Do you wear a fitness tracker like a Fitbit or Jawbone — or perhaps you log your calories and/or physical activity in an app on your smartphone? If so, then you’re like over half of Americans (51% to be exact) who also use a fitness tracking device on a daily basis.

As fitness technology becomes more and more sophisticated, its uses continue to expand. Nowadays, fitness wearables can do much more than track steps or calories burned: they can keep a record of sleep patterns, measure our heart rate and even lead us through guided breathing exercises to reduce stress and anxiety.

However, as the use of fitness trackers begins to grow, so do concerns that fitness trackers may be triggering disordered eating patterns — or even full-blown eating disorders. A study published in the journal Eating Behaviors in August 2017 found a significant and concerning the correlation between fitness tracker use in college students and eating disorder symptomology.

So, are fitness trackers linked to eating disorders — and are they safe for use by patients in eating disorder recovery? Here’s the lowdown on fitness trackers and eating disorders, once and for all.

What Are Fitness Trackers?

If you’ve ever been curious how many calories you burn during that hot yoga class, how fast your heart beats on your morning jog or even how effective your daily meditation is at reducing stress, today’s modern technology can help.

Fitness tracking technology takes many forms. Most frequently, the fitness tracker is a wearable watch or other fashion accessory that collects fitness data throughout your day. Then, the tracker syncs with your smartphone to report its data to you and/or your healthcare provider.

Pros of Wearing a Fitness Tracker

Fitness trackers have evolved greatly since the first Fitbit was released in September 2009. Nowadays, fitness trackers do much more than track minutes of exercise, number of steps taken or calories burned throughout the day.

Wearable trackers like the Fitbit Versa and Bellabeat Time now allow the wearer to partake in guided breathing sessions for stress relief, receive suggestions for improved sleep and even track changes across the menstrual cycle. New technology like the Feel wristband can even sense emotions, offering tailored therapy sessions to improve mood throughout the day.

Physical activity of any kind — not only structured exercise programs — has important health benefits. Research conducted at Harvard University shows that today’s modern fitness trackers may motivate the user to increase their physical activity. Compared to the control group using traditional pedometers, users wearing digital fitness increased their physical activity by an average of 38 minutes per week, suggesting fitness trackers may motivate the user to squeeze a little extra movement into their day.

Speaking to the pros of wearing a fitness tracker, many health insurance companies offer discounts on wearables, subsidies on premiums for patients who use them or even free wearable technology to their subscribers. And, in 2018 alone, an estimated 600 million Americans received wearable fitness trackers as part of workplace wellness programs, according to NPR. It’s definitely worth asking: if wearable fitness trackers are really that harmful, would doctors, insurance companies and workplaces promote them so readily to patients?

Cons of Wearing a Fitness Tracker

In reality, there’s a good reason for the relentless promotion of wearable fitness trackers: fitness trackers are moneymakers! These days, wearable fitness trackers have so many people hooked that sales are expected to grow by 20% each year over the next five years. Yet, as is to be expected, the high number of sales among fitness trackers don’t reflect their potential pitfalls.

As Alissa Rumsey writes for U.S. News & World Report, “For some people, the devices can disguise — and fuel — unhealthy behaviors.” In an interview with registered dietician Rachael Hartley, Rumsey found that Hartley had worked with a number of clients whose eating disorders started with an innocent intent to track activity or calories using a fitness tracker, whether for weight loss or fitness purposes.

Unfortunately, turning health into a numbers game can quickly become a slippery slope for our mental health. Using a fitness tracker can turn a goal of losing weight or becoming fitter into an unhealthy obsession — especially for users who previously suffered from an eating disorder, many of whom report relapsing after purchasing a digital fitness tracker. Journalist and recovering anorexic Arwa Mahdawi has even dubbed this phenomenon “techorexia.”

And for all the good they do, research conducted at Stanford University suggests that fitness trackers may not be completely accurate. While six out of seven devices measured heart rate within 5%, none were able to match calories burned while exercising. According to a report written by Stanford Medical School, the fitness trackers some people are using to make important life decisions are off by as much as 93%!

Fitness Trackers and Eating Disorders

Despite their benefits, it’s easy to see how, in the wrong hands, fitness trackers can fuel an unhealthy obsession with numbers that can easily deteriorate into an eating disorder. But is it possible to know whether a fitness tracker will affect you this way — or whether the positives will outweigh the negatives — before purchasing?

What Causes an Eating Disorder?

Despite the strong correlation between excessive fitness tracker use and disordered eating behaviors, studies have yet to conclude that fitness trackers cause eating disorders. In fact, for many people, fitness trackers can be helpful additions to their lives, increasing their physical activity, helping them maintain a healthy weight and even prompting them to take part in stress-reducing techniques like mindful breathing.

So, if fitness trackers don’t cause eating disorders, what does? And how do fitness trackers trigger those characteristics in some users, but not others? Today, the most widely accepted model of psychopathology — or the study of how mental illnesses develop — states that no one cause leads to the development of mental illness.

Instead, mental illnesses develop at the intersection of multiple environmental, biological and sociocultural factors. According to this model, the use of fitness trackers can be considered an environmental cause that combines with other factors to trigger an eating disorder in people who are already at high risk.

Can I Wear a Fitness Tracker in Eating Disorder Recovery?

Given the risks associated with wearing a fitness tracker, patients suffering from eating disorders (or who have suffered from an eating disorder in the past) may want to avoid purchasing and using a digital fitness wearable.

During weight restoration and the first months of treatment, patients should be especially wary of using a fitness tracker, since this could lead to relapse. According to a National Institutes of Health study conducted by Boston Medical Center Psychiatry, one-third of eating disorder patients experienced at least one full or partial relapse within 18 months of treatment. So, if you have a history of eating disorders, wait until you have passed this vulnerable period before using a wearable fitness tracker.

Is My Fitness Tracker Doing More Harm Than Good?

Fitness Trackers and Eating Disorder Behaviors

According to The Emily Program, an eating disorder treatment program affiliated with the University of Minnesota Medical School, participants in a study who developed an unhealthy relationship with their wearable fitness trackers displayed a number of disordered eating behaviors. Those behaviors included:

• Obsessive logging. Feeling an obsessive need to log every meal and challenging yourself to see how low your calorie log can get may signify a problem with disordered eating behaviors.
• Need for precision. Some participants reported the need to meet exact calorie goals for their day, and that this led to inflexibility — for example, not wanting to eat out with family members at a restaurant they didn’t plan on going to because they didn’t budget the calories for it.
• An acute awareness of numbers. Others said the tracking app made them equate food with numbers, and that they started counting calories, macros and other nutrients in all the foods they ate.
• Restricting calories. The app made some users feel they needed to restrict their calories to maintain control over their eating and avoid hitting their daily caloric limit.
• Manipulating the app. Some participants in the study even manipulated the app to lose weight in an unhealthy way — for example, not logging all of their daily exercise, because they knew it would exceed healthy limits. Others did so to avoid negative emotions — for example, not logging foods they ate because they didn’t want to feel ashamed for exceeding their daily calorie limit.
• Compensatory behavior. Much like a patient with bulimia would, some patients restricted calories on certain days to make up for exceeding their calorie budget on other days.

Optimistically, it’s worth noting that many users were able to recognize when their relationship with the technology had become problematic. During the course of the study, most patients who became distressed by their use of the fitness tracker decreased or discontinued use of the trackers altogether, without the need for therapeutic intervention.

Signs Your Fitness Tracker Use is Becoming a Problem

Some signs of an unhealthy relationship with your fitness tracker, like the ones detailed above, are clearly disordered behaviors and may be easier to spot. Other signs of a potential problem, according to Hello Giggles and Prevention, may be less obvious, including:

• Obsessively talking about the tracker or about daily caloric, exercise or step goals
• Frequently checking the wearable or app to ensure they will reach these goals
• Clear anxiety over the numeric data collected by the tracker, such as calories or steps
• Skipping social events due to the presence of “unhealthy” foods or the need to work out instead
• Being constantly late because of trying to get extra steps, burn extra calories or take additional measures to ensure daily fitness tracking goals are met
• A warped mindset or relationship with food — for example, that exercise or food does not count if it is not tracked, or that certain foods are “bad” because they are high in calories

Many people use fitness trackers to lose weight, perhaps even on a medical professional’s advice. It’s important to remember that weight loss does not equal health — and that being “overweight” does not equal a lack of health. If you notice you are developing a disordered relationship with food or exercise after using a fitness tracker to lose weight as advised by a medical professional, you may want to switch to seeing a certified Health at Every Size practitioner, who will measure your health against lab values and other standards rather than your weight.

If you are struggling with your body image and looking for a way to manage your relationship with food, you have options. You have The Meadowglade. We’re open 24/7 and we’re open for tours. We offer free consultations to help potential clients discover how we can help them. Contact us today so we can help!