This shouldn’t come as a surprise to most readers of American HealthScare, but 2 recent studies found that wearable fitness bands did not improve outcomes.
One was a study comparing 4 incentives to increase physical activity: Fitbit Zap activity tracker, tracker plus charity incentives, tracker plus cash incentives, and a control group. After 6 months, the tracker plus charity or cash groups showed more physical activity. The tracker alone was not different from the control group. At 12 months when the incentives stopped, there was no difference between groups. There was no difference in health outcomes at any time (weight, blood pressure, etc.).
The other was a study of “wearable technology.” Both groups got extensive counseling and telephone support. One group added the wearable technoglogy at 6 months and the groups were followed for a total of 2 years. As usual in these types of studies, the overall average weight loss was modest, but the wearable technology group did not lose as much weight as the control group (3.5 kg vs. 5.9 kg).
Why did this happen? One of my family medicine residents told me how he will allow himself to eat more if he knows he achieved a certain number of steps in a day. I suspect this and similar stories drove the outcomes in these studies.
The bigger picture issues are twofold. First, more information often does not lead to better health outcomes. Another example in this category is the doctor who keeps ordering CT scans, MRIs, and chem99 panels because he is uncomfortable with uncertainty and hopes that more information will provide more insights than he currently has. Second, the obesity problem in this country, and other places in the developed world, are not problems for the healthcare systems to solve. They are a result of infrastructure and attitudes of the populations, crossed with crazy incentives such as subsidizing sugar-producing crops. Physicians should report to the policy makers the health consequences they are seeing in their offices. It’s up to policymakers and the American people to make the necessary but painful changes to fix the problem.
The first year that I had a fit band around 2008, I walked more because I wanted to get the prize for an average of 10,000 steps a day. Later, under a retirement medical insurance program from a different former employer, I wore a Fitbit for several years. My only reward was lower insurance deductibles but the steps required was easily met partially because I have been more physically active in retirement than I was at my former engineering desk job.
Amen! For 20 years I have urged my patients to eat a well balanced diet and exercise 30 minutes daily but to no avail. I started a nutrition challenged in January this year with my work out group. I started the Zone diet and exercise (both cardio and strengthening) and decreased my body fat from 30% to 23%. I feel like a million bucks but I can’t get my patients to realize how much fun my diet and my exercise are with my work out buddies. This is something I did for myself not for any one else. The majority of my patients’ BMI is over 35%, they sit all day and never exercise, they think fast food is a staple. I don’t know how to reach them.