Living the quantified self: the realities of self-tracking for health

The end of 2012 and the dawning of a new year brought with it a multitude of news reports and blogs on the phenomenon of the quantified self or using self-tracking tools for health promoting purposes. Much hype has been generated around ‘digital health’ or ‘mHealth’ technologies, or mobile digital devices such as smartphones and wearable materials with embedded sensors that are able to connect to device apps or websites and download the data collected. These technologies include thousands of health-related apps for smartphones, tablet computers and iPods that can keep track of the user’s food and alcohol consumption, physical activity, body weight, ovulation cycle, stress levels, mood, sexual activity and many other physical functions and habits. It has been argued that by using such apps the smartphone can become a ‘”soulmate device” that knows your body better than you know it yourself’.

There are also an increasing number of specifically designed devices such as the Fitbit, Jawbone’s Up, Nike Fuelband and Zeo headband and various brands of adhesive patches that are available for self-tracking. All of these are designed to be worn upon the body to automatically collect data on bodily functions such as physical activity, pulse, heart rate, body temperature, calories burned and sleep patterns. Some can be worn 24 hours a day to provide constant readings of biometrics. Digital body weight scales, blood oxygen saturation monitors and blood pressure monitors that link to smartphones are also on the market. To motivate users, some devices include ‘gamification’ strategies. These use built-in reward or docking systems so that points or real money can be collected or paid if various commitments (to regular exercise or weight loss goals, for example) are either met or unmet, as well as websites where one’s metrics can be compared competitively against those uploaded by other users.

Nike+ FuelBand

Nike+ FuelBand (Photo credit: LoKan Sardari)

The combination of New Year resolutions season, predictions for digital innovation in 2013 and the reporting of the new technologies that were showcased at the 2013 Consumer Electronics Show in Las Vegas has contributed to the recent intensified focus on self-tracking for health reasons. Self-tracking mobile devices, apps and gadgets were reported as the new way of ensuring resolutions to lose weight or engage in more exercise would be accomplished (see here and here). They were frequently mentioned in lists of trends to watch in digital health technologies in 2013 (see here and here). Weird and wonderful devices such as self-tracking devices for dogs to wear to monitor their exercise levels, smartphones that could detect bad breath and other odours and a ‘smart fork’ embedded with sensors that could warn people they were eating too fast all received media attention in the early days of 2013.

I have written elsewhere about the ways in which self-tracking for health and the quantified self movement may be theorised sociologically, drawing attention to some of the ethical, moral and political issues (see here and here for previous blog posts on the topic and here for a lengthy academic article). Little academic research has yet been published on how people are taking up this approach to health promotion as part of their everyday lives. But accounts are beginning to appear in news stories and blog posts that have begun to explore the lived experience of self-tracking.

On the positive side, several self-trackers have reported that they feel more in control of their health using digital devices and have argued that there are many benefits to quantifying the self. Many people have discovered that tracking of their food intake and body weight has allowed them to achieve weight-loss goals. One success story is that of Dan Hon, who has type 2 diabetes and uses the Nike Fuelband and the Fitbit to monitor his physical activity levels as well as a digital blood glucose meter and weight scales. He reported that the combination of these technologies had allowed him to reduce his blood sugar levels to normal and that he had ‘healed myself through data’ (see here for his story). Another user experiencing problems with sleep used a Zeo headband to track his sleep patterns and experimented with taking magnesium supplements, giving up caffeine and changing the lighting in his room to see which of these factors affected his sleep. Using the data downloaded from the headband he eventually worked out how to best achieve a good night’s sleep. Other people with a diverse range of health problems have used self-tracking devices to monitor medical treatments for acute diseases or chronic conditions, evaluate the moods created by eating certain foods, track their alcohol consumption  and many more aspects of their bodily functions, health and illness states. Patients have also been able to ‘crowdsource’ the data they have collected on websites such as PatientsLikeMe and CureTogether, allowing the massing of data for a better understanding of what treatments are effective (see here and here for overviews).

Image representing PatientsLikeMe as depicted ...

Image via CrunchBase

Also beginning to emerge are accounts by people who have tried self-tracking for health reasons but have become disenchanted with the practice. As these stories demonstrate, the realities of quantifying the self do not always meet expectations. The devices do not share data with each other, so it is impossible to track different activities using more than one device and then produce statistics that combine the data collected. Some users find them inconvenient or uncomfortable to wear. Some people quickly become bored with the effort involved in self-tracking. It has been reported that the devices are often not compatible with some types of smartphones.

Other users who have tried self-tracking for health have suggested that the intense focus on the body that these devices encourage may place too much pressure on oneself, leading to feelings of failure and self-hatred. It has been argued that intense self-tracking may cause ‘cyberchondria’, leading to people becoming unduly anxious about their health state based on the data they collect. Devices may be used by people such as anorexics to facilitate health-destructive behaviours by engaging in too much obsessive self-tracking. Activities such as walking may become viewed through the lens of the self-tracking device rather than for the other pleasures they may bring, as one commentator wrote of his experiences using a Fitbit while visiting Paris. As he noted, ‘the data mind is hard to shake’, even while immersed in the sights and sounds of one of the most celebrated cities in the world.

Privacy issues are a concern as more and more data are collected by self-trackers. The manufacturers of self-tracking devices are beginning to approach workplaces as a site for encouraging people to use them and compete against each other. There are concerns that people may feel pressured into using them to meet employers’ expectations and that employers may use the data. Other critics have questioned what may happen if health insurance companies begin to expect their clients to use the devices if they wish to avoid higher premiums (see here for an account of these issues). The quality and efficacy of health apps and their potential for harming rather than promoting users’ health have also been questioned, given that they are currently not regulated (see here).

Using digital devices to self-track for health reasons is a very new phenomenon. While stories such as those referred to above are beginning to identify both positive and negative dimensions, it is a practice that still requires much more investigation and analysis in the face of all the hype.

29 thoughts on “Living the quantified self: the realities of self-tracking for health

  1. I would be curious about how tracking affects people’s intrinsic motivation to do things like exercise and eat well. My cynical suspicion is that it would negatively impact it, in the long run, though I can see the usefulness of using tracking temporarily to look for a solution to a specific problem, like having trouble getting to sleep.

  2. Pingback: Living the quantified self: the realities of self-tracking for health | Health stats and digital health cornerstones | Scoop.it

  3. Pingback: Living the quantified self: the realities of self-tracking for health | The Sociology of the Quantified Self | Scoop.it

  4. “Other users who have tried self-tracking for health have suggested that the intense focus on the body that these devices encourage may place too much pressure on oneself, leading to feelings of failure and self-hatred. ”

    I 100% disagree! It would be the same to say if you start keeping track of your finances (e.g. how much money you have in your wallet) then it might cause depression or too much pressure on oneself. QS in your daily life is taking responsibility of your doings (eating, exercise etc) and by changing the bad habits you can loose the reasons what make you depressed. I would say that if being responsible about your own life puts you too much pressure then you have a problem.

  5. Pingback: Living the quantified self: the realities of self-tracking for health | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

  6. Pingback: Living the quantified self: the realities of self-tracking for health | DbtMobile, le blogDbtMobile, le blog

  7. Pingback: Living the quantified self: the realities of self-tracking for health | Hopital 2.0 | Scoop.it

  8. Pingback: Living the quantified self: the realities of self-tracking for health - Hôpitalweb2.0 | Hôpitalweb2.0

  9. Pingback: Living the quantified self: the realities of self-tracking for health | E-santé, m-santé, suivi du patient & quantified self | Scoop.it

  10. Pingback: Living the quantified self: the realities of self-tracking for health « E-santé, m-santé & quantified self

  11. Pingback: Living the quantified self: the realities of self-tracking for health | Digital et santé | Scoop.it

  12. Pingback: Living the quantified self: the realities of self-tracking for health | Self-care and self-management | Scoop.it

  13. Pingback: Living the quantified self: the realities of self-tracking for health | SelfOmics | Scoop.it

  14. Pingback: Living the quantified self: the realities of self-tracking for health | E-Pochindriac | Scoop.it

  15. Pingback: Living the quantified self: the realities of self-tracking for health | le monde de la e-santé | Scoop.it

  16. @ Karoli and others, people may ‘have a problem’ but whose problem is it?

    One of the flip sides to framing health and wellbeing in terms of individual responsibility rather than, say, an issue of communal responsibility, is that it also tends to frame ill health in terms of individual culpability and blame. This is especially true in areas such as obesity.

    Ill health, or more worryingly ‘less-than optimal health’ is presented as an undesirable category of personhood and frames the individual who fails to meet socio-medical standards of health as at best irresponsible and at worst immoral. There is a serious danger in this approach of using the rhetoric of individual responsibility and informed choice to diminish, in practice, the range of socially acceptable forms of living.

    I am rather sympathetic to the probable unpleasantness of living in a society where health is raised to a ‘super value’ where every decision made during a day from how to travel to work in the morning to what to eat at lunch becomes a locus for informed health-conscious decision making which is then duly recorded and added to a lifetime repository of health information and used to calculate future health outcomes.

    A focus on individual responsibility/blame also ignores or pouts in the background alternative approaches such as much more stringent regulation of commercial food products to ban the production or sale of foods with dangerously high levels of salt, sugar, fat etc.

    • Thanks for your points, Michael. I have written extensively, both on this blog and in my publications in academic journals and books etc about the apparently inexorable move towards making the individual responsible for their health to the exclusion of doing something to address the social determinants of health. Thank you for highlighting these issues, which in my opinion are important ones.

      • Dear Deborah,
        I should perhaps have said that I am familiar with your academic work, although I have only recently discovered this blog. I’m definitely not trying to stea anyone’s thunder, but I have also been thinking about issues of increasing emphasis on individual responsibility in healthcare recently, primarily with regards to emergence of ‘personalised medicine’.

        I am an affiliate of the Health Technology and Society (HTS) research group at the University of Exeter, UK. Some of these issues are addressed in our most recent report (specifically p34-40) which is freely available from the following web-page: http://socialsciences.exeter.ac.uk/sociology/research/healthtechnologyandsociety/launchevent/
        [under the ‘Additional Resources’ section]

  17. Woah. Such an interesting post, particualrly your brief note about health insurance, which I’ve never thought about before.

    I do love tracking my running on runkeeper (and using my garmin GPS watch) – it encourages me to run, and I can match performance against goals, and also interact with other people interested in running. I’ve lost 10kg just through being obsessive about data mining.

    I think the positives, for the time being, outweigh the negatives, but really enjoyed this post.

  18. Pingback: Living the quantified self: the realities of self-tracking for health | Patient Hub | Scoop.it

  19. Pingback: Living the quantified self: the realities of self-tracking for health | Digital_Lifetime | Scoop.it

  20. Pingback: Moving attachments: our emotional relationship with mobile digital media technologies | This Sociological Life

  21. Pingback: Living the quantified self: the realities of se...

  22. Pingback: Living the quantified self: the realities of self-tracking for health ← Msante & Quantified Self

  23. Pingback: What We Are Reading | Quantified SelfQuantified Self

  24. Pingback: The rise of the quantified self as a cultural phenomenon | This Sociological Life

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s