Why Changing Health Behaviors is So Hard

The health care issue rages on within our political halls – but the real problem is raging on in American's bodies.  Preventable, behavior-based health issues are creating enormous costs for individuals and for our current employer-sponsored insurance system. 

Companies are working hard to develop programs and ideas that will help reduce the costs associated with poor health.   The almost ubiquitous application of "wellness" programs with incentives is testament to the value companies see in reducing the cost of health care.

But impacting behaviors associated with health issues has always been a very tough row to hoe.  One of the basic reasons, I believe, is the distance between adopting new behaviors – and the rewards associated with those new behaviors. 

Temporal Discounting

I've posted before on temporal discounting – its means we place a higher value on an immediate award than one provided sometime in the future.  In incentive terms, the closer the award is to the behavior you're rewarding the greater the perceived value.  The further into the future the reward is the less value the award "seems" to have.  I put quotes around the word seems because the value really doesn't change but we as humans perceive it that way.

If you think about health behaviors there is a huge gulf between when I start my healthy behavior and the payout for that change.  Graphically it might look like this…

In addition, adopting healthy behaviors not only has a long, long, payout – but there is an immediate drop off in a behavior that was reinforced either by drugs (say, nicotine) or through pleasure (food).  So something I used to do that was pleasurable is no longer there, and the behavior that is better for me has no immediate reinforcement – the payoff is in the future.

Those are some tough, tough hills to overcome and one of the reasons I believe traditional incentive programs for wellness have had only moderate success. 

Back To The Future

If the time lag between behavior change and reward is one of the problems how do you fix it?  Without a DeLorean and a flux capacitor I don't think we can bring the future to today.

Oh… but you can.  Not necessarily the "rewarded future" – but the "unrewarded future."

What I'm referring to is the process by which Dr. H on "The Biggest Loser" brings the long-term payout for bad behavior into the present.  As part of the process participants go through on the show they are put through a battery of tests to assess their health – and are then presented with the outcomes.  One of the tests shows them their "biological" age.

Watch the video from last season below (email feed subscribers may have to click through to the post on the web – and I apologize for the commercial before the clip – big media companies don't get social media) and see the effect presenting the participants with their "biological" age has. 

It cements it – it makes the outcomes of their behavior today a present day problem – not a problem to worry about tomorrow.

If we are ever going to impact wellness we have to make either the negative consequences (or the positive ones) present day issues.  Telling people they should do it to ensure they live another 10 years is too far in the future and too abstract to grasp.  Show them the present.  Connect with today and you will have a better chance of changing behavior.