The MIT Technology Review July/August 2011 journal features an article by Emily Singer describing the development of self-monitoring devices that can function as a robotic mothers, nurses and personal trainers. Many of these devices resemble sleeker, more efficient models of instrumentation used by research labs to record brain activity during sleep, physiological changes during stress, migraine triggers, activity levels and even early symptoms of debilitating neurological diseases. Teams of technicians have used similar devices to acquire this information for research purposes -- but now the devices are being marketed for consumer use.
Interpreting the information provided by these devices does not require a Ph.D. The article displayed graphs of the writer's own physiological state; there was a print-out of the stages of her sleep cycles, a 24-hour chart of her movement measured in steps and even a recording of changes in skin temperature, related to her stress and activity levels. The graphs and charts showed obvious changes without the need to know what the exact numbers said.
The next few years may bring about a variety of such self-tracking devices -- and perhaps we can expect to see electrodes instead of earbud wires dangling from people's heads as they go about their daily routines.
Companies are, not surprisingly, experimenting with self-monitoring devices for weight loss. The article mentioned that a French company, Withings, is considering marketing a scale that will refrain from showing the weight the dieter has gained since the previous day. Withings explained that this censoring will prevent the dieter from feeling discouraged and abandoning the diet. Perhaps Withings could also develop a device with an audio message praising the dieter if a hidden camera detects the dieter ordering grilled chicken rather than fried?
Although I am dubious that any device will have the power to stop overeating once it is underway (unless it delivers an electric shock or makes the person acutely nauseous), devices that monitor eating, sleeping and exercise patterns over a period of time might provide a predictive model. Imagine being notified by your device that overeating is likely to occur, and so now might be the most effective time to diet. For example, let's imagine that over the past year, you wore devices that constantly monitored and recorded your daily calorie levels, activity levels and sleep cycles every night. Let us suppose this is what was recorded:
1. You ate more calories on the weekend than during the week;
2. Your calorie consumption increased by about 800 a day every 25 days and this increase lasted two days;
3. You were much more active and slept fewer hours in May, June and July than the rest of the year;
4. Calorie intake from alcohol and fat increased dramatically the last two weeks of December;
5. On the days you skipped breakfast and lunch, you ate twice as many calories in the evening as on the days you eat three meals;
6. Your calorie intake went up drastically at dinner on the third Friday of every month;
7. Your calorie intake increased by more than 1,000 additional calories a day during the last week in August but your physical activity levels increased as well.
Let's imagine how these measurements would tell you when and why you might be gaining weight -- and when and why it will be easy for you to lose it. Imagine this:
1. You tried to control what you were eating during the week but didn't bother during the weekends. Your calorie record showed that Sundays in the fall and winter were particularly hazardous because you ate a large meal around 11 a.m. (brunch?) and then snacked from 4 p.m. until you went to bed; or
2. You were susceptible to PMS, which occurred on the 25th day of your 28-day menstrual cycle. PMS made you unable to resist eating large amounts of chocolate; or
3. Your energy levels went up during the long, sunny days of late spring and early summer and you spent less time sleeping and more time doing recreational sports; or
4. You attended too many holiday parties; or
5. You were so hungry by late afternoon that you ate continually while you were making supper and then snacked several times during the evening; or
6. Your team at work went out for pizza and beer the third Friday of every month; or
7. Your cousins and their children stayed with you for a week at the end of the summer. You spent all your time either in the kitchen, doing laundry or cleaning the house.
This record, although hypothetical, gives some idea of how tracking our individual patterns of eating, sleeping and moving might be helpful in losing weight and preventing it from returning. A weight-loss counselor might obtain the same information from a very careful and extensive interview, but it is unlikely the meeting could approach the accuracy of actual real-time measurements.
It is doubtful that any of us would be able to recall specific changes in sleep and physical activity patterns throughout the year or notice accurately how our calorie intake changes during specific days such as Sundays. Indeed, few of us at dinner can recall what we ate for lunch unless it is the same thing every day. (In my weight-loss practice, I have rarely met any client who had the self-knowledge of calorie intake, sleep patterns and activity levels that self-tracking devices provide.)
Anyone who has been on a diet will understand how useful this information might be in identifying times when a diet will be successful or simply a frustrating failure. Moreover, most of us are not mindful of weekly or seasonal changes in our eating, sleeping and exercise patterns. And most of us simply don't want to notice the impact of Friday night pizza and beer gatherings, Sunday brunch and holiday parties on our calorie intake.
When devices are developed that integrate all of this self-tracking information into a personal computerized chart (according to the MIT Technology Review article, this is just beginning to happen) then we can use them to seek help and support in our weight-loss efforts. A weight-loss counselor would be able to look at the record and immediately notice the times when you, the dieter, are vulnerable to overeating or inactivity. He or she might notice the increased calorie intake for a couple of days every month and inquire about PMS or suggest that your cousins vacation elsewhere in the interests of your continued weight loss. Such records would also be helpful in understanding why weight loss efforts might stall. A dieter might be eating fewer calories but sleeping more hours per night or decreasing physical activity. Or the answer might be that the dieter has some metabolic problem that makes weight loss very slow. Having such records to present to a physician will prevent the almost inevitable comment, "You are probably eating more than you think you are."
Don't expect to see these devices any time soon. Many are still in the development and testing stage. But awareness of their utility in tracking information that might affect your health and well-being is growing rapidly and new uses are being identified. Who knows? Maybe someone is even now working on a device that will allow you to lose weight without self-denial or willpower.
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