Once upon a time, the biggest threat to our health was that we didn’t think about it enough or make an effort to improve it. And really, that’s still a big problem. But with the rise of mobile technology, we've seen the emergence of a new problem: obsessing about health so much that it becomes unhealthy.
Orthorexia is, essentially, a fixation on being healthy that becomes so extreme that it can cause real physiological harm, and even death. It’s different from diseases like anorexia in that the person isn’t typically fixated on losing weight or being thinner. Instead, it’s about consuming the “right” foods, and eliminating anything that may be bad or toxic for you. That doesn’t sound so terrible at first glance, but it’s possible for it to spiral out of control, to the point where the person isn’t getting enough calories or nutrients.
Some people believe the rise of orthorexia (which is not yet in the DSM, the Diagnostic and Statistical Manual of Mental Disorders created by the American Psychiatric Association to guide diagnoses, and so the definition is still a bit amorphous) aligns with the rise of health-tracking apps and wearables because these devices constantly remind us of our health status, tracking our food, steps, and weight. That’s not entirely outside the realm of possibility, though we remain skeptical.
“These apps and devices are untested and unscientific, and they will open the door of uncertainty,” says Dr. Des Spence in a recent article for the British Medical Journal. “Make no mistake: diagnostic uncertainty ignites extreme anxiety in people.”
Spence’s concern is that fitness and calorie trackers will dramatically increase the number of those whom he calls “the worried well.” People who are perfectly healthy, but who worry to a disproportionate extent about the state of their health. These people typically flood doctors’ offices and waste a fair amount of everybody’s time. It’s not entirely unlike hypochondria, it’s just more specific. He continues, "our technologically advanced society is avoidant, fearful, insecure, and worried about anything and everything. We have an unhealthily health-obsessed generation who will seize on these new health apps and devices.”
Which, sure, sounds worrisome, but it’s important to note that there’s no evidence to show that this is happening. Taking the counter point in the same article is Dr. Iltifat Husain of the Wake Forest University School of Medicine. Husain argues that while there is little evidence suggesting that these apps and trackers can defeat the problems they purport to eliminate, there’s even less evidence that suggests that they do any harm. He also notes that it’s possible that using these apps may help users adhere to diets and exercise regimes, since we nearly always have a smart phones (and/or our wearables) on us.
“So yes," Husain says, "healthy people may well benefit from using some health apps, such as those that encourage more physical activity and better diet, but doctors need to be proactive about telling the public which metrics matter and which apps they should buy.”
So who should you believe, ultimately? We spoke to leading sports psychologist Michael Gervias and asked him to weigh in.
“Left to our own devises, for those who are highly competitive and slightly anxious, we might find ourselves overwhelmed by the amount of data that we now have access to,” Gervias told us. “It’s not the data that is the challenge, it’s the insight and skill of the user to (a) interpret the data, (b) properly and potently use the data to optimize thoughts and behaviors, and (c) let the data run in the background, while the user lives in the present moment… It’s not the data that triggers people to become obsessed, rather the obsession of the person to worry about how he or she might be (or not be) in the future.”
In other words, Gervias doesn’t think these apps and wearables are likely to cause orthorexia-like behavior, but he acknowledges that it’s a tool that could be used by a person who already has these obsessions. It’s a chicken-egg type scenario, except he sees a very clear answer as to which comes first: the obsessive behavior. “The essence of the technology interface begins with a relationship with oneself,” Gervias continued. “Those who have a healthy relationship with themselves, nature, and others, likely will also have a good relationship with the technology and information that they choose to entertain.”
Ultimately, our understanding of orthorexia and other such compulsive over-healthing is in its nascent stages. Until psychology experts can agree on a definition of it (or even whether or not it exists as a true disorder), it will be very hard to pin down what the root causes may be. It’s fine if you want to wear an Apple Watch or FitBit to help you manage your weight and exercise levels. Just don’t let yourself get too carried away.