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Why the NHS should prescribe wearable fitness trackers

The quantified self. Andrey_Popov/

It’s not yet clear whether wearable fitness trackers, such as Fitbits, Jawbones and Microsoft Bands, really do encourage us to become healthier over the longer term. They might make us move more and eat healthier in the first few days of strapping them around our wrists, but how long before the novelty wears off?

From my own experience of using these gadgets for research purposes (over nearly two years now), I must confess that using them is a bit of a chore. Still, when I’m wearing one I use the stairs instead of the lift, park further away from places so I have to walk, and I sit less and eat less. This takes effort and willpower. But, by reaching daily activity targets and measuring my progress, I have improved my body mass index (BMI), I feel healthier and I am fitter. Even when I’m on holiday, I force myself to wear one. Why? Because I am overweight and I am not motivated enough on my own.

My self-experimentation aside, the benefits of using wearable fitness trackers are not well understood yet. That’s maybe because they’ve only been around a few years, so it’s early days in research terms. And while the physical results that individuals experience as a result of wearing them might show promise, the benefits are not necessarily applicable to everyone.

The appeal of wearable fitness trackers, and their cost (they range from tens to hundreds of pounds a piece), mean that current use is largely among the “worried well”, “fitness geeks” or “quantified selves” (people who use technology to track all aspects of their daily lives with the goal of self-improvement). In other words, those who want them rather than need them. But what if these devices could really make us all healthier?

Fitness trackers could prevent this. gmstockstudio/

The NHS is already exploring the potential of various innovative approaches to reducing our expanding waistlines. In some areas, financial incentives, free access to dieting clubs or exercise classes are offered to encourage people to address poor diets and inactive lifestyles in the “war on obesity”. Might it be time to investigate the feasibility of wearable fitness trackers, too? Going by my own experience of using them – which is very much self-imposed – I wonder whether widening accessibility might attract and encourage a wider section of society to commit to trackers and reap the same benefits I have.

Obesity is strongly linked with poverty and low educational attainment, so we might assume that many of those at risk would not be your typical fitness tracker consumers. But if fitness trackers were made available through health services, like the other options are, they could have the potential to improve eating habits and increase activity for those who need encouragement most.

The Medical Research Council provides guidance on how to develop and evaluate new strategies to improve health. But these take time and it seems a shame that our health services are not exploiting current trends in self-tracking. The NHS already offers advice on wearable fitness gadgets to potential wearers – why not the devices themselves?

An ounce of prevention

My recent research found that the NHS has started to use new technologies for lifestyle management. But it seems that their use is mostly for people who have already developed chronic health conditions, including type 2 diabetes (which can be linked to obesity), rather than to target disease prevention. Are we missing an opportunity?

There are research gaps around the everyday impacts of using these devices on people’s lives – will they become addicted, will they get tired of self-monitoring – and some concerns about how wearable fitness trackers might negatively affect our relationship with our doctor, for example by replacing face-to-face contact with machine interactions.

There are also issues around information, surveillance and privacy, and the lengths to which, if we use NHS-provided tech, our data might be used against us if we don’t comply with recommendations about healthy living. But, at the moment, these fears could be allayed by the simple offer of a wearable fitness tracker on the same terms as any other prescription.

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