Research Review:
With motivation, timing matters

By Helen Kollias

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If you’re embarking on a life change, remember to schedule a few “motivation boosts”  for when the novelty of your new lifestyle might wear off — and when you need to re-focus on self-motivation.

Introduction

Ahhh, New Year’s resolutions seem a distant memory these days. We’re nearing the 150-day mark for 2010 and the gyms haven’t been crowded since February. The local fast food restaurant is looking pretty busy.

Well, there’s another 215 days ‘til the next resolution.

But what happened? Why didn’t New Year’s resolutions become resolved? Two likely reasons: motivation and adherence.

Motivation

Motivation is being excited or energized to do something, usually something goal-oriented.

Motivation can come from within (aka autonomous, or self-motivated) or externally (aka controlled, or environmental motivation).

Self-motivation is motivation coming from self. You convince yourself, and the motivation is intrinsic.

Controlled motivation is anything that comes from the outside world — from money, to praise, or disapproval from your parents. Others (real or imagined) convince you.

People are usually a mix of motivation types.

Adherence

Adherence, or compliance, is doing what you decided to do or agreed to do.

Let’s say in your New Year’s Resolution, you decided to work out 4 times a week.

  • If you only worked out twice, then you’re not adhering to the plan – obviously.
  • But if you work out 4 times a week with no effort and read a book while doing your exercises (yes, I’ve seen that) then you’re not adhering to the plan either.

A few months back I discussed how simpler was better for adherence and long term weight loss. (Also see All About Measuring Compliance.)

How compliant should we be?

As PNers, you know that you don’t need to be 100% compliant with eating, since having no wiggle room usually leads to the ultimate justification of “since I’ve already messed up my diet I might as well…” Very stringent restriction often ends up backfiring. And we know that getting it right 90% of the time still gets pretty good results.

But in other situations, less than 100% compliance usually leads to relapse. There’s no 90% compliance with heroin addicts, for instance.

In any case, though, usually the better the compliance, the better the results. There’s probably no situation in which 10% compliance to a good self-improvement plan is better than 80%.

Increase motivation and adherence

OK! Being motivated and adhering to my plan is key for success! Will do.

Wait a second — isn’t that about as helpful as telling someone who’s hysterical that they should relax? Thanks for the tip — here I was thinking, Gee, if some just told me to what to do I’d be fine. Oh relax… wish I thought of that!

There’s the problem with motivation and adherence: People already know they need them to be successful in changing habits, whether that’s weight loss, smoking, or recycling garbage — but HOW do we get motivation and adherence?

One way to boast motivation and adherence is the method they used for the study in this review: a counselling technique called motivational interviewing (MI). MI’s basic principles include:

  • Supporting self-efficacy – the counsellor encourages the belief that change can happen, but you are the one responsible for deciding to change and carrying out the change.
  • Helping you understand what benefit not changing has given you, and why you’ve held on to dysfunctional behaviour patterns. The idea is that for whatever reason, your problem or not changing is somehow useful or valuable to you.
  • Helping you tap in to your own sense of dissatisfaction (rather than the counsellor lecturing you on why your current behaviour is bad) with the way things are, and helping you move through the change process.

MI uses self-motivational statements to help with autonomous motivation or self driven motivation.

For instance, you say things to yourself that acknowledge the pros of changing, affirm your commitment to change and help you remember the problems with the status quo.

Basically, you motivate yourself with your internal monologue, by saying stuff like I will feel better if I stick to this program or I can do this (whatever your goal might be). Or you can do it out loud in front of a mirror or in front of a live audience… It worked for Stuart Smalley — he’s the senator of Minnesota now! (Wasn’t their last senator an ex-pro wrestler? Oops. Must stay focused…)

The whole idea of MI is that intrinsic change or change from within is important for successful change. People don’t change because someone else says “You should change.” They change because they themselves want to change. (Naggers, your efforts are largely pointless. Of course, you won’t stop nagging until you decide not to nag…)

Research question

All right, we know that we have to want to change if we’re going to change ourselves. We know that motivation and adherence are  important for weight loss. Now, let’s look at a study that adds an extra factor: The researchers find that when you’re motivated actually makes a difference, and the ways in which daily diaries are key to success.

Webber KH, Tate DF, Ward DS, Bowling JM. Motivation and its relationship to adherence to self-monitoring and weight loss in a 16-week Internet behavioral weight loss intervention. J Nutr Educ Behav. 2010 May-Jun;42(3):161-7.

Methods

Take 66 women, aged 22-65, with BMIs between 25 and 40. Give them:

  • one face-to-face motivational session on weight loss (which includes info on exercise, dietary goals and other weight loss pointers),
  • a personal online page to fill in daily calories eaten, daily exercise and weight…

…and wait for 16 weeks.

Oh, half the women also got weekly on-line chat session with the researchers, but that didn’t make a difference as far as motivation or weight loss, so the researchers just analyzed all the women together.

Every four weeks the women completed a questionnaire to see how motivated (both self-motivated and controlled/externally motivated) they were;  and the researchers looked at how the women were adhering to the self reporting (reporting daily calories eaten, exercise and weight.)

Since this was pretty much entirely an online study, the only times the women were weighed in the lab were at the beginning and at the end of the study. Thus, even though there are motivational and adherence data throughout the study, there aren’t any reliable weight loss data. Keep this in mind, because I think it makes a big difference how we look at the results.

Results

After 16 weeks, the women lost 4.5 kg (just under 10 pounds) with a pretty big standard error of 4.6 kg (that means that some women lost a lot more and some women lost a lot less), but that isn’t the story.

If you sub-group the women who lost more than 5% of their bodyweight from the rest of the group you find that women who lost more than 5% of their bodyweight were more motivated (both self and controlled) after four weeks into the study and kept their motivation until the end of the study. Before the four week mark everybody had the same motivation, but four weeks and onward you see a difference, with weeks 5-10 being the key to weight loss success.

Hmm this is a bit of chicken and the egg scenario – did the initial success of losing weight lead to more motivation or did more motivation lead to more weight loss?

As a physiologist I wish they’d have had weight loss throughout the study, because I think it would have really helped with this question. However as psychologists, the researchers wished they had motivational levels for day 2 (right after the motivational weight loss session).

And it turns out the more self-monitoring diaries the women completed (adherence) the more weight they lost. Adherence affected self motivation.

Conclusion

Over 16 weeks there were changes in motivation in the participants that influenced adherence to reporting daily measures and weight loss.

More motivation meant more adherence and more weight loss – particularly between from weeks 5 to 10.

Bottom line

Motivation is key for successful weight loss, but it seems that motivation around the second month (5-10 weeks) is particularly important.

If you’re embarking on a life change (such as our PN Coaching programs), remember to schedule a few “motivation boosts” (whether that’s a one-on-one with a coach, revisiting your goals, enrolling yourself in a competition, or whatever floats your boat) for when the novelty of your new lifestyle might wear off — and when you need to re-focus on self-motivation. (Luckily, our PN coaching programs have built-in adherence and motivation boosters.)

And remember — the more people adhered, the better their results. So if you find ways to stay motivated, you’ll be rewarded!

 

 

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References

Click here to view the information sources referenced in this article.