The right Why: The surprising start to cultivating sustainable behavior change

Abstract

Immediate rewards are at the root of sustainable motivation.For people older than age 50, sustaining to be physically active and practicing other self-care behaviors is especially important, given the plethora of evidence-based enhancements to mood, cognitive function, and balance.But why do most people who want to change their behavior, sometimes even desperately so, eventually lose their and stop? The answer to this question reflects the fundamental solution to helping individuals take charge of their so they are fueled for a lifetime of fitness, meaning, well-being, and health.Fuel as a Metaphor for MotivationWhile I use it in my work, I've come to believe that the word motivation might not be helpful without first explaining how it works. Motivation refers to the drive and desire we feel to pursue our goals and values. While the word is tossed about regularly, the ubiquitous usage doesn't really get at motivation's core meaning and the crucial role it plays in our long-term success (Segar, in press).A more helpful way to think and talk about is to consider that it is the fuel we need to push ourselves toward our goals. If there is no fuel, it means there is no energy to pursue what is most important to us. If we are not energized to persevere toward our goals, then we will not be able to realize what is most important to our lives.Most people don't realize that whether their energy source is external or internal is fundamentally important. However, research shows that whether we are externally or internally motivated has implications for our success in achieving our goals (Ryan and Deci, 2000).Externally motivated people get their fuel from a clinician's admonition or, perhaps, that new Nutrisystem ad. While external fuel sources effectively help us initiate behaviors, such as getting more exercise and sleep, or changing our diet, being fueled by external forces is not optimal for retaining behaviors over time. Thus, if our drive for self-care depends upon other people or events, we are dependent upon a foreign source of fuel.Externally fueled energy not only is less likely to lead to success, but it is costly for everyone: individuals, practitioners, patients, and organizations. If individuals seek external sources of fuel to motivate them, then they are investing their precious energy and inspiration pursuing something that will likely lead to disappointment. When we invest energy and money in approaches that are less effective over time, we are not investing in the most strategic approach. This has an exponentially negative effect. Not only do we fail to achieve the longterm results we want, but also we wind up being deflated, with our core intentions undermined.Practitioners prescribing and advocating that patients or clients adopt healthier lifestyles to achieve clinical gold standards (e.g., in blood pressure, cholesterol, or weight) hinges the behavioral process on something that is, to a great extent, irrelevant to daily pressures and roles. Once patients leave the context in which they were motivated (i.e., a clinician's office), their tank quickly empties, setting both practitioner and patient up to fail. This joint failure kills the desire and energy to change, possibly even influencing future decisions to not seek care, which can leave those involved feeling frustrated and ineffective.The cost of externally fueling also is expensive for organizations. Incentivizing employees to take a Health Risk Assessment (HRA) or sign up for a lifestyle change program with financial rewards (an externally sourced fuel) are both popular in the health promotion industry. While there is research showing that incentives work to help some of the population to get started, there is little evidence that these participants sustain lifestyle changes (Volpp, 2014; Paul-Ebhohimhen and Avenell, 2008). Without sustainable behavior, optimal healthcare savings and performance benefits cannot be achieved. …

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