Back in March, I wrote about how Fitbit and Pebble had changed my view of wearable devices, turning me from a skeptic into a promoter. I also wrote about how easy it was for me to to get hooked on activity-tracking as a wellness tool. Although I'd bought my Fitbit to encourage me to be more active, I hadn't really planned on using it specifically as a weight loss solution. I figured I probably would lose some weight, but setting a goal or actively tracking calories wasn't part of my intention, though the Fitbit app does include an excellent database for calorie tracking.

Despite not setting an intention for weight loss, I have lost weight. That wasn't a big surprise. After all, I'm doing more than 15,000 steps and 10 flights of stairs almost ever day -- way more than the 6,000 to 7,000 steps a day that I was doing when I first bought my Fitbit Force (which was subsequently recalled and replaced by first a Fitbit Zip and then the more feature-laden Fitbit One). During the past couple of months, with the warm weather, I've actually been exceeding that goal and getting 20,000 steps or more in at least a couple of times a week. Other than that, however, I really haven't made any lifestyle changes, particularly to my diet, although I've always tended to a relatively healthy eater. I honestly assumed I'd lost five or ten pounds at most.

After a recent doctor's appointment, I realized I was wrong. During the visit, I was invited to join the practice's new patient portal. I did so and went poking around the pieces of my medical history that were available including the section of vital signs. I was shocked to discover that since an appointment earlier this year, I'd lost 22 pounds. Over the couple of weeks since, I've lost another four pounds. All totaled, over the past 23 weeks (I resumed using a Fitbit in mid-March), I've lost a total of 27 pounds. That equates to roughly one pound per week, which fits with the general one to two pound per week guidelines for healthy weight loss.

I think there are a couple of interesting takeaways from this. Wearable devices can be an excellent motivational tool, particularly paired with social and reward apps like Every Move. Consistent use of activity trackers and similar fitness and wellness apps can be incredibly effective without making the experience seem like an intrusive effort into daily life. Doing a little bit more every day can add up to significant outcomes.

The value, for me at least, wasn't so much in accumulating aggregate data as it was as a daily motivator. It's useful to have all that data, but for me it really is just the daily awareness of achieving or coming close to a goal.

The debate in the medical industry

This brings up important questions about wearable devices that exist at the intersection of fitness/wellness, medical care, and employee or insurer wellness programs, particularly with Apple's HealthKit and similar platforms expected to come to market over the next few weeks or months.

  • What data is useful to individuals both as a motivational tool but also as a way to gauge progress over time?
  • What data is helpful to doctors and other health care professionals?
  • Should apps have the ability to issue alerts to us as individuals, our doctors, or family or support network?
  • How much detailed information to we what our employers or insurers to have about our daily activities?

There are no easy answers to these questions. In part that's because every stakeholder I just described has a very different way that they'll want to use this data.

I don't have a need or interest to look back at how many steps I took on St. Patrick's Day. My doctor doesn't -- as long as I'm active and losing weight at a healthy rate, he has no need for that data. A wellness plan coordinator for an employer or insurer, however, would want to see a large aggregated view of my activity levels in order to gauge my fitness or the overall fitness level for members of the plan over a long period of time to know if it represented a sustained effort.

The debate over the usefulness of this data is currently a hot topic in the medical field. With major electronic health record vendors working with Apple, it seems clear HealthKit will allow some users to upload information into their EHR (and Apple is likely to be just the first player in this space). First, these devices must ensure privacy and user control. Second, the industry has to decide whether they offer any actionable data, and if so, how to store it.

That challenge isn't as clear cut as it might sound. My doctor has no need to see data from my Fitbit, but there was a real value in him reviewing my daily blood pressure readings when we trying to find the ideal medication and dose to manage my hypertension.

A physical therapist treating some of my back issues isn't likely to see much value in my Fitbit data, but might find it helpful treating someone with mobility issues. For someone older or special needs living alone, the ability to recognize a potential problem by a lack of activity could mean a great deal.

My Fitbit experience doesn't offer much in the way of answers to these challenges. If anything, it's made me reconsider just how complex they are in large part because how each of us uses a device like a Fitbit or an app that tracks health or fitness metrics will be similar but never quite the same.

Setting all those questions aside, however, I have no plans of ditching my Fitbit anytime soon and I already foresee myself linking to iOS 8's Health app the day Apple launches it. I may have lost 27 pounds, but that doesn't I'm resting on and activity laurels.