura ring and it tells me I am not getting enough deep sleep.’

‘I am tracking all my calories on an app and then sending the information to chat gpt to tell me what to do.’

‘I am tracking my heart rate at the gym using my Garmin watch.’

‘The fertility calendar on smart watch tells me I can conceive in the next 3 days!’

‘My Whoop watch is telling me that my stress level is high today! And, that my health age is actually 5 years older than my current age.’

These are common statements I hear from clients.

The wearable tracking devices market has completely exploded in the last 5-10 years.

We can now wear a watch or a ring that can apparently tell us how we slept, if we’re stressed, exactly how many calories to eat, how many calories we are expending every day, if we are fertile and so much more.

Additionally, more and more people are also using CGMs- Continuous Glucose Monitoring Devices - to ‘discover’ how they need to eat for optimizing their blood sugar. (More on CGMs another time, this article does not focus on these.)

In the future, we may see microneedles attached to wearable devices that go into the skin to measure metabolites, electrolytes and more. There is research on this already.

What are wearable tracking devices?

Trackable devices include products like the Oura Ring, FitBit, Apple Watch, Whoop and more.

They use algorithms that take information like heart rate, age, skin temperature and more to estimate and calculate things like when you are in REM sleep, how fertile you are, what your ‘strain’ is that day, and more.

Whoop actually offers an ‘age’ that you are at based on heart rate variability, your sleep, how active you are, etc.

If you read the fine print for any of these devices, you will notice that these devices are all using calculations - that is what algorithms are - which are actually not defined.

Further, the companies actually state on their websites that the information they gather is not always accurate. In fact, the fine print often states something like: ‘we do not recommend using these in place of medical advice’. In fact, on the Whoop website, they state that the fertility tracker should not be used for conception.

Yet, what these companies promise is life-changing data that will help you become a ‘healthier version’ of yourself.

The Potential Benefits of Wearable Devices

The one benefit of using tracking devices, in my opinion, is to build awareness.

For some, building awareness of habits and what may be happening in the body can be helpful.

With this awareness, one may have the opportunity for change.

There are prerequisites to be met before using wearable tracking devices:

• No active eating disorder

• If there is a history of an eating disorder, awareness of potential vulnerabilities

• Knowing your red flags. For instance, if you start using it and change  behavior only based on the ‘data’ from the device and nothing else, or you start having more rigid thoughts or your OCD is activated, it is likely time to stop.

• Understanding that it is not 100% accurate and it is only one tool among others that tells you how things are going

• You can use it for a short time and don’t have trouble stopping use. Temporary use can help create awareness, which should be interpreted with nuance, and you have a set time you will stop before you even start.

• The data is one of many inputs. Others include: how you feel, bowel habits, energy level, lab data, medical test data, your mood, your thoughts, stress levels, etc.

Here is an example:

Someone would like to figure out when they actually fall asleep. Instead of laying awake and looking at the clock to figure out when this is, the watch can be helpful to give them a sense of how much time there is between getting into bed and falling asleep. This can then help them, perhaps, determine the best time for getting into bed or sleep routines to do prior to getting into bed. For instance, they may see how much sooner they fall asleep if they read versus look at their phone.

Once changes are implemented, or even before, the tracking is no longer necessary.

The Negatives of Wearable Devices:

My biggest concern with these devices is that they lead us to trust ourselves less and are potentially triggering, especially to people already prone to rigidity and perfectionism who can become over-reliant on the ‘data’, chasing things that are not always actionable, leading to more stress and worsened health.

The cons I see in practice and in research are the following:

Accuracy: Many of these devices do not have research behind them, or if they do, they are only done by the company itself. People can interpret their sleep data, for instance, as if they are not getting any deep sleep or REM sleep and then blame their lack of energy on that when, in fact, they could have sleep apnea or be burnt out.

Studies show that while wearables are great at telling you if you actually are sleeping or not, but they are not so great at knowing if you are in deep sleep or light sleep. In one study, the best performing device was the Oura ring, which predicted REM sleep and deep sleep at best, 78% of the time. The FitBit and Apple Watch’s sensitivity was even worse.

Over-reliance: We start using it as a safety net. Checking our ‘data’ makes us feel relieved and reassured or frustrated and guilty and needing to ‘fix’ something. We can start to use the tracking device as a safety, just like a scale or calorie counting app may be. This can make it very hard to stop and also, hard to clue in, once again, to what we may already know we need.

Delaying professional care: Along the same lines, if someone is using a tracking device and trying to manage sleep, sudden constipation or blood pressure through it, they may actually delay going to a professional to get medical testing and discover underlying issues.

They make us LESS aware: We can become overreliant on these devices to tell us what is going on with our bodies and in this process, start to second guess our own feelings, both physical and emotional. We may start thinking, ‘Maybe I am really stressed because the device says I am?’

This can complicate our perception and understanding of ourselves.

We end up feeling disconnected from ourselves because we are not listening to our bodies at all and rather using some calculation to guide decisions.

Increased stress: ‘My ‘strain’ is high today!!’ I have heard this often from wearers of the Whoop watch. What can one do about this message? Many people, understandably, freak out and get more stressed when it is likely many of us can just check in on our energy levels and stress internally and figure out that we are feeling ‘strained’. And, even if we cannot check in or we are not sure if we are really stressed, what does knowing our ‘strain score’ actually change? What does it even mean?!

Overwhelm: More is not always better. The data coming to us from so many directions does not actually always create change. Many of us can feel overwhelmed by all the data and information. Of course, then, it makes sense to try to do so much at the same time.

Costing (More) Time and Energy: Do we need one more thing? While technology claims to make things easier for people, we are increasingly becoming reliant on more and more technology, which actually takes a lot of our time. Instead of googling about how much deep sleep we need, maybe that time is better spent sleeping :)

Eating Disorders, Obsessive Compulsive Disorder (OCD), Health Anxiety and Wearable Tracking Devices

A few words here for those who have struggled or are struggling with EDs, OCD, health anxiety, severe rigidity and other related concerns.

Tracking devices can be quite triggering if one struggles with any type of anxiety. Reasons for this include:

• Your mind may already be primed to think in numbers, figures and outcomes. More numbers = more input = more short-term relief followed by long—term overwhelm, confusion and disconnection.

• You can use these apps and devices as ways to seek reassurance, and it can become compulsive. Seeking reassurance is not bad in and of itself. However, if we are basing our actions and decisions only on external sources like tracking data or what others tell us, we are not always living the life we want.

• Comparison can creep in. We are social creatures. Comparison is normal. However, these devices can also lead us to compare our ‘data’ to our past data or someone else’s data. This can get messy, in that we are constantly feeling not good enough.

• Reliance. We start to rely on these devices for constant reassurance and even self-worth if the ‘data’ looks good. We find it hard to disengage with it. We have urges and compulsions to use it, check it, etc. It becomes another compulsion or obsession.

Closing Thoughts

Nothing is black and white. For some, using a tracking device may be helpful.

Same with an app. Apps like Recovery Record, which allows folks with an ED to log their thoughts, feelings, emotions, food intake, etc. can help some stay accountable to themselves and get feedback from their team. For others, this same app causes distress and a place their perfectionism flourishes.

With wearable tracking devices, the key questions is - if you can accept the data is not 100% accurate and we get information from other sources as well -

What will you do with the data??

My stance is that most people do not benefit from a wearable device.

The messages in our environment are currently so fixated on constant optimization that we end up getting numb and disconnected from ourselves and also the world around us. There are real issues that we are dealing with as individuals and that we are dealing with as a society.

More focus on the data keeps us further away from ourselves and these issues.

If you want to use a tracking device, using it under the supervision of a professional and with a specific goal and end date in mind is encouraged.

Awareness can be built without a wearable tracking device.