Wellness Tech: Don’t Use as Directed

The Great Technology Plan for Wellness, to simplify only slightly, envisions a path to health that runs through data: collect more (through wearables and blood tests), analyze with AI, and deliver personalized coaching that improves as the data grow and the models sharpen.

It sounds sensible, and one day it may even deliver — I’m long-term optimistic.

But today it seems largely precision health theater; our ability to offer advice that is both meaningfully personalized and scientifically valid is remarkably limited, as Kevin Hall persuasively demonstrated in the case of continuous glucose monitors for non-diabetics (the instruments are unquestionably valuable for those with diabetes).

In fact, if you use tech wellness platforms as directed — intensively pursuing metric maximization — there’s a decent chance you’ll wind up feeling worse. A slew of adverse consequences are starting to be described, from orthosomnia (trouble sleeping because you’re obsessed with sleep metrics) to orthorexia (the obsessive pursuit of “perfect” eating). A New York Times feature introduced us to “Oura paranoia,” a debilitating obsession with the data from your wearables; one user described it as a constant effort to hit metrics in order to “make the ring happy.”

Or consider how Rachel Feinzeig described her time on her exercise bike: “I get on my Peloton and am confronted with a veritable dashboard of my inadequacies: cadence (sluggish), resistance level (embarrassing), output (am I even alive?).”

Do these platforms actually enhance health? So far, the data aren’t compelling. Several comprehensive academic reviews — one in 2022, another in 2025 — found solid evidence of wearables increasing physical activity (slightly), but mixed results on actual health impact.

If there is a benefit, it may come not from data-driven optimization but from the effect of these platforms on mindset — the degree to which they reinforce your sense that you’re the sort of person who cares about their health, and supply dynamic visible evidence of your commitment to it.

Mindset Matters

Mindset, as a mechanism, is surprisingly powerful. A classic 2007 Harvard study examined hotel workers who viewed themselves as doing very little activity. One group was told (accurately) that their daily work already met the criteria for an active lifestyle; the other was told nothing. Four weeks later, the informed group had significantly reduced their body weight, body fat, and blood pressure compared to the control group — apparently driven simply by the shift in mindset, since their actual activity did not change.

The impact of self-belief shows up at the population level too, across a much longer horizon. Examining national samples of over 60,000 adults followed for up to 21 years, researchers found that people who believed they were less active than others their age were far more likely to be dead at follow-up — even after adjusting for a range of risk factors, including actual activity. Believing yourself sedentary independently predicted earlier death, even after accounting for how much you actually moved. To be clear, moving more genuinely is associated with better health; the surprise is that mindset adds to it, independent of the activity itself.

A large CVS/Aetna analysis points in the same direction. Members enrolled in a wearable-and-incentive program incurred in the first year roughly $10 less in monthly medical spending than matched non-enrollees — and the savings came almost entirely from fewer non-emergent emergency room visits and reduced specialist and mental-health visits. That looks less like bodies that grew healthier than like people who found themselves in a better headspace and made different decisions about when and where to seek care.

But belief cuts both ways. In a 2023 study, people wearing an Apple Watch received manipulated feedback about their walking: one group saw a step count deflated by 40%, another saw it inflated by 40%, and a control group saw the truth — about 7,000 steps for all of them, well above the US background level of around 4,000. Compared to controls, the deflated group (seeing ~4,200) ate worse, felt worse, and had higher blood pressure and heart rates after four weeks. The inflated group (~9,800) didn’t differ from controls — probably because 7,000 and 9,800 read as much the same, while 4,200 reads as meaningfully low.

What stands out is what didn’t move. The belief reliably changed how people felt, what they ate, and how their bodies registered — heart rate, blood pressure — while the walking itself stayed essentially flat. The mindset shifted; the behavior it was ostensibly about did not follow.

The sports performance literature, by contrast, is replete with cases where inflated feedback shifts mindset and behavior together. Endurance runners given fake EPO ran measurably faster; runners told (falsely) they’d scored above average lifted their VO₂max on retest; cyclists on placebo ergogenics produced measurably more power — gains generally in the 1–5% range. Inflated feedback seems to work when it targets a salient, actionable performance gap, which “7,000 versus 9,800 steps” apparently wasn’t.

Mindset, then, reliably moves how you feel, how you eat, and how your body responds. Whether it moves what you actually do is a separate question — sometimes it does, as the large wearable reviews and the sports studies show, and sometimes, as with those manipulated step counts, it doesn’t. A changed mind doesn’t automatically become a changed life, and belief still has to be translated into durable action.

The initial challenge is how to influence mindset — which is where Dr. Peter Attia, author of Outlive, joins the story. Attia, as best I can tell, has motivated far more people than the many sensible physician- and scientist-authors who urge readers to eat deliberately, move joyfully, and connect with others — exactly the right advice. Attia urges much the same thing, but wraps it in exceptionally specific, detailed protocols, a concrete, actionable-sounding roadmap that gives people something to grip in a way the other authors, very reasonably, do not.

Yet the readers likely to benefit most from Attia aren’t the ones who adhere to his script with religious zeal; it’s those who absorb the spirit and believe they now have a place to start — who take prevention more seriously even if they never get the comprehensive bloodwork he favors, for example. Attia provides a useful scaffold that falters when it’s taken as an inviolable prescription.

Proof, Not Precision

Many wellness tech platforms, I suspect, work the same way. For users engaging with these platforms in the most healthy fashion, quantification isn’t really delivering precision so much as proof. A step count takes an ordinary walk and turns it into evidence — evidence you can see, and show, that you’re the sort of person who moves and pays attention. The hotel workers got that validation in a sentence, but most of us would wave a sentence away; we trust a number on a screen far more than a pep talk – perhaps because a number aligns better with our technology-inflected explanatory model of health.

For many people, the palpability of this receipt is what makes the effort feel real enough to keep making. That is what these platforms can offer — not the optimization they advertise, but the sense of being someone who takes their health seriously, and a place to act on it. (Supplements may work in much the same way, contributing more directly to identity than biology.)

It’s also worth noting that while so much of today’s data-driven personalization looks like theater, the same companies patiently collecting reams of biometric data may be building something genuinely valuable: a longitudinal asset that assesses each individual against their own trajectory rather than against population norms. This is the approach Nathan Price, Professor and Co-Director of the Center for Human Healthspan at the Buck Institute and Chief Scientific Officer of Thorne, has championed for years, and described in his prescient 2023 book with Lee Hood, The Age of Scientific Wellness.

At some point we’ll hit the inflection between theater and real value. Until then, if we’re going to embrace tech wellness platforms, let’s make sure we’re not holding on too tightly — and that the platforms are serving us, rather than the other way around.