ADA 2010: Bolster self-determination to boost exercise motivation

Exercise research has found that boosting patients’ self-determination is an effective way to improve their motivation to exercise. The results were presented during an oral presentation, Practical Issues in Diabetes and Exercise on Sunday afternoon.

“The number one reason people give for not exercising is lack of motivation and interest,” said exercise motivation researcher Shane Sweet, MA, doctoral candidate at the University of Ontario, Ottawa, Canada. “Increasing their sense of self-determination increases motivation, which results in better adherence to exercise, medications, glucose, and A_1c.”

Increasing self-determination means helping patients realize that they have choices. Once patients recognize that they have control over those choices, they tend to make the right ones.

“We all have an inborn tendency to prefer well being,” Sweet explained. “We all want to feel comfortable in our skins. If you can help them [patients] recognize that they have choices about exercise, help them build confidence and competence in exercise activities, and help them relate better to exercise, they are going to feel more motivated.”

The key is to behave in a warm and caring manner using motivational interviewing and expressing empathy.

“You want to help the patient discover choices,” Sweet explained. “It gives a greater sense of control and less sense of pressure.”

The next step is to build confidence and competence by helping the patient identify the expected outcome and set realistic goals. Using more frequent, easier-to-achieve goals instills confidence. It is also important to build skills and coping strategies. That may mean helping patients learn an exercise skill or realize that minor aches and pains are normal.

Controlling language-phrases such as “you must,” “you should,” or “you ought to”-are probably counterproductive.