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“Just Do It” serves as an adorable marketing catchphrase. However, in a practical sense, it doesn’t yield effective results. The truth is, from a clinical perspective, a significant portion of individuals do not engage in physical activity. The advised weekly duration of physical exercise is 2.5 hours (equivalent to 150 minutes). Yet, recent statistics from the Centers for Disease Control and Prevention indicate that fewer than fifty percent of adults aged 18 and above adhere to the recommended aerobic exercise standards.
Sylvia Gonsahn-Bollie, MD
Moreover, in relation to surveys conducted concerning both aerobic exercise and strength training, only 24.6% of respondents adhere to these weekly recommendations. The notably low rates of physical activity raise concerns, considering the substantial advantages that exercise offers in terms of enhancing mental and physical well-being.
While many individuals are aware of the positive impacts of exercise, maintaining a consistent workout routine can be a struggle. I am intimately acquainted with the difficulties involved. Beyond my role as an integrative specialist in addressing obesity, I personally transitioned from being inactive in 2014 to evolving into a dedicated fitness enthusiast who has completed over 5300 miles of running across eight years. I recognize that as medical professionals, we hold significant sway over the exercise journeys of our patients.
Outlined below are five strategies aimed at motivating your patients to shift from a mindset of
“I won’t do it” to “I’m doing it.”
Tip 1: ‘[Clinician], Heal Thyself’
The data speaks for itself. Physicians who engage in greater physical activity are more inclined to provide advice to patients about exercising. I’ve experienced both sides of the exercise spectrum as a medical professional. During periods of higher body weight and limited physical activity, I found it difficult to offer exercise guidance to patients without feeling hypocritical.
When I did offer exercise advice to my patients during that time, it tended to be quite prescriptive and detached. However, once I started consistently running, I swung to the opposite extreme. I was so enthusiastic about running that it took me a while to realize that not everyone is interested in running extensive distances each week – a surprising revelation! Some individuals are unable to manage rigorous workouts. Adopting the mindset of “I accomplished it, so you can too” didn’t prove effective for generating enduring changes in most patients.
What truly proved beneficial was recalling the challenges and emotions I faced (and still face) while striving to maintain regular physical activity. When physicians and clinicians engage in regular physical movement themselves, we are better equipped to provide authentic advice to our patients, grounded in practicality rather than mere theory.
Tip 2: Motivate, Don’t Berate
“What obstacles prevent you from engaging in exercise more frequently?”
The utilization of open-ended questions plays a pivotal role in the practice of motivational interviewing, which facilitates collaborative discussions.
Rather than dictating actions to patients, motivational interviewing centers around uncovering an individual’s underlying motivations and devising a viable strategy based on those motivations. Utilizing open-ended questions proves particularly useful in identifying potential hindrances to regular exercise, reframing these challenges as constructive opportunities for growth instead of labeling them as “excuses,” which could have counterproductive effects.
I encourage patients to view challenges as chances for enhancement. For instance, if a patient claims, “I can’t find time to exercise,” I propose the concept of “creating” time by engaging in a 10-15 minute walk during lunch breaks or after dinner. Extracting insights from open-ended questions assists in setting practical SMARTER goals, a topic we’ll delve into shortly.
Tip 3: Set SMARTER Goals
After evaluating the patient’s incentives and obstacles, apply this information to convert their intention to make changes into a practical plan by using a SMARTER goal. SMARTER is an acronym representing Specific, Measurable, Attainable, Relevant, Time-Sensitive, Enjoyable, and Rewarding. Constructing achievable goals requires integration of all these elements. This is why slogans like “Just Do It” or even a directive such as “Exercise 150 minutes a week” aren’t sufficient as clear pathways for effective change. SMARTER goals transcend mere directives, aiding individuals in customizing their approach to change.
For instance, a SMARTER version of the “Exercise 150 minutes a week” directive for a busy individual with a 50-hour workweek might appear as follows: “My objective is to incorporate 150 minutes of physical activity by engaging in 60 minutes of aerobic exercise on weekdays (comprising 20-minute lunchtime walks) and 90 minutes of mixed resistance training on weekends (split into two 45-minute sessions). While I exercise, I will listen to my preferred music. To attain my goal, I will treat myself to a rewarding phone call with a friend or purchase a new workout outfit.”
Another valuable strategy for empowering patients with a practical exercise plan is the implementation of exercise prescriptions. In my practice, I’ve created my own exercise prescription that concentrates on surmounting time constraints and discovering enjoyable exercises tailored to each patient. To further boost self-directed physical activity, I’ve found it beneficial to have patients complete a portion of the “exercise prescription” independently before or after their appointment.
Tip 4: Use Accountability Tools
Making a SMARTER goal is one thing, but sticking with it takes regular reinforcement. Even with the best plan, once patients leave the office, there are many distractions from their goals. Accountability is the secret sauce to cultivating consistency. Fitness trackers are an affordable form of accountability. Studies show that wearing a fitness tracker can help people get up to 40 minutes of extra walking compared with people who don’t wear trackers.
Additionally, clinicians can use different ways to offer exercise accountability. For example, more frequent check-ins, individually or in groups, can be helpful. The increase in telehealth has made interval visits easier. Reimbursement and time can limit clinician-level accountability, however. Other options are referring patients to online support groups or programs sponsored by the government or organizations. For years, I co-led a Walk With a Doc chapter in Richmond, Virginia. There are chapters throughout the country.
Tip 5: Prepare and PLAN for Setbacks
It’s a common scenario that most plans don’t unfold precisely as intended. Factoring in the potential for setbacks early on assists patients in establishing pragmatic expectations. In our capacities as physicians and clinicians, we can aid our patients in preparing for a few foreseeable hurdles. This proactive approach might mitigate the impact of setbacks when they do arise. Additionally, guiding patients to ready themselves for potential setbacks by devising a PLAN for swift recovery proves advantageous. PLAN encompasses Pondering the situation, Learning from it, Adjusting the original goal, and Now resuming the intended path. Swiftly returning to the right course is crucial to maintaining motivation and preventing muscle deconditioning.
The significance of exercise cannot be overstated; it functions as a form of medicine. Physical inactivity stands as a prominent contributor to numerous avoidable health conditions. While the statistics regarding physical activity levels might be disheartening, the potential for improvement exists. Instituting comprehensive alterations is necessary to elevate physical activity on a societal level.
While awaiting more extensive systemic changes, we possess the ability to furnish patients with individualized, actionable tools for elevating and sustaining physical activity.
We have the capacity to effect change on a one-on-one basis through our clinical interactions. Let’s leverage effective strategies to guide patients in shifting from a mindset of “I won’t do it” to “I’m doing it.”
Sylvia Gonsahn-Bollie, MD, DipABOM, is an integrative obesity specialist focused on individualized solutions for emotional and biological overeating. Connect with her at www.embraceyouweightloss.com or on Instagram @embraceyoumd. Her bestselling book, Embrace You: Your Guide to Transforming Weight Loss Misconceptions Into Lifelong Wellness, was Healthline.com’s Best Overall Weight Loss Book of 2022 and one of Livestrong.com’s 8 Best Weight-Loss Books to Read in 2022.
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