TL;DR: Wearables can be useful, but true health comes from consistently listening to your body’s own signals, not chasing numbers. Use trackers as guides, not rules, and focus on sustainable habits, self-awareness, and balance for lasting well-being.
At PrimaryMD, we embrace innovation, and that includes monitoring data gathered from our Members’ wearables. But in an era where health metrics are just a wrist-glance away, it is more important than ever to pause and ask:Are we listening to our bodies, or just our devices?
Let’s explore how over-reliance on wearables can backfire, why internal cues and behavior consistency still matter most, and how you can find a healthier, more sustainable balance.
Wearable devices like smartwatches, fitness trackers, and rings have revolutionized how we engage with our health. They track heart rate variability (HRV), sleep scores, step counts, and more. About 44% of U.S.adults reported using wearable healthcare devices in 2023,1 and the numbers are climbing annually. For many, these metrics provide motivation, accountability, and even early warning signs for health issues. Research shows wearables can support behavior change, especially when paired with expert guidance and realistic goal setting.2
As usage increases, however, a new set of challenges is emerging.
The quest for perfect sleep, perfect recovery, or perfect steps can easily tip into over-monitoring. Here is what I’m seeing, in the research and in our practice:
• Notification Overload & Data Anxiety: Wearables bombard users with alerts to move more, sleep better, or stress less. While well-intentioned, this constant stream of data can lead to stress, anxiety, and even a distorted sense of well-being. As Psychology Today reports, over monitoring with wearable technology can actually lead to an unhealthy fixation on bodily data, compulsive checking, and distraction from daily life, rather than providing reassurance or improved health.3
• FalseAlarms & Misinterpretation: Not all wearable data is accurate. Devices may flag harmless fluctuations as problems, leading to unnecessary worry and/or medical visits. For example, a smartwatch can’t always distinguish between a normal increase in heart rate from exercise or a medical issue.4 My new Apple Watch constantly alerted me that the noise level in my environment was reaching damaging levels when I was . . . in the shower!?
• HealthAnxiety & Preoccupation: For patients with conditions like atrial fibrillation (AFib), wearables can significantly amplify anxiety, prompting more frequent doctor visits and increased health-related stress, even when no medical intervention is necessary. Wearable users were more likely to be preoccupied with their symptoms and concerned about their AFib treatment compared to non-users.5
• Disrupted Daily Life: The pressure to “hit your numbers” can overshadow the joy of movement, rest, and genuine self-care.Instead of feeling empowered, many users become preoccupied with meeting metrics, sometimes at the expense of listening to their own needs and having a good time.3 I’ve had dozens of patient who’ve related similar experiences: “I took the most amazing hike/walk/ride/yoga class, but I realizedI’d forgotten my [tracker of choice] and so the whole way, I felt this disappointment that the experience ‘didn’t count.’” Spoiler alert: Your body keeps track, all on its own.
So, what’s missing? The answer lies in a skill that is as old as humanity itself: interoception, or the ability to sense internal bodily signals such as hunger, fatigue, and stress. This inner compass is crucial for resilience, emotional regulation, and long-term health,6 and as we outsource our monitoring to trackers, we’re losing our ability to internally source answers to questions like, “Is today the day to push for that PR?” In this hustle-focused world, we’ve become more and more detached from our internal cues.
I work with our Members to strengthen their interoceptive muscles.Many high achievers have to continually override cues to get their jobs done and/or climb their respective ladders. Over time, this disconnect can contribute to burnout, emotional overwhelm, and even chronic illness.6 Learning to listen to your body is essential for physical, emotional, and mental well-being. Doing this will help you to respond better to stress, build resilience, and ultimately, to stick to your healthy habits more easily.
Wearables can be helpful tools, but they shouldn’t be the destination. Instead, they should be used as signposts along the way to along-term, sustainable, healthy lifestyle. One of the most useful applications of wearable technology in our practice is the ability to observe trends overtime—such as changes in sleep, activity, or heart rate patterns—rather than focusing on isolated data points. This long-term perspective helps us determine whether a change in your metrics warrants a response, or if it simply reflects normal fluctuations. Humans don’t need to be “perfect”; they need to regularly show up for themselves in how they eat, sleep, and move. The real magic happens when you build consistency into your routine. Here’s what this looks like:
• Regular Movement: Whether your tracker says 7,000 or 10,000 steps, what matters most is finding activities you enjoy and can stick with.2 Looking to improve your some aspect of your fitness? Let’s work together, starting where you are and improve from there.
• Quality Sleep: Sleep scores are interesting, but tuning into how rested you feel is far more actionable.7 You should be interpreting your sleep tracker data through the lens of how you feel in the morning, not letting the tracker dictate your feelings of rest and energy.
• Mindful Nutrition: No device can tell you exactly what your body needs. Learning to recognize hunger, fullness, and satisfaction is a lifelong skill.8 I encourage our patients to tune into their hunger, energy, and cravings several times each day. We work “backwards” from there to refine calorie and macronutrient targets based on how they feel, not some random “plan” that’s plugged into their calorie tracking app.
• Stress Management & Recovery: HRV is a trendy metric, but your own sense of calm, focus, and resilience is a better guide to recovery.9
This isn’t just what I see in my office: Research confirms that behavior change techniques, such as self-monitoring and goal setting work best when they foster intrinsic motivation and self-efficacy, not just compliance with numbers.10,11
Let’s be clear: Wearables are not inherently bad. Used thoughtfully, they can:
• Provide objective feedback to support new habits
• Help identify trends, such as how stress or sleep affects your energy
• Encourage accountability, especially when paired with expert support from someone like your physician and/or health coach
Problems arise when:
• The pursuit of “optimal” numbers becomes an obsession
• You ignore your own sensations in favor of device data
• Anxiety increases, rather than decreases, with more information
• You feel less agency or ownership over your health journey
Bottom line: Trackers often give the illusion that there is some“optimal” state at which to arrive, when instead, life and health are about a constant push-pull between forces, a balance-counterbalance. In fact, "Natural selection does not produce organisms perfectly suited to their environments. It… allows the survival of individuals … that are 'good enough' to survive...."12 Our trackers don’t have the capacity to track the nuance of “good enough”!
How can you harness the benefits of wearables without falling into the trap of over-monitoring? Here is what I recommend to our Members:
• Use Data as a Conversation Starter, Not the Final Word: Bring your metrics to your care team, and we’ll interpret them together in the context of your goals, symptoms, history, and lifestyle.
• Cultivate Body Awareness: Spend a few minutes each day checking in with your body. How do you feel? Energized, tired, tense, calm? If you have a minute, jotting these down in a journal (a note on your phone does the trick) can help you reconnect with your internal cues.
• Set Process Goals, Not Just Outcome Goals: Instead of aiming for a specific HRV or sleep score, focus on habits you can control, like winding down before bed or taking a daily walk.
• Limit Health-App Notifications: Adjust your device settings to reduce alert fatigue. Choose which metrics truly matter to you and ignore the rest.
• Prioritize Recovery: Listen to signs of fatigue, soreness, or emotional stress. Rest is not a sign of weakness; it is an essential part of progress.
• Seek Expert Guidance: If you are feeling anxious or confused by your data, reach out. Our team is here to help you interpret metrics in the context of your whole health picture.
At PrimaryMD, we believe in a personalized, whole-person approach to patient care. We appreciate the transformative power of small, sustainable lifestyle changes. Wearables can be a useful adjunct, but they are no substitute for expert guidance, self-awareness, and maintaining healthy behaviors over time.
Whether you are a current member or considering joining us, know that you don’t need to navigate this alone. The care team is here to help you make sense of the noise, tune into what truly matters, and build habits that last a lifetime.
If you are ready to a more balanced, sustainable path to health, let’s talk. Together, we can harness the best of technology along with the wisdom of your own body, guided by the support and expertise of your care team. In the end, your most powerful health tool is not on your wrist, it’s within you.
1 RockHealth. (2024, August 5). Put a ring on it: Understanding consumers’ year-over-year wearable adoption patterns. https://rockhealth.com/insights/put-a-ring-on-it-understanding-consumers-year-over-year-wearable-adoption-patterns/
2 Piwek,L., Ellis, D. A., Andrews, S., & Joinson, A. (2016). The Rise of ConsumerHealth Wearables: Promises and Barriers. PLoS Medicine, 13(2), e1001953.https://doi.org/10.1371/journal.pmed.1001953
3 PsychologyToday, "How Wearable Technology Can Worsen Health Anxiety," 2024.
4 Perez, M. V., Mahaffey, K. W., Hedlin, H., et al. (2019). Large-Scale Assessment of aSmartwatch to Identify Atrial Fibrillation. New England Journal ofMedicine, 381(20), 1909-1917. https://www.nejm.org/doi/full/10.1056/NEJMoa1901183
5 Rosman, L., et al., "Wearable Devices, Health Care Use, and Psychological Well‐Being in Patients With Atrial Fibrillation," Journal of the AmericanHeart Association, 2024.
6 Khalsa, S. S., et al. (2018). Interoception and Mental Health: A Roadmap. BiologicalPsychiatry: Cognitive Neuroscience and Neuroimaging, 3(6), 501-513. https://www.sciencedirect.com/science/article/pii/S2451902218300990
7 de Zambotti, M., Goldstone, A., Claudatos, S., Colrain, I. M., & Baker, F. C.(2018). A validation study of Fitbit Charge 2™ compared with polysomnography in adults. Chronobiology International, 35(4), 465-476. https://www.tandfonline.com/doi/full/10.1080/07420528.2017.1413576
8 Herbert, B. M., & Pollatos, O. (2014). Attenuated interoceptive sensitivity in overweight and obese individuals. Eating Behaviors,15(3), 445-448. https://www.sciencedirect.com/science/article/pii/S1471015314000701
9 Shaffer, F., & Ginsberg, J. P. (2017). An Overview of Heart Rate Variability Metrics and Norms. Frontiers in Public Health, 5, 258. https://www.frontiersin.org/articles/10.3389/fpubh.2017.00258/full
10 Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: Anew method for characterising and designing behaviour change interventions. ImplementationScience, 6, 42. https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-6-42
11 Ryan, R. M., & Deci, E. L. (2000).Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist,55(1), 68–78. https://doi.org/10.1037/0003-066X.55.1.68
12 McDonough, S. L., et al. (2021). A Pilot Investigation of Exercise Adherence on Fitness Outcomes in Firefighters. International Journal of Environmental Research and Public Health, 18(9), 4838. https://www.mdpi.com/1660-4601/18/9/4838
13 McCourt,O., et al. (2019). Compliance, adherence and effectiveness of a community-based pre-operative exercise training programme. World Journal of ClinicalOncology, 10(12), 406–417. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886214/