Anyone who has done the Rainier Medical program before (or knows someone who has) knows one thing for sure: if you follow the program, the program works. So, what’s the problem? As Nike says, “Just Do It,” right? Well, sometimes! What is that unicorn thing called motivation? Where does it come from? Why do we feel so focused sometimes, like it is easy to do the thing we are trying to do, whereas other times, it seems like we can make the best plans and wake up everyday saying,”today is going to be the day that I get back on track, but it feels so hard to do?” Most importantly, how do we get motivated, when it is not coming naturally?

This is the unveiling of “Dr. Sutherland’s 3 Step Plan to Get Motivated and Stay There!” Twelve steps was too many for my attention span!

Motivation Theory

There are two parts to this equation, the motivation, or desire, to take action, and the actions themselves. A deep intrinsic motivation for the outcome is the foundation for the actions, so let’s look at that step first. After all, a house built upon a weak foundation can not stand.

One of the most famous theories of motivation is Maslow’s Hierarchy of Needs. It states that humans are motivated by certain categories of needs, and that certain “needs” goals must be met before one can move on to “growth” goals. However, critics states that motivators do not actually fall in a hierarchy; people are motivated by these things simultaneously. You may feel the need for things at the top of the pyramid at the same time as or before ones lower on the pyramid. But, there are a few useful “take aways” that are borne out by research and expert opinion from this theory of motivation as it applies to weight management.

Studies do show that more older adult Americans are motivated to lose weight because of a health event than for any other reason, such as cosmesis. For example, more people are starting a weight loss journey because of a health diagnosis, although sometimes a vacation or a wedding is that "push" we need! Health falls into the “safety” category in this hierarchy of needs.

Another useful message is that meeting other categories of need can free up capital, or focus, to work on the need for health. Studies show that motivation is a finite resource that is not endless. So, if you have unmet needs in multiple categories in this hierarchy of needs, you may feel “burnt out” or “stretched thin” and feel ineffective in meeting any of your needs. For example, if you are sleep deprived, are in a difficult relationship, are struggling with low self-esteem, it may be more of a struggle to get motivated on a weight management plan. What to do in this case? Be deliberate about your priorities or pragmatic and methodical in your approach so that one need does not drown out the other. What is most important to you? Can you compartmentalize? Can you focus on self-care first or create clearer boundaries so that one need does not interfere with your need for health?

Types of Motivation: Extrinsic vs Intrinsic

Much of your health outcomes is determined by your daily habits, rituals, and work. When trying to change a nutrition pattern, be consistent with a workout plan, or stick to a bedtime routine, many people are looking for that motivation to get them started and keep them going when the going gets tough. There are two basic types of motivation: intrinsic and extrinsic, and one is better than the other! Intrinsic motivation comes from inside of you, while extrinsic motivation comes from some reward or feedback outside of you. Studies show that while an extrinsic reward timed early in an activity can lead to increased pleasure in an activity even when the reward is removed, intrinsic motivators are generally much stronger and more durable. In fact, the use of extrinsic motivators may actually interfere with the development of intrinsic motivation. So, refrain from rewarding yourself for staying on your plan for the week or for exercising with a cheat meal. Rehearse in your mind the intrinsic value of your actions and how they relate to your motivation of the need for health instead! This is what will lead to that elusive “lifestyle change” and “learning how to eat”. Comes from deep within, it does, Yoda says.

I have observed that the concrete feedback on health parameters, such as the body composition, blood pressure, blood test results, changes in medication needs and diagnoses, are highly motivating. This is likely because it reinforces the intrinsic motivator of health rather than the extrinsic motivator of just the weight on the scale.