February 14, 2016
I have always been boggled by the psychology of a person, especially when it comes to their own health. You, I and almost everyone believes that we should be living a healthy life. How is it then we are our own worst enemy, often falling into the temptations of fast, fried and filthy food.
It seems that the companies which sell us these kinds of foods have figured out a magic formula, a set of emotional triggers, to keep us coming back to them and we are just helpless.
What if we can use the exact triggers that these large corporations use against us but instead use them FOR us. Can we setup our life so that the emotional triggers that make us eat bad make us lead a healthier life?
I wanted to test this out. I ran a bunch of experiments with a few patients that I recruited for my study. These patients had either diabetes or cardiovascular diseases (High Blood Pressure – hypertension, Heart Failure etc.). My ask was simple – make healthy choices every day and get paid. Granted, I was not paying them a lot of money ($15 a month) but I felt that it was a reasonable ask since all I was asking was to look after their own health.
They had to send me pictures (selfies sometimes) doing healthy things such as eating salads, exercising, meditating etc. I did not tell them what to do, just asked them to document with pictures. How easy, right? Just a picture and nothing else. No need to count calories, not need to describe that they did, no need to track anything. All they needed to do was spend no more than 1 minute a day!
I let this experiment run for two months. At first, things seem to go well. People were sending me their selfies and some even commented that because they were sending me selfies, they were more willing to make healthy choices. I saw some great pictures – quinoa salads, vegetable stir fries, no-cheese pizza.
However, in a week the frequency of pictures began to drop. When asked, I heard about how they got busy, how they went to a party and HAD to eat unhealthy to fit in, how friday nights with friends involved give glasses of alcohol. In a month, half my participants dropped off.
The interesting thing was with a few of the participants, who said that $15 was just not worth it. Not good enough of an incentive. I reminded them that I was actually paying THEM to just take care of their own health, without getting anything in return. Still, it was not worth it. I stopped the experiment.
I didn’t want to give up just yet. I re-ran my experiment but this time instead of $15, I offered to pay for their Netflix subscription every month as long as they participated in my experiment. What did I notice? Much higher engagement! Suddenly, a lot more people were interested in my experiment. I got more pictures, for a longer period. I got a lot more just before their monthly subscription needed renewal!
Here is the kicker – Netflix subscription plans run for less than $15 a month, which is what I offered in my first experiment. I now paid less money and got better results. Of course, when you think about it, it makes sense. For some, Netflix is about having the freedom to see hundreds of movies, documentaries and shows.
For others, it was about having their kids watch cartoons, which meant more time for themselves. For some others, it was catching up on shows which they could talk to their friends about – House of Cards anyone?
To be sure, the engagement did start to drop although much later than it did in the first experiment. The same reasons were the culprits. Somehow, the ‘value’ of Netflix started to wear out. One person told me that there weren’t any ‘new shows’ on Netflix and it was ‘stale’ content! Maybe next time I will offer Netflix right before the fourth season of House of Cards is released 🙂
Coming out of my experiment, there are two take-aways for you all. First, you cannot expect people to do the right thing for something as important as their health. There is a tremendous implication here for big Pharma, Payers, Doctors etc., many of whom operate on that assumption that people will do the rational and right thing for themselves. Secondly, there is value in finding the right incentive to drive behavioral changes. However, most external motivators will peter out sooner or later.
Using consumerism – the impulse decisions, feel good moments, need to fit in, buying something on sale – can work but someone needs to crack the code on long term incentives that can actually make a long term impact.
For us individuals, it is far more impactful to think of internal motivators rather than external motivations. What would it mean to you to live healthy? What are some activities you can do that you cannot now? How can you better interact with your children, friends and family?
Nudge of the day: Do 50 sit-ups or 25 push-ups with your favorite video on Netflix, Amazon or Youtube and see how it feels. Research calls this temptation bundling and this may just be the key to your health.
What are some motivators that you use to make healthy decisions?