Moralistic behavior change often starts with the idea that we have complete control over our behavior. Consider the view many have about the obese. Though study after study have shown that the relationship between the brain, gut and weight are more complex than simply “eat less,” the majority of people believe that it is bad choices (emphasis mine) that lead to bad outcomes.
As a result, most behavior change programs are based on a morality play that either views the subject as being capable of willing their behavior to change (Narcotics Anonymous) or completely incapable of it (Methadone). Weight management — the biggest category of behavior change in the United States — follows this same basic pattern. At varying degrees of difficulty, you have:
- Diet and Exercise: High Willpower (just resist temptation)
- Weight Watchers: Medium Willpower (just follow the program)
- Ozempic: Low Willpower (just take the drug)
The parallels to various streams of religious thought shouldn’t be lost on anyone (saints, laypeople, heathens), and this pattern recurs again and again throughout history and in our efforts to “reform” or change people’s actions.
But what if lasting behavior change isn’t a question of willpower, but rather one of imagination and flexibility.
Put simply: can you imagine a better future, under your control? Can you make an alternative choice now that still gets you most of what you want without putting you in harm’s way?
Clues to this path may be found in Cognitive Behavioral Therapy — or CBT.
At the heart of CBT is the idea that thoughts create feelings, feelings create behavior, and behavior reinforces thoughts. In its simplest form, CBT programs help stop this negative cycle by questioning and reframing thoughts as they arise. CBT for obesity (CBT-OB) has shown some promising early results with highly overweight individuals, and many companies have sought to capitalize on this theme, e.g. Noom. The same is true of CBT in most other behavior change protocols, though many questions remain about applicability outside of academia.
Underneath CBT’s success is a fundamental assumption: in order to act on your thoughts…