It isn't news that unhealthful habits are tough to break. But an article in last week's Journal of the American Medical Association suggests that some "asymmetric paternalism" might help. The idea: It's possible for policymakers to realize change by designing systems that make the healthful choice the default choice. Having doctors automatically schedule screening exams for people rather than relying on the patients to keep track, for example, would probably be good for preventive medicine. George Loewenstein, one of the paper's authors and a behavioral economist at Carnegie Mellon University, says individuals can apply the concept within their families, too.
Why do we make bad choices even when we know better?
Part of it is that we are wired to care more about immediate, tangible consequences than about delayed and intangible consequences. If we eat a high-calorie snack now, the pleasure is immediate and tangible and the consequences—an indiscernible impact on our weight—are delayed and intangible. If we buy a $5 latte now, we get immediate pleasure, but the long-term impact on our goal to have half a million dollars when we retire is minute.
Hmm...is this hopeless then? How can people change their ways?
No, not at all. The answer is to build systems into your life that reward healthy choices or that make healthy choices more convenient than unhealthy ones. People will naturally take the path of least resistance. Set up your lives or the lives of your children so that the path of least resistance is the path that you actually want to take.
In the arena of finances, for example, have your employers automatically deduct money from your check for a retirement account rather than trying to put together a deposit each month for the bank. Or say you hate flossing and don't do it. Consider replacing standard floss with those little flossing sticks or upgrading to a floss that glides easily and smells good, as just a subtle change like that could be key.
Say you are a parent trying to get your kid to eat more wisely. How could you make that the convenient choice?
Well, don't forbid your children to eat junk food, but rather make it more convenient for them to eat the healthy stuff. When they come home from school hungry, have a plate of carrots or celery and peanut butter ready that they can eat immediately. Even celery is going to look good to them if they haven't eaten for several hours. Do that regularly enough and the healthy behavior becomes a habit.
What about the rest of us? We're all surrounded by food that isn't really very good for us.
Absolutely. Bad habits can be extremely difficult when you are constantly faced with temptation. I wanted to quit coffee, but on my campus there is a coffee outlet everywhere you walk. You're always in the position of saying "no, no no." I never succeeded in kicking the coffee habit. But we know that people tend to eat a lot when they are at home alone watching TV. So set up a schedule to make sure you keep busy. Volunteer. Join a bicycle club. Set a regular time to jog with a friend you enjoy spending time with and try to make that time as inviolable as possible so you'll feel really guilty if you cancel. Do anything to get away from an environment in which food is always available in which it is too easy to backslide.
What about using punishment as a way to banish bad habits?
No way. It just doesn't work. We know, in fact, that stress and negative emotions often lead to things like binge eating, drug relapse, and impulse buying. Incentives work much better.
What sort of incentives do you suggest building in?
Set up systems in which you reward yourself with small, immediate rewards for doing the right thing. Seemingly stronger incentives—such as the desire to not die from a stroke or to be thin—don't change behavior because the goals are too remote and the benefits are insufficiently tangible.
We do something called a deposit contract. Say you are trying to lose weight. You would put down a deposit with a spouse or friend who gets to keep the money if you don't lose the weight. Every week, let's say, you either get paid by your friend for losing a few pounds or you lose some money. You don't want to create a deposit contract where after six months if you haven't lost a lot of weight you lose a bunch of money. It's been very successful. There are a number of versions. In one the friend donates the money to a political party or organization that you dislike. That's proven to be very motivating.