Thursday, September 27, 2012

Sticking to Health & Wellness Goals: These Websites Made Me Do It

My regular readers know how important I think behavioral economics will become in the field of health care.  (  The best place to start thinking about applications of behavioral economics principles to wellness is Nobel Prize Winner Daniel Kahneman’s book Thinking, Fast and Slow

Several start-up companies have created ways for people to apply behavioral economics heuristics to their own individual fitness and wellness programs.  Jordan Goldberg was so intrigued by these possibilities he encountered in undergraduate classes at Yale that he started a company, Stickk, with his professors Dean Karlan and Ian Ayres. 

As Goldberg related in an e-Patients Connections 2012 talk in Philadelphia recently, people say they want to do healthy things, but then life happens, and they don’t follow through on their stated intentions.  Stickk creates clever ways to take advantage of nudges and libertarian paternalism to frame choices so people do what they really want to achieve.

My favorite example of this concept  is their anti-charity option where Stickk takes money away from you to give to a charity you hate if you do not achieve your goal.  If your stated goal is to walk 10,000 steps every day and you slack off, the despised charity you choose gets an automatic contribution.  According to Goldberg the George W. Bush Library is a favorite charity in this program.

By applying the behavioral economics principles of hyperbolic discounts, real time loss aversion, carrot vs. stick, reference points, and power of defaults,  Stickk has created both public and commercial websites that may really get people to stick to their stated health and wellness goals.

Aherk! is another website designing tools for people having difficulty sticking to their weight loss regimen. 

“The user also emails Aherk! An embarrassing photo – referred to as ‘the bomb’ on the site.  When the deadline hits, Facebook friends vote on whether the goal was achieved.  If not, up goes that incriminating pic at the expense of some social media status.”

Other start-ups applying behavioral economic heuristics to healthcare include GymPact where smartphones track missed exercise workouts and automatically fine the participant and MetaReal’s Virtual Fridge Lock with its refrigerator device that posts a Facebook notice when one raids the refrigerator when one is not supposed to.
One can find psychology professors who think the above tactics are laudable and those who object to these approaches:

“I would rather see a website that allows a person to define a goal and state a reward the person will give him or herself if the goal is met.”  Erin Way

“Committing to anything in public, something that has been known for a long time in psychology, is a good way to get people to stick to their guns…People don’t like to feel like a fool.” Andrew Ward (


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