A decade ago, when Francesca Baker-Brown was 27, her anorexia became so severe she was hospitalised for 18 months, and afterwards on bed rest for a long period until she recovered. She had struggled with exercise addiction and disordered eating since she was just 19 years old, but this relapse was so severe she also had to move back home with her parents. In the years since, Baker-Brown, a communications consultant from East London, has built up her career and married and felt in more control of her health.
But then she hit stumbling block: she began downloading health and wellness apps to track her exercise performance and calorie intake. “I just become obsessed and I can’t stop monitoring,” she says. At her worst she was using a phone-based stepometer, inputting every food she ate into a diet tracker app, tracking her daily runs, and wearing a wristband all day and night to monitor her bodily functions, such as heart rate fluctuations and sleep quality.
Eventually she realised something had to change, particularly when it came to tracking her nutrition. “Deep down I know that you don’t know exactly what’s in your food; one apple is different to another. It just feels like another way for people to beat themselves up and hyper fixate,” she says.
Through her doctor and employer, Baker-Brown was able to access private counselling and has now reduced how many apps she uses. Her case might be extreme, but the rise of health apps isn’t always leading to improvements in our wellbeing. In fact, the hyperfocus on our own physical state they encourage is actually leading to declining mental health for some users – and with so many people logging and tracking their every move, these negative effects are becoming a social problem.
Over the past five years, the popularity of health and fitness apps has grown significantly – almost doubling since the beginning of the Covid pandemic. The health app industry is one of the fastest growing tech sectors, generating $3.43 billion in 2023 according to consultancy firm Business of Apps – an increase of 10 per cent on the previous year. There were 311 million health app users in 2023 and people in the UK are among the most dedicated health watchers. As a nation we rank sixth in the world for health and fitness app downloads, according to data analysis by Healthnews.
Our obsession is being fuelled by the level of detail these tools can provide. The evolution of smart tech – such as skin-prick testing or temperature and heart rate monitoring – means that apps can now measure and chart some of the more obscure functions of the body such as glucose tolerance and fertility levels, previously the preserve of medical professionals. The problem is, we don’t have the training to understand them and can become very concerned by fluctuations in our readings which do not indicate any physical problem.
Psychologists warn the problems some users are recording are not physical, but signs of a growing health anxiety among the “worried well”. Psychologist and therapist Barbara Santini, whose work involves how technology impacts on mental health in relationships and the workplace, has observed a trend in which use of wellbeing apps leads to heightened health anxiety and an unhealthy focus on bodily functions.
She says: “Many of my clients find themselves caught in a cycle of constant self-monitoring, which paradoxically may detract from their overall wellbeing. This hyperfocus can escalate to a compulsive need to control or adjust these metrics, leading individuals to perceive problems where none exist, driven by the data provided by their devices.” She advises those caught in this cycle to try cognitive behavioural therapy to challenge the “catastrophic predictions about their health” that can arrive from misinterpreting this data.
Ruby*, a 35-year-old copyeditor from South London, first began using an app (which tracked her sleep, activity, temperature and variable heart rate) to monitor a long-term health condition and found it both useful and reassuring to understand how well her body was responding to treatments. Then she started trying to conceive a baby, and used it to follow her menstrual cycle more closely.
“I liked that I had a visual representation of my temperature cycle throughout the month for my periods and having access to the constant stream of data was positive for my mental health at first. It reassured me everything was working,” she says. “But then I became obsessed over whether my temperature was rising after ovulation – a sign that a conception has occurred. I spoke to a lot of doctors about it and they explained it wasn’t a perfect science, but the constant tracking made trying to conceive hugely more stressful.”
Ruby sought multiple fertility checks from private providers, fearing that her or her partner were suffering infertility, even though they’d only been trying for a few cycles. She went on to have a miscarriage, which only deepened her anxiety when she conceived for a second time. “I noticed a huge temperature dip which correlated with the timings of when the sonographer said the heart would have stopped beating. It meant that when I later became pregnant again I was obsessively tracking my temperature. If it dipped it caused huge anxiety. I had access to the data that I didn’t really know how to apply, or even how accurate it was. I had to take a step back,” she says.
The mental-health impact of these apps is starting to hit the NHS. A 2017 study by the National Institute for Health Research found that tackling health anxiety could save the NHS more than £400m a year, labelling many patients as suffering from “cyberchondria”. As early as 2018 the Royal College of Surgeons was warning that health tech could lead to increasing demand for NHS service from patients tracking their bodies and finding problems that weren’t there.
Amanda Azzopardi, a nurse who now works in aesthetics, sees a lot of clients who use multiple wellbeing apps and are concerned about data or symptoms that are quite normal. “If a parameter shows slightly high or slightly low on the reading this may instigate an appointment or a checkup at the GP, putting undue strain on the NHS, when this reading may be normal for that person.”
Relationship psychotherapist Claire Law says those people who realise they are in a cycle of anxiety about health data must step back. “Remind yourself these apps are just tools. They’re there to help you, not to rule your life,” she says. Law recommends setting personal limits on how often you check them, and if that doesn’t work take a break from them altogether. “It’s important to tune into your body naturally without letting the data dictate your every move,” she says. “Your mental health is just as crucial as your physical health.”
Sonia Ponzo, a 35-year-old entrepreneur, fell in love with running and began to track her workouts. Then, in her words, “things got complicated”. “Running became a competitive and unhealthy addiction. I became obsessed with my pace and distance, constantly sharing and checking stats on social media. Whenever my fitness watch indicated a drop in performance, I felt down. Seeing others’ runs triggered feelings of inadequacy, and I often finished runs feeling sick and nauseous from excessive effort,” she says.
Her obsession led to overtraining and two serious injuries requiring months of physiotherapy, followed by a descent into depression. “I still remember coming home from a run, limping, wearing sunglasses to hide my tears, and yelling at my body to “do its job.”
Running had restored her physical health but broke her emotionally. She took a step back and then founded her company, Outset Wellness to design an app with the aim of making exercise more accessible and enjoyable, rather than competitive. The platform, which launched this month, syncs calendars, adapts to the weather and learns from past data what works to make users feel well after exercise, not just their physical performance. “I realised my body was doing its job by forcing me to listen to it,” she says. “The real issue was the excessive focus on metrics and performance.”
