Is the 'Nocebo Effect' Hurting Your Health Goals?

Is the 'Nocebo Effect' Hurting Your Health Goals?

Photo: Jacob Lund (Shutterstock)

Many of us have no problem checking in on the status of our New Year’s resolutions to “walk more” or “sleep better,” and it’s all thanks to our trusty Fitbits, Apple Watches, and other wrist-sized fitness gadgets. At any moment of the day, you can look to your wrist and have access to your health data. And if you don’t have the instinct to check, chances are your smart watch will–ding!–send you notification after notification to remind you.

When it comes to your physical health, these gadgets are helpful for providing a snapshot of your daily activity levels, sleep habits, and so on–but at what cost to your mental wellbeing?

You know about the power of the placebo effect, wherein the mere belief that your wellbeing is improving can actually result in physical improvements. Your mind can be a powerful healing tool. On the flip side, your mind can also be a powerful force of relentless anxiety. If it feels like your fitness gadget is causing more harm than good to your mental state, here’s how to manage the “nocebo effect” triggered by the device strapped to your wrist.

What is the nocebo effect?

Whereas placebo comes from the Latin for “I shall please,” nocebo is Latin for “I shall harm.” Research on the nocebo effect has shown the many ways that the expectation of side effects leads to them being experienced. More specifically, the nocebo effect is typically used in clinical settings to describe the phenomenon of patients report feelings of pain due to the expectation that painful side effects will occur.

Earlier this month, Tim Culpan argued in Bloomberg that the nocebo effect helps explain what goes on when we keep looking at our wrists and expect to see failures, insufficiencies, and red flags.

Non-stop tracking leads to anxiety

Call it the nocebo effect, “Fitbit anxiety,” or some other term to describe the mental stress of round-the-clock fitness-tracking. As Culpan puts it, “We want to believe that technology can forewarn us of dangers and risks. We’ve come to depend on the devices on our wrists to constantly flag us about our physical and mental health.”

What it comes down to is the fact that notifications to “get moving!” will often lead to a sense of expectations or obligation, which can trigger very real anxiety. Think about the pressure to achieve 10,000 steps a day: It’s a totally arbitrary goal, yet even if you’re getting a perfectly healthy amount of steps in your day, you feel bad when you see that you failed to reach your Fitbit’s lofty goal.

Outside of feelings of perfectionism, research shows that there are potentially dangerous consequences to patients relying on smart watches to gauge their health. A 2019 study about how patients with heart disease experience self-tracking activity data found that, overall, ”self-measurements are more problematic than beneficial.” In the study, patients didn’t receive any help interpreting their watch data, just as how the average Fitbit or Apple Watch user doesn’t consult their doctor on a daily basis. n the Journal of Medical Internet Research, Tariq Osman Andersen, one of the researchers behind the study, notes that when patients were (literally) left to their own devices, their interpretations made them “unnecessarily anxious” or led them to come to conclusions that were “far from reality.” For example, if they saw that they weren’t sleeping as much as they should be, they became uncomfortable and feared that the data showed they were exacerbating their illnesses.

Unsurprisingly, the research above revealed that when patients did not reach the recommended 10,000 daily steps, many reported feelings of guilt—even though their doctors would tell them that number is, again, completely arbitrary.

“Have you closed your rings today?” 

An important fact to keep in mind is that the apps strapped to your watch are designed as consumer devices, not clinical devices. As Victoria Song points out in The Verge, “modern wearables are fundamentally centered around building and maintaining streaks.” This sort of gamification is a pretty effective tool to get you hooked to their product, but it isn’t a substitute for talking with your doctor.

This doesn’t mean your fitness device is bad. I’ll say it: I love my Apple Watch. Honestly. Sure, I know firsthand how addicting, discouraging, and anxiety-inducing the daily data can be. But I also know some tools to manage the nocebo effect from taking root.

How to manage fitness tracker anxiety

You don’t have to toss your gadgets just yet. A lot of fitness apps and gadgets have recognized the negative mental effects they can have. For instance, Fitbit has made moves away from its arbitrary 10,000-step goal toward a broader metric called Active Zone Minutes (AZM), which focuses on weekly activity level, as opposed to daily streaks.

Ironically or not, Fitbit features the ability to track your stress levels. Exercise caution if the sight of high stress levels makes you stressed, which you log, which makes you more stressed, so you log high stress again, which makes you even more stressed–you get the picture.

Otherwise, the right move for you might be to turn off notifications and the setting that lights up the screen every time you turn your wrist over. This way, you can have more control over when you actually want to access the data on your wrist.

You could also set times to remove the watch according to your goals; e.g. making sure a round of drinks with friends doesn’t get interrupted by your watch telling you that you need to take 500 more steps today.

The bottom line

It’s clear that the purpose of fitness trackers to help you achieve your goals can be overrun by the negativity of less-than-perfect feedback. We know the power of your mind when it comes to physical health, so try to harness that power for good.

If you decide to wear a fitness gadget, it should make you feel proud of the work you’re putting in–not disappointed in the perceived failures. Don’t sacrifice your mental health for 10,000 steps.

 

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