How Should We Harness Behavioral Economics for Better Health?

Man choosing healthy food. Abstract image with wooden puppetAs much as humans think they’re objective beings whose every decision emerges from cold logical calculation, we’re just irrational, emotional animals. That’s why stories and anecdotes are more convincing than facts, why people fear losing money twice as much as they enjoy making it, and why the guy making $100k per year feels poor if his neighbors make twice that. This kind of phenomenon is best explained by behavioral economics, a method of economic inquiry that uses psychological, emotional, cognitive, and social factors to explain why we make the often-irrational financial choices we do. And it has some interesting applications for health….

In a recent piece in the NY Times, a doctor discussed how health care professionals are beginning to leverage behavioral economics to make their patients healthier. He begins with a few examples of behavioral economics in action.

People are more likely to choose an option if it’s the default position. In one study, countries where people had to opt-out of organ donation had organ donor rates of over 90%, compared to donor rates of 4 to 27% in places where people had to opt-in.

People are more likely to make a decision when given fewer options. Too many options make decision-making harder, as anyone who’s spent two hours reading hand blender reviews on Amazon before giving up and ordering nothing can tell you.

While we wait for the experts and authorities to fine-tune their benevolent social nudges, how can we take advantage of behavioral economics for our own health?

Penalties Work Better Than Rewards

People hate losing money. Future rewards are just that: in the future. They’re abstractions. Forking over money, placing your own hard-earned cash in limbo while you succeed or fail is very real. You had money, then it went away. That’s happening in the present moment, and you feel it—rather poignantly. As behavioral economics pioneers Kahneman and Tversky said in 1979, “losses loom larger than gains.”

Stickk was created by a behavioral economist who knew the power of loss aversion. With StickK, users interested in accomplishing a goal formally make a commitment to reach that goal by a certain date and put some of their own money on the line to be forfeited if the commitment is not fulfilled. You set the goal, lay out the stakes of your commitment (how much money, if any, will you put on the line, and where will the money go if you fail?), choose a “referee” to track your progress, keep you honest and report your progress to StickK, and choose other StickK users as supporters to cheer you on. Choose a goal template or create your own from scratch. Goals can be ongoing commitments requiring constant check-ins, or one-time things where you either succeed or fail.

Another option is Pavlok, a device created by the guy who paid a woman off Craigslist to slap him across the face each time he stopped focusing on his work. You strap the Pavlok onto your wrist—it looks a lot like a FitBit—and decide on a bad habit you’d like to break or a good one you’d like to establish. Each time you fail to hold your side of the bargain, the Pavlok zaps you with a mild but uncomfortable electric shock. (This option might not be for everyone, but I’d love to hear from those who do try it.)

Don’t Shop When You’re Hungry

Shopping for anything when hungry is a bad idea. Studies show that hunger increases the amount we spend, even if we’re shopping for something totally unrelated to food. When you’re hungry, you desire more of everything.

Hungry grocery shoppers make worse choices, too, choosing unhealthier, higher-calorie junk food over healthier, lower-calorie real food.

To this, I’d also add the tangentially related “Don’t go out to eat at an expensive sushi restaurant if you’re starving.” There’s no quicker way to run up a bill.

If you must go shopping while hungry, prepare a list beforehand. That list will be your life vest of rationality in the stormy, boiling sea of gurgling stomach juices drifting you toward the snack aisle.

Sink Your Costs in Health

You may have heard of the “sunk cost fallacy”—which describes how people feel compelled to stick with something they’ve already paid for, even if it’s horrible, just to “get their money’s worth.” It usually refers to a negative, harmful behavior.

Sometimes the sunk cost mentality is helpful, though. Wasting 3 hours of your life on an awful movie just bcause you paid $12 is bad. Going to the gym three times a week for a full year because you paid $1000 for the year membership up front is good. Both are sunk costs, but one has a good result. Other examples of positive sunk costs include personal training sessions, massage sessions, expensive exercise equipment (barbells, stationary bikes, kettlebells, etc).

Price matters here. The sunk cost effect will be greater the higher your initial investment. It’s harder to ignore a $1000-a-year membership at the local powerlifting gym than it is to ignore the Planet Fitness package you got for less than $100.

Surround Yourself with People Making the Choices You Want to Make

According to a 2013 study, people tend to converge to the lowest common denominator. Office workers were all given access to treadmill desks, then followed for six months. When people got regular updates about everyone else’s treadmill usage, they used them less, regressed to the lowest common denominator. When people didn’t know how often the others were using the treadmills, usage went up.

Since social media and basic physical proximity make it nearly impossible ot avoid knowing what everyone else is doing, your best bet is to surround yourself with people doing awesome, healthy things on a regular basis. Follow Facebook and Instagram friends with healthy habits. Train at a gym where the other people’s feats inspire you. Make sure the lowest common denominator is higher than most.

Order Groceries

When you’re at the grocery store, even a healthy one like Whole Foods, they’re tugging on your emotions and base desires at every turn. I don’t fault them for it. It’s how merchandising works. Just know that’s what you’re walking into, unless you decide not to walk into the store at all.

These days, that’s actually possible. You can order groceries from a place like Thrive (my favorite) or Instacart. Instead of idly browsing through the entire store’s inventory, where you might run into something junky, you search for the exact categories you want, and then you browse. If you don’t want the gluten-free almond flour macaroons you can’t ever walk past, you simply don’t search for them.

Don’t Just Imagine the Worst Possible Scenario—Feel It

In an effort to dissuade cigarette usage, many countries have established laws requiring the use of graphic warning labels that depict potential consequences of long-term smoking, in lurid detail. Does the sight of a cancerous orifice, tracheotomy hole, or dead body make people more likely to try quitting? It appears so. Graphic warning labels correlate with both more attempts to quit and reduced rates of smoking

This can work for everyday health practices, too. Immerse yourself in graphic, visceral evidence of the worst thing than can happen to you if you don’t lose weight/exercise/do what you need to do.

Prediabetic? Rev up the images of diabetic foot amputations and festering sores.

Stiff and inactive? Look up knee replacements, watch arthroscopic surgery videos.

Make Healthy Food and Exercise the Default

We stick with the default option more often than not. It’s harder to opt-out than opt-in. Make it so that you have to opt-out of eating right and exercising.

Every Sunday, do meal prep for the rest of the week. Cook up a big batch of something. That way, if you want something unhealthy, you have to “opt-out” of eating the healthy food you already have prepared and ready to go. This also works on smaller scales, such as keeping hard-boiled eggs on hand or chopping veggies and prepping salad makings days in advance.

A few ideas for making exercise and movement the default position:

Start active commuting to work.

Eliminate your office chair. Force yourself to stand (or walk).

Keep a kettlebell (or barbell, or dumbbell, or weight vest, or any piece of equipment) right outside your bedroom door. Whenever you wake up, there it is waiting for you.

Behavioral economics is powerful and, in my opinion, quite accurate. Most of us “use” it every day without even realizing it. How else can you leverage behavioral economics to make it easier to eat, move, and live Primally?

Thanks for reading, everyone. Take care.

Primal Kitchen Pizza Sauce

TAGS:  marketing

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

If you'd like to add an avatar to all of your comments click here!

22 thoughts on “How Should We Harness Behavioral Economics for Better Health?”

Leave a Reply

Your email address will not be published. Required fields are marked *

  1. Not sure I could willingly shock myself to kick a bad habit, but maybe knowing that this is an actual strategy can light a fire under me! Great post. 🙂

  2. So true on making healthy eating the default. I RARELY opt out of my pre-made lunches, but it’s easier to opt out of dinner, which still would need to be prepared. Hmmm… I also can’t wait till sit/stand and treadmill desks are the norm. Office life has broken me down.

  3. I keep a picture of myself 80lbs ago on the bathroom mirror. I was bloated and looked tired and unhappy, even though I was smiling. Even at my heaviest, I still had all the “healthy” biomarkers – except being nearly 100lbs overweight. But I was depressed, moody, got sick all the time, and never felt like getting up and putting in any effort at physical activity. Never again.

  4. I used the Pavlok successfully two years ago. Every year I go without alcohol for at least a month. Most years it became a test of will, but using the Pavlok that year it felt effortless. For 5 days prior, I simply shocked myself at every cue regarding alcohol I could think of- when I first saw the bottle/can in the store. Later at home, I shocked myself when I held the bottle/can, when I opened it, when i first tasted it, and finally shocked myself when I felt that warm rush overtake me. I did this for 5 days and then went 40 days without a drink easily.

  5. Comfort is not good for the organism… It is strength that makes all other values possible… nothing survives without it. I say, make strength your default.

    Everyday is gym day… except when it’s rest day (Sunday). Everyday and every meal is nourishing… except when it’s not (which is almost never). Park as far away as you can… take freezing cold showers… take the stairs… take the more difficult path by default because it builds strength in every fiber of your tribes existence. It becomes the norm… your kids don’t even ask “why” anymore… they just do it.

    I’m certain that this is why my 10 year old just ran the mile for time (at school) in 6:36… he’s not a runner nor does he play a sport where running is fundamental. His default is strength!

    It is strength that makes all other values possible…

    1. I’ve got my favorite parking spot at the far end of the isle at Wal-Mart. But it’s the isle directly in front of the door. Recently, they started making employees park at the end of the isles, so “my” isle and “my” spot is very popular. The first time I pulled into the parking lot and saw all the cars where I usually park, my daughter said that I sounded like Sheldon, from Big Bang Theory “They’re in my spot.” “But it’s my spot.” Guess I’m going to have to pick and end of an isle that is farthest away from the door. Then nobody will take “my” spot!

    2. I don’t know where you get the idea that any and all discomfort is synonymous with strength. It’s possible to make ourselves miserably uncomfortable in just about everything we do, but that doesn’t necessarily equate to strength. I do take the stairs whenever possible. My house is full of them and it’s good exercise. But a freezing cold shower? Nah. I don’t think that sort of discomfort is going to improve my life any more than sleeping in the driveway instead of my bed would. Have you stopped to consider that maybe your 10-year-old is too scared of you to fail?

      1. Hi Shary,

        Our early ancestors were regularly subjected to cold temperatures. It’s most likely why we humans have brown adipose tissue (bat). In the modern world though, we are rarely subjected to hot or cold temperatures for any real duration. Intentional cold exposures initiate adaptive processes and response mechanisms that are hardwired into our genes.

        Mark has written many articles on cold exposures too. A few of the benefits include: improved immunity, better circulation, stimulates weight loss and enhanced metabolic flexibility. Rhonda Patrick, PHD writes “cold exposures increase cold shock proteins including one in the brain that repairs damaged synapses and in muscle prevents atrophy, how cold-induced norepinephrine lowers inflammation and pain by decreasing the levels of 3 inflammatory mediators…”

        I tend to agree with you… discomfort is not synonymous with strength; however, most of the things that develop strength include a certain degree of discomfort.

        As it relates to my 10 year old boy, I was hesitant to share this publicly bc I have never shared details about my boys in an online setting… with people that I don’t know. I decided to share here because I feel like this community is more like a family… and, I am dam proud of him! To address your statement, we embrace failure in our tribe… we down right celebrate it!! When we fail, it means that we went big… we weren’t afraid… it means that we have an opportunity to learn… to grow… to prepare for the next opportunity.

        I love talking about the cold… I’m passionate about it. Especially since it’s evolutionary science. I look forward to seeing your comments on other posts.

          1. Sorry, that was a “thumbs up” emoji but it converted to a question mark for some reason…

        1. Hi Brian, it was great to hear about your boy – fantastic. I am seeing this way of life becoming the norm for my boys too.

          1. ‘We make men without chests and expect from them virtue and enterprise. … We laugh at honor and are shocked to find traitors in our midst.” — C.S. Lewis

            Thank you for the support and the sentiment! That’s great to hear regarding your boys too.

            Is there anything in particular that you’re doing with your boys that you could share with us? Would love to learn something…

            P.S. MDA asked me to change my name… I was actually using my business name (Ancestral Supplements)… then it would magically change to “Brian.” It seems that we have settled on “Liver King” and I’m happy with that!

  6. So many good ideas here! I really like the positive ones…surrounding yourself with likeminded people and prepping food ahead so healthy food is the default. I’m definitely much more likely to make good food choices when the food is already there in the fridge ready to go. Accountability can be really helpful for some people. I’ve been holding myself accountable on Instagram lately, posting some exercise goals. It’s amazing how that motivates me, even when I am dragging. I also love that other people are joining in with me…makes the whole thing more fun.

  7. “Don’t Just Imagine the Worst Possible Scenario—Feel It”

    I’m world class at doing that, but with enough therapy I’m hoping to overcome it some day.

  8. I’m not really big on ordering groceries. I find it easier to click and order something unnecessarily. I do however never go to the store without a list anymore. Ever since I started that the emotional buying has gone out the window – except for the occasional dark chocolate bar ha. Mmm. So good.

  9. thats some interesting stuff understanding human psychology can help you in many ways to be prepared for stuff as you stated it can be very manipulative but understanding it can give you the edge to avoid these marketing tactics and if you go further you will be able to even identify people who are legitly your friends or guiding you to bankruptcy would love to hear more about this from you awesome post 😀

  10. Write a list before you go to the grocery store, and take a pen and write the price as you grab things. Makes one very efficient. And sometimes you realize you’re ahead of the game so you can go buy a little extra.

  11. Tony Robbins has a great exercise for ‘what’s the worst that can happen’ – I think it’s in his original Personal Power cds (avail at the library) – he calls it the Ebeneezer Scrooge effect. Takes you through a visualization where you think of the thing you want to quit or stop and imagine what your life will be like 5, 10, 20 years into the future. I used it to quit smoking about 15 years ago.

  12. The lowest common denominator factor is really curious. I would have thought that knowing everybody elses habits would have triggered a certain competitiveness… but then, no, now that I think about it, haha! ‘What, you’re skipping the 7-minute workout today? Oh, okay, I will too.’. Having said that, if I’m teaching conceptual stuff (yoga/meditation/nutrition), I take the opposite approach. I try to make my explantations as clear as possible, but communicate to the highest common denominator. I want to connect with and wake up the innate intelligence that is in everyone, rather than assuming that information needs to be ‘dumbed down’.

    It’s what I like about this community: even though some of the science might be beyond our individual educations, it’s assumed that people know how to read and assimilate information, that we continue to learn, that we can always deepen our knowledge.