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Co-workers, friends, and strangers showered Kaila Prins with praise. She packed nutritious lunches every day, never missed a workout, and was totally devoted to her pedometer, calorie counter, and health apps. What her community saw was a woman totally committed to her health, but in reality, she was battling an eating disorder and exercise addiction.
Prins, who lives in San Jose, had dealt with such issues for most of her adult life. But in the past, it was clear to her when restricting calories had become a problem. This time, things seemed different, and it took a while for her to realize that her strict dedication to health tracking was a quiet sign that her problems had resurfaced.
Prins, now 30, started using a calorie counter in 2009, calculating exactly how much she ate every day and formulating strict meal plans. During the following years her tracking intensified when she added pedometers and smartphone health apps to the mix. She ended up with symptoms of orthorexia and anorexia. Orthorexia is defined as a “fixation on righteous eating,” and although it’s not currently categorized as a clinical diagnosis, many people experience aspects of it, like obsessing over food quality and portion sizes and punishing themselves for slip-ups, according to the National Eating Disorders Association. (Here are five eating disorders you've never heard of.)
Sure, she had lost a large amount of weight since she started using health trackers, but she thought she was doing OK because she was eating regularly and everyone commended her on how healthy she was being. “I ate six meals a day, but they were all perfectly-portioned," says Prins. "I didn’t know I had an eating disorder or exercise addiction because it didn’t look like what you might see on TV.” When she finally sought help, she was diagnosed with "eating disorder not otherwise specified" and later anorexia.
“I used food as a way to control my emotions, and the tracking apps were an excuse to lean into my exercise addiction and my eating disorder,” says Prins. Her tracking habit became so all-consuming that other pillars in her life crumbled.
“I ended up with no friends, dropped out of my graduate program at Columbia University, became an absolute terror to anyone who tried to disrupt my schedule, and sunk into suicidal depression,” she says.
Finally, an ankle injury—caused by running four miles daily as part of a tracking challenge—forced Prins to make a change. After taking disability leave from her job and undergoing two surgeries, she slowly separated herself from her pedometers, calorie counters, and social media-connected tracking apps. “I had to do a lot of work,” she says. “I started tapering off, and thinking, what if I only count calories one day this week? Or what if I don’t get rid of my FitBit, but I just keep it in my nightstand?”
As she weaned off the trackers, Prins took dance lessons so she could associate fitness with something fun rather than extreme exertion and dieting. Although Prins is now doing well—she eventually became a body image coach—her story exposes the vulnerability many people may have to compulsive behaviors when using health trackers.
“Though these devices don’t necessarily cause compulsive behavior, they can certainly be a potential vehicle for it,” says Gail Saltz, MD, an associate professor of psychiatry at the NewYork-Presbyterian Hospital Weill-Cornell Medical College. “Obsessive health tracking is not unusual for people who have a tendency toward obsessive compulsive disorder (OCD) or anxiety.”
Of course, tracking isn't all bad. It can provide the motivation and accountability many people need to become less sedentary and lose excess weight. But for those prone to obsessive thoughts and behaviors, the same tools can turn dangerous. How do you know if you've crossed the line? Read on for signs that you may be taking your pedometer checking, calorie counting, and other health tracking too far.
Jonathan Jordan, a personal trainer based in San Francisco, often has the frustrating task of asking clients to stop fiddling with their wearable trackers during sessions.
“Some people use the data from trackers to make positive changes, but I get a red flag if someone looks at their tracker, sees that their heart rate or step count isn’t where they want it to be, and starts getting anxious,” says Jordan. “It’s unhealthy when people look at their tracker as though their boss just sent them an email saying they’re in trouble.”
Mental health issues aside, focusing more on the tracker than on your actual workout can interfere with your progress (and that's just one of many mistakes that can hinder your results.) “One client insisted on keeping his data on his phone visible when he was exercising, which slows a workout down,” says Jordan. “If you become obsessed with the data, it can pull you into your device and away from your exercise.”
When you depend too much on data to reward you for meeting a goal, it can start to feel as though you need proof of accomplishment for every workout or healthy food you eat. Although it’s natural to feel a little annoyed if your tracker is malfunctioning and not recording your hard work, it shouldn’t give you major anxiety or ruin your entire workout.
“If clients have to have their tracking devices out during a workout, it tells me that they believe if it’s not being tracked, it doesn’t count,” says Jordan. “If you look down and see your tracker is not calculating your work, and you have a panicked reaction to that, it’s a sign of something unhealthy. These things are supposed to encourage movement and make us healthy, not be a source of stress.”
Of course, sometimes it may be best to say “Next time!” to happy hour so you can squeeze in a workout you’ve been neglecting or prep food on a Sunday night. But if you’d always rather workout than see a friend—or you refuse to set foot in a restaurant lest it ruin your careful calorie counting—it could be a sign your tracking is starting to take an unhealthy turn.
“That type of behavior is a compulsion to try to manage anxiety someone is having about their body, their health, fending off disease, or relieving disease,” says Saltz. “There’s a dividing line between ‘I should do these things because I want to be healthy,’ and ‘I can’t not do these things, and I have to do them to the detriment of my life.’ If you can’t get together with family or friends because you must run a certain number of miles and it can’t wait, it has gone too far.”
When someone is obsessed with health tracking, meeting the goals on their trackers takes priority over just about everything. Not only may this manifest in cancelling plans with loved ones, but you may find yourself late to important appointments or work in the morning because you need to weigh your food, fit in an extra mile on your run, or pace your kitchen to reach a certain number of steps.
“You know it’s gone too far if it impeaches significantly on your ability to function in other ways, such as getting out the door on time,” says Saltz.
Today, health trackers can test BMI, sleep cycles, calories burned, and much more. It certainly can be interesting information to have on hand, but if you track everything you can and view that data as indisputable medical information, you may be placing too much value on it. Even top-of-the-line trackers have a margin of error: One study from California State Polytechnic University, Pomona, found that Fitbit trackers could miscalculate heart rate by up to 20 beats per minute. (On the flip side, this woman's fitness tracker helped save her life.)
“Some people think the data is gospel, and don’t have a true grasp of its accuracy,” says Jordan. “These are not medical-grade devices, and they’re designed to give you a large picture of trends over time. If you try to give it a level of accuracy it doesn’t have, you get too hung up on that data, and that can be unhealthy.”
Jordan recommends not tracking larger health markers, like body fat percentage, every day since these values take longer to change (and seeing no change can be frustrating and discouraging). Instead, focus on eating right, exercising, and check larger markers every 4 to 6 weeks.
Do any of these these signs sound familiar? Saltz recommends people who find themselves obsessing over health data try to slowly decrease the frequency in which they use trackers. “Don’t wear a tracker for just a few days,” she says. “Allow yourself to see that the anxiety will be there, but it will dissipate over time, and you’re still OK.”
If you attempt to cut back but find that you can’t, see your doctor or a mental health expert to get to the root of this compulsive behavior.