Your patients could turn to fitness apps to not only track their progress on a health journey but to motivate them to reach benchmarks to promote more physical activity. 

But could these apps have a counterproductive effect on health goals? Consider a study published in the British Journal of Health Psychology that found negative behavioral and psychological consequences of commercial fitness apps reported by users on social media. Such responses may impact users’ well-being and health motivation.

What Are the Study Dynamics?

In the study, investigators used artificial intelligence (AI) via a method called machine-assisted topic analysis to help analyze 58,881 posts on X.com, referring to the five most profitable fitness apps. 

Investigators discovered negative themes. Some of these included “challenges of quantifying diet and physical activity, the complexity of tracking calories and exercise through oversimplified algorithms, technical challenges and malfunctions, and aversive emotional responses to the apps’ notifications.”

Based on these negative themes, the data demonstrated how some fitness app users displayed feelings of disappointment, shame, a lack of motivation and disengagement with both their health behavior and the apps themselves. 

“Our analysis of nearly 60,000 social media posts showed that many users experience shame, guilt, and frustration when they struggle to meet rigid targets imposed by the apps,” the study’s corresponding author Paulina Bondaronek, PhD, of University College London in the United Kingdom, told Medscape. “These emotional reactions can undermine motivation and well-being — in some cases may lead people to give up entirely.” 

Users described feeling “pestered” by notifications to log calories, disappointed when progress seemed slow, and reluctant to record foods they saw as “bad.” This suggests that tracking and goal setting, though powerful behavior change techniques, are often over-used or used without enough psychological support, Bondaronek said.

Data User-Centric Models Lead to Engagement

The findings point to a need for app designs that prioritize well-being and intrinsic motivation, rather than narrow calorie or step targets, said Bondaronek. “Real health behavior change is more sustainable when people are guided by enjoyment, meaning, and personal values, rather than external pressure or fear of failure,” she said.

Furthermore, when such app tracking becomes like self-surveillance, it can dissuade the user. 

“App design should instead support self-compassion, flexibility, and social connection, elements we know are protective for both mental and physical health,” Bondaronek said. “Fitness apps are highly profitable and widely used, but their design often reduces health to numbers. When people internalize the idea that missing a target means personal failure, it can lead to shame, avoidance, and a sense of ‘giving up.’’’

How to Use the Data to Help Your Patients

The findings of the study could prove helpful if patients in your practice ask about how fitness apps could be used in a health journey. 

“This study uses some interesting methodology that utilizes AI to scour social media for clues about the practical struggles with fitness apps that might not otherwise be reported,” said John Vasudevan, MD, an associate professor of clinical physical medicine and rehabilitation at Penn Medicine in Philadelphia, who analyzed the research. “It echoes some of the concerns that I hear from patients about practical challenges of apps — such as determining an accurate calorie count — but also uncovers unpleasant feelings, such as anxiety or guilt, that might be too embarrassing for my patients to admit, even to in the doctor’s office.”

One caveat he shared with Medscape Medical News is that social media sourcing isn’t always reliable. 

“A disadvantage of sourcing feelings from social media is that, as most of us know, social media is often a place where people brag excessively about their success or complain excessively about their failures; so more moderate thoughts are often drowned out...or simply aren’t posted,” Vasudevan said. 

Messages to Help Patients Using Apps

Remind patients that apps are only a framework for success. “An app cannot accommodate vacations, conferences, injuries, and other stressors,” Vasudevan said. 

Explain how different goals can apply. Goals could be weight loss, fitness, longevity, sports, etc, that require different strategies, he said.

Advise patients to give themselves grace. “Failure is inevitable; success requires discipline to look ahead not behind,” Vasudevan said. 

Build a support system. A circle of support can motivate one to achieve health goals. Encourage patients to seek support from others, as well as their doctor, and remind patients they aren’t the only one struggling with this, he said.