Nudging: how we can trick our brains into making healthy habits stick

It’s no understatement to observe that many of our health, money and environmental problems are essentially a result of our own bad habits. Although behavioural changes that prevent disease – like eating healthier and exercising 30 minutes a day – can literally save our lives, we struggle to sustain them. Why?

Researchers have studied behavioural economics for years to try to explain how and why we make certain decisions. Why so often we opt for junk food, sedentary lifestyles, and spending instead of saving – despite knowing the consequences.

So, what’s stopping us from making better choices?

“We tend to blame the lack of willpower when we fail to stick to a new healthy eating plan or exercise routine. But often, our irrational beliefs – called behavioural biases – are the cause of our perceived failure to make healthy choices stick. And most of the time, we’re completely unaware of these biases and how they influence our decision-making,” says Vitality CEO, Dinesh Govender.

He adds that attaining wellness is tougher because people tend to be overly-optimistic about their health status. “It also doesn’t help that the positive spin-offs of healthy choices are often only evident in the future, making it easier to give in to instant gratification.”

So, the question is not just how to get people to adopt positive health behaviours, but also how to sustain them. The solution, says Govender, lies in ‘nudging’ – a term from a ground-breaking book by Richard Thaler and Cass Sunstein. In Nudge: Improving decisions about health, wealth, and happiness, the authors explain that people can be prompted to make healthier choices through subtle, positive interventions.

“Nowadays, nudging is widely seen as an effective way to persuade people to make better decisions, and no company has mastered this better than Vitality – the largest science-based wellness programme in the world. With more than ten million members in 22 countries, Vitality has shown that nudging helps its members to live healthier and more active lives,” says Govender.

Does nudging work? Vitality proves it does

Dan Ariely, professor of Psychology and Behavioural Economics at Duke University in Durham, North Carolina says: “People underestimate how much they enjoy exercise because of a myopic focus on the unpleasant beginning of exercise, but this tendency can be harnessed or overcome, potentially increasing intention to exercise.”

The trick, he says, is to focus on the good feelings (endorphins) you will get while doing the exercise. ”What looks dreadful on a to-do list usually isn’t that bad when you’re in the middle of it. Focus on the good feelings in the moment,” says Ariely.

“And then there’s the reward! Knowing you will benefit in health, but also earn tangible rewards, anything from a simple cup of coffee, to devices and travel, means your healthy lifestyle is twice as fruitful,” says Govender.

Vitality has various programmes that encourage members towards positive behaviour, and regularly commissions large, science-based studies to measure the impact of its programmes. For example:

• The Apple Watch Study: In the world’s biggest study on physical activity, RAND Europe investigated if the Vitality Active Rewards with Apple Watch benefit leads to higher physical activity levels than the initial Vitality Active Rewards incentive.
  The results: Participants of the Vitality Active Rewards with Apple Watch benefit increased their activity levels by 34% and sustained it over the long term. The increased activity amounted to 4.8 extra days of activity each month across the whole spectrum of participants, regardless of gender, age and health status.

• The HealthyFood study: Based on Vitality’s HealthyFood benefit, US-based policy research programme Rand Corporation explored whether lowering the cost of healthy foods in supermarkets would motivate shoppers to buy more healthy food items and less unhealthy ones, like sugary snacks and drinks.
  The results: A discount of 25% on certain healthy foods led to a 9.3% increase in the buying of healthy foods. It also increased the ratio of fruit and vegetables to total food purchases by 8.5%, and lowered the purchase of not-so-healthy items by 7.2%.

• The Vitality ObeCity Index: The 2017 Vitality ObeCity Index explored important factors in combating obesity, particularly within a South African context.
  The results: Vitality showed that subsidising healthy eating with financial and other rewards encouraged healthier food purchases, which positively lowered the body fat percentage of members.

The converse: when we are our own worst enemies

Research has found that dietary risk factors and physical inactivity are responsible for the majority of global disease – nearly double the number of deaths caused by tobacco and four times the number caused by abuse of alcohol and drugs. In South Africa alone, half of all South African adults are overweight or obese, which in most cases, is the outcome of poor diet and a sedentary lifestyle.

Being obese increases healthcare costs by as much as R4 400 a year for each person – a hefty added burden on the cost of healthcare nationally. But, it’s not only healthcare costs that escalate in the face of lifestyle risks. A recent study from RAND Europe and Vitality – The economic benefits of a more physically active population – has deepened our understanding of the link between physical inactivity trends and economic indicators globally. Some of the main findings showed that if people between the ages of 18 and 64 walked just 15 more minutes a day, it could boost the world economy by an estimated $100 bn until 2050. In South Africa, we could add at least US$ 500 million or R7 billion rand to our balance sheet every year, if we continue on this path for the next 30 years. 

While the data is astonishing, the good news is that in more cases than not, obesity and its resulting illnesses, are preventable – if people make healthy choices a lifestyle.

Changing the world through smart choices

“The results of these studies underscore the success of nudging. All they do is gently urge people to make better judgments by offering compelling incentives, which encourage people to make positive changes every day, towards a healthy lifestyle. Combined with access to knowledge and awareness through screening and prevention, Vitality hopes to help turn the tide on preventable diseases globally, one positive habit at a time,” says Govender.