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No, no, nocebo!

Some think that obsessive self-monitoring creates a ‘nocebo effect,’ from the Latin ‘nocere’ (‘to harm’), meaning that information overload about your health or well-being can make you feel worse.

H. Hopp-Bruce/Globe staff; simantovskaya/Adobe

Is the over-examined life worth living? I have my doubts.

’Tis the season for over-monitoring. I can confidently predict that some child or relative will “gift” you an innocent-looking device — a smartwatch, a fitness tracker ring, or even an online Sleep IQ mattress — that is programmed to analyze every micro-iteration of your purportedly interesting life.

Case study in absurdity: a CGM, or Continuous Glucose Monitor, which Men’s Health magazine calls the “hot new biohacking tool.” (The article is titled, “You CGM, Right, Bro?”) Diabetics need glucose monitors to track their blood sugar levels. Now Joe Bro has seized on CGMs as the must-have fitness accessory of the New Narcissism, because blood sugar counts can affect one’s mood and/or energy levels.


According to The Wall Street Journal, CGMs have become a plaything of the “worried well” (read: worried wealthy) “who haven’t been diagnosed with anything but fear they might be. . . . Users include high-profile athletes like Los Angeles Dodgers pitcher Trevor Bauer and a long list of Silicon Valley founders, executives, and investors, including some from venture-capital firm Andreessen Horowitz, which is backing one of the [CGM] ventures.”

In COVID World, real-time antibody tracking “has become a common practice among certain members of the nervous affluent class,” The New York Times reports. “A lot of my patients and some of my friends are counting their antibodies,” wellness center owner Juhi Singh told the newspaper. “It’s the Upper East Side, the Hamptons circles. It’s like dinner conversation at this point. It almost feels like counting calories.”

The Superman of self-monitoring might be Stanford Genetics professor Michael Snyder, who has “compiled a decade of lab data — on his genome (the sum of his genetic code), his epigenome (the markers regulating gene expression), his transcriptome (RNA transcripts of expressed genes), his blood proteome (the proteins in his blood), his urine metabolome (the molecular by-products of metabolism), his blood and urine lipidome (the fat contained therein), and his microbiome (the microbial organisms living in his mouth, sinuses, skin and gut),” according to Stanford magazine.


To what end? Massive data sweeps like Snyder’s can function as early warning systems. For instance, Snyder predicted the onset of his own Type 2 diabetes and correctly self-diagnosed a case of Lyme disease.

Prediction is one thing, prevention is quite another. Some think that obsessive self-monitoring creates a “nocebo effect,” from the Latin “nocere” (“to harm”), meaning that information overload about your health or well-being can make you feel worse.

Columbia University cancer researcher Dr. Siddhartha Mukherjee suggests that the future accoutrements of somatic surveillance, such as “a bathtub that scans your body to detect abnormal masses,” or a computer program that scours your social media feeds “evaluating changes in your photographs that might signal signs of cancer” might unleash a pervasive anxiety about hypothetical future maladies.

“A strange new term, ‘previvor,’ has emerged,” Mukherjee writes in the Journal, “to designate a person who has not yet experienced an illness she is predisposed to have.” Using not-yet-perfected diagnostic tools to “predict” hypothetical maladies, he argues, “can be life-distorting. As the shadow of future illness dilates and magnifies, so too do the shadows of anxiety and dread.”


Stanford’s Snyder disagrees. “Although there may be instances where the ‘nocebo effect’ occurs,” he wrote in an e-mail, “I think it is a very minor set of cases. It would be like saying — I do not want to have a dashboard on my car because it might tell me problems with my car. I do not think most people think that way — they like to be tipped off if they have a possible health concern.”

Happy New Year! Let your many steps — logged by your First World tchotchke, or not — be toward happiness and health for you and your family.

Alex Beam’s column appears regularly in the Globe. Follow him on Twitter @imalexbeamyrnot.