Augmented reality (AR) is an emerging technology with potential to combat the obesity
epidemic among younger populations in the United States and healthcare providers ought
to embrace the use of this advancement in promoting a healthier society. AR involves
integrating digital information with one’s environment in real time. With the advent
of this technology, users are empowered to interact dynamically with their surroundings
in new ways all while safely partaking in physical activity. The hope is that by spurring
activity we can reverse disconcerting trends related to obesity (i.e. an excess of
body fat compared to one’s height, and age for pediatric populations). Two-thirds
of adults in the United States are considered overweight or obese and the same is
true for over a third of children and adolescents [[1], [2]]. Furthermore, given certain overarching trends such as technological innovations,
advances in transportation, and a shift toward an information-centric economy, more
Americans are leading sedentary lifestyles. Obesity and sedentary behavior have both
been linked to increased risks of developing cardiovascular disease and to higher
rates of all-cause mortality [[3]]. Many expert groups, including the American Heart Association, recommend that adults
pursue at least 150 minutes of moderate-intensity aerobic activity each week. Researchers
estimate that inactivity costs the global economy nearly $70 billion annually in medical
expenses and productivity losses [[4]]. Even moderate physical activity has been estimated to prevent over a quarter of
a million deaths each year [[5]]. One survey demonstrated that among Americans with cardiovascular disease, those
who met recommended exercise guidelines had about $2,500 lower annual healthcare costs
than those who did not meet the guidelines [[6]].
While many healthcare delivery reform efforts are directed towards managing elderly
populations with multiple chronic conditions, the disconcerting trends in obesity
and inactivity particularly in younger populations also warrants attention and resources
to secure the wellbeing and economic stability of future generations. One strategy
to promote healthy activity and combat obesity in younger groups is to leverage emerging
technologies. AR could represent an innovation with the potential to positively influence
the health and wellness of young people. The popularity of and interest in AR has
exploded with the release of popular entertainment titles such as Pokémon Go (a multi-player
game in which players use their smartphone camera and GPS to walk around and explore
their neighborhoods to find, catch, and train fictional creatures that are overlaid
onto the real world). While AR applications for wellness are relatively new in the
marketplace, AR solutions have been used in healthcare for some time, for example,
to enhance the phlebotomy process, to assist surgeons in the operating room, and to
easily locate external defibrillator machines in cases of emergencies.
By stimulating consumers to engage with technology in novel ways, developers of consumer-directed
AR solutions are poised to significantly drive physical acstivity in millennials and
future generations to the benefit of societal health and wellbeing. Given their growing
popularity, AR solutions which encourage physical activity (by incorporating geolocation
technology and other solutions) promise to supplant common sedentary activities such
as television watching, internet surfing, and the playing of static video games. Promisingly,
there have been recent strides related to AR. In the last few years, popular video
game console manufacturers have marketed motion-controlled video systems such as the
Sony Move, Xbox Kinect, and the Nintendo Wii. These systems require participants to
actively move around, thus promoting more physical activity then predecessor products.
The downside to these systems is that they require consumers to purchase separate
and often expensive equipment and may necessitate a great deal of dedicated space
for optimal use. On the other hand, modern AR solutions are increasingly being adapted
to technologies that are already widely adopted such as smartphones and tablets. Consequently,
AR solutions require little to no additional equipment investment and enable users
to engage nearly anywhere with limited space needs.
While AR solutions stand to promote healthy behaviors in younger populations where
obesity is becoming commonplace, the potential benefits must be considered against
the risks of excess “screen media exposure” in the pediatric group. The American Academy
of Pediatrics recommends limiting total entertainment screen time in children to less
than 1–2 hours a day and the group discourages any screen media exposure in those
less than 2 years of age [[7]]. As the evidence base guiding these recommendations continue to evolve, we must
acknowledge the fact that advances in our technology may outpace guidance literature.
We must also rigorously investigate the impact of AR despite our intuition of their
beneficial effect, especially considering recent evidence demonstrating that wearable
tracking technologies may not confer a benefit to young people attempting to lose
weight [[8]]. There have also been reports of motion sickness associated with these types of
novel technologies and a user may risk injury on account of not being aware of his
or her surroundings. Furthermore, while we anticipate the cost of AR solutions (and
the platforms upon which they are built) to continue to decline over time, there is
still a risk that those of lower socio-economic standing will be unable to afford
these technologies (and/or the associated data plans) for some time. In the same vein,
wellness-focused AR solutions may be poorly suited for more destitute neighborhoods
which may lack safe spaces for recreation. Given this reality, the use of AR solutions
to combat obesity may potentially exacerbate healthcare disparities as they relate
to inactivity and associated sequela. Stakeholders must be vigilant in terms of identifying
and promoting affordable advances for obesity management.
From a commercial standpoint, health and wellness AR developers will also be obliged
to create stimulating products that capture the hearts and minds of young people while
spurring them to action, lest their products be quickly discarded as fads. These products
will need to be continually refreshed, updated, and reimagined if AR developers hope
to win recurrent customers. We expect AR developers to rise to the challenge and the
industry will benefit from continuous improvements in geolocation and accelerometer
technology in mobile devices. The most successful AR developers will likely find novel
ways to incorporate data from and robustly interact with other technological platforms
such as various wearable solutions, other media and entertainment devices, and electronic
health records. Ensuring data interoperability, privacy, security, and optimizing
data usability will be key elements for the success of AR in the health and wellness
space. Further, in order to achieve outsized returns in health and wellness, AR developers
should recruit employees with deep healthcare domain knowledge (particularly healthcare
providers and other allied health professionals), align with influential stakeholders
who envision a healthier society (e.g. working with the American Heart Association
to fashion AR solutions in keeping with their recommendations of healthy activity
levels, working with nutritionists and other allied health professionals to incorporate
a broad set of lifestyle interventions into AR solutions, working with pediatrics
groups and the research community to better elucidate risks and benefits of AR solutions
aimed at wellness).
Despite the aforementioned challenges, it is clear that AR has the potential to play
an important role in healthcare and it should in wellness also. Undoubtedly, ensuring
adequate privacy and security of health-focused AR systems as well as clarifying data
ownership rights will continue to be important issues. Innovators in this space must
attract a broad swath of consumers while addressing these various issues. Many will
fail to gain a lasting foothold but those who do stand to improve the health of younger
populations while accruing substantial profit for themselves.
Multiple choice question
Expert groups, including the American Heart Association, recommend that adults pursue
at least how many minutes of moderate-intensity aerobic activity each week?
