Last week my Garmin smartwatch gave me an update after a week of strength workouts, bike commutes, and two runs: “Training Status: Unproductive.” Subjectively I had been feeling pretty good, fitting in so much exercise despite a busy week. And yet, here was my watch, crunching thousands of data points into a single demoralizing status. I felt unfairly judged. Or was the watch onto something? Was I really training ineffectively? Or are these devices that promise optimized training plans and inevitable personal bests actually counterproductive, especially when their feedback starts to affect our mood, motivation, and mental health?
25 Years of Wearables
I am not a Luddite when it comes to wearable technology. I was marathon running with a Polar heart rate monitor back in the early 2000s, with an awkward chest strap and no way to export the very limited data. At the time, this type of measurement was mostly reserved for serious athletes. Eventually I upgraded myself to a Garmin GPS that was absolutely massive – but it could track so much running data! But these devices were strictly for workouts only.
The first mainstream consumer tracker, the Fitbit, launched in 2009. Since then, wearable fitness devices have exploded in popularity, promising to help us “optimize” our workouts and our lives with real-time feedback on everything from heart rate and sleep quality to training load and stress levels. Millions of people now wear devices like Garmin, Fitbit, Oura and Apple Watch not just to count steps, but to establish training schedules, monitor our sleep “quality”, and track our recovery. The appeal is obvious: objective data, personalized recommendations, and a sense of “control” over our health. But as these tools become more sophisticated and prescriptive, questions have been raised: How accurate are these devices? Is the advice they provide evidence-based? And to some, could all this tracking and data do more harm than good?
The Optimizer’s Curse
For some users, wearables have shifted from helpful tools to relentless performance auditors. Reddit is filled with posts from people who feel anxious when their heart rate spikes unexpectedly, guilty for missing step goals, or demoralized by poor “sleep scores” despite feeling well-rested. A recent article in Vox, entitled, I covered my body in health trackers for 6 months. It ruined my life. describe one person’s negative experience:
In the six months I spent hooked up to every health tracker I could find, feeding my morbid curiosity, I drove myself slightly crazy. Each hit of dopamine I enjoyed by getting good scores on a health-tracking app was offset by long periods of self-doubt that came from not fully understanding how to make sense of the torrent of data without my doctor’s help. I also became obsessive — checking the apps was the first thing I did in the morning and started occupying hours of my day.
That’s the contradiction embedded in this cutting-edge technology: It can often lead to panic rather than peace of mind.
In some cases, wearables encourage healthier behaviors, motivating people to move more, sleep better, or pay closer attention to how their body responds to training. But for others the constant stream of biometric data can lead to anxiety, self-doubt, and stress. When a device tells you your body is underperforming, even if you feel fine, who do you believe?
What the Evidence Says (So Far)
There is research that shows wearables can lead to modest improvements in health behaviors, at least in the short term. And the evidence base is growing. Most clinical trials and systematic reviews have focused on chronic disease management, cardiovascular health, physical activity, and psychological well-being.
Wearable smartwatches are associated with improvements in physical activity, self-management behaviors, and some surrogate health outcomes. A 2024 systematic review of smartwatch interventions found positive effects on outcomes such as foot ulcer recurrence, depression severity, healthcare utilization, lifestyle changes, medication adherence, unplanned hospital readmissions, atrial fibrillation diagnosis, and goal attainment for emotion regulation. The most used smartwatch was the Apple Watch. However, the review noted that the number of high-quality studies is actually quite limited, with only moderate quality: most studies were small and of short duration.
Other studies have found that using fitness trackers is associated with increased daily step counts and higher physical activity levels. A few randomized trials have shown small benefits for weight loss or cardiovascular risk factors. Direct impact on measurements like blood pressure or cholesterol are not as consistent. Effects are often modest, and long-term adherence tends to decline over time. While wearable technology shows promise for improving certain health behaviors and intermediate outcomes, persuasive evidence for long-term clinical benefit is still lacking. As “they” say, more research is required.
Effects on Mental Health
While wearables may support healthier behaviors, their psychological effects are more complex. For some, tracking activity, sleep, or recovery provides structure and motivation, potentially reducing stress and improving self-efficacy. Wearables are now being studied for monitoring and early detection of depression, anxiety, and stress. It’s hoped the devices can support self-management, and reduce psychological distress.
However, there is also evidence of wearables being associated with overuse or obsessive tracking. In some, wearable data may contribute to health anxiety, compulsive tracking behaviors, and even negative or maladaptive compensatory behaviors (e.g., disordered eating). Data overload, and the potential for misinterpretation of health data may negatively impact mental health, particularly in those that may be vulnerable. Obsessively checking heart rate, sleep scores, or recovery status may aggravate stress, especially when the reports provided seems at odds with subjective experience. While there are lots of anecdotes online, the negative consequence of wearable technology have been understudied.
Tools and Not Judges
While writing this post, a friend of mine went into atrial fibrillation, and it was his smartwatch that alerted him to it. He was assessed at the hospital and when he converted back to normal sinus rhythm, his watch notified him first. He even sent me the ECG his watch had recorded. Thinking back to my early 2000s Polar heart rate monitor with such limited functionality, I’m amazed how far this technology has progressed. Much of it s genuinely impressive, and in some cases, even possibly lifesaving. But as wearable devices become more advanced, we still need to think critically about what they tell us. These devices can be helpful tools when thoughtfully integrated into our broader health goals. They may be crunching our data, but they aren’t infallible. And if the feedback begins to affect our well-being or mental health, it’s worth stepping back and remembering who’s supposed to be in charge.
