Episode 43 – Exercise Adherence: Will You Stick With It Or Fade Away?

Live Fit : Exercise AdherenceWill You Survive Exercise Drop Off?

Every new year thousands of people make a resolution to get in shape. This is a great goal and one that should have a positive effect on that person’s life. But, studies show that 60% of the people who begin an exercise program drop out within 6 weeks.

Exercise adherence is a person’s ability to maintain regular exercise for an extended period of time. This time period is debatable, but I would say if a person is adhering to exercise, then they are, until they’re not.

For those that began the first week of January, they will likely drop out  by Valentine’s Day. How many people do you know have dropped out of their regular exercise program after 6  – 8 weeks?

Why People Drop Out of Regular ExerciseLive Fit : Exercise Adherence

To emphasize the problem of adhering to exercise, consider that 60% of the people who begin an exercise program drop out within the first six weeks.

Why People Drop Out of An Exercise Program:

  1. (Perceived) Lack of time
  2. Lack of convenience
  3. Expense
  4. Physical discomfort
  5. Embarrassment
  6. Poor instruction
  7. Inadequate support
  8. Loss of interest

 

It is difficult to accurately determine what percentage of the American population exercises on a regular basis, but studies show that anywhere from 20% – 45%. Even the highest number isn’t high enough for me.

What is Exercise Adherence?

“Exercise adherence has been loosely defined in research literature both as exercise behavior within a structured program and as exercise maintenance outside of a formal program” (Emery, 1992, p. 466). This definition and others are vague and don’t include any time limitations, but most of the studies lasted six months or less. For adherence to be true, a person must exercise for more than six months because, as we all know, six months of exercise is not enough to give a person a lifetime of fitness.Live Fit : Exercise Adherence

To truly adhere to exercise, it needs to be part of a person’s lifestyle and not just a fad or a phase they are going through. When they are getting to know someone, do they mention that they exercise, what sort of activities they do? It must be a part of who they are for it to be a lasting lifestyle. It can’t just be something they do now and then, like taking the car to get an oil changed every 3 months.

The Daunting Task of Adherence

How do I help a person adopt a healthy, fit lifestyle? How do I help them to not only see the light in the first place, but to see it for the rest of their lives? How do I keep them motivated when they are tired, busy or low on money? How do I help them to see and feel the same magic that I feel when I’m feeling strong and fit?

This is where the difficulty lies. Telling and showing a person how to be active, eat, shop, and all the other little traits that lead a person closer to good health and fitness, is easy. The hard part is the consistent execution. Because, following healthy habits for a day, a week, or even a month is not going to change the body’s health. Being active EVERY DAY is the only way that real, lasting, change is going to take place. It MUST be part of their lifestyle, a part of who they are, a daily habit.

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Why Do Exercisers Exercise?

Live Fit : Exercise AdherenceAside from the innate drive to exercise, researchers have discovered that the motivation to do so falls in two general categories: Intrinsic and extrinsic motives. Meaning, a person’s motivation to exercise comes from either internal reasons like challenge, enjoyment, or satisfaction or external reasons such as body-related issues or social factors. There are a number of sub-factors which contribute to exercise adherence or the lack thereof, a few of which are: Rewards, expectancy of outcome and self-efficacy (“An individual’s estimate or personal judgment of his or her own ability to succeed in reaching a specific goal” (The Online Medical Dictionary).

Studies have shown that a person is more intrinsically motivated when they participate in an activity that is interesting and challenging to them. For example, adherence rates for martial arts classes are much higher than for aerobics classes. This is because people who take aerobics classes do so (primarily) for body-related reasons (extrinsic motives). Whereas most people who participate in martial arts classes do so for intrinsic reasons and feel more energized, confident and satisfied (Ryan, 1997).

Intrinsic vs. Extrinsic Motivation

Live Fit : Exercise Adherence

The brain must be involved

Body-related, extrinsic motivation is not usually enough to maintain a regular exercise program; a person will lose interest and find reasons why they can no longer exercise. Ryan’s (1997) study found that for a person to continue in an exercise program they would need to find enjoyment and/or growth of competencies in the physical activities. If this doesn’t happen within a reasonable amount of time for that person, they are very likely to drop out.

Women, Ryan said, are more prone to exercising for body-related, extrinsic reasons, then men, because they are, in general, less satisfied with their bodies. Thus, men are more apt to exercise to build their competencies or for the enjoyment of the activity, equating a far better chance for adherence to regular exercise (1997).

How To Increase Adherence

One of the most remarkable studies involving adhering to an exercise program resulted in a 94% adherence rate. In 1988 Gillett studied a group of women in an aerobic dance class for 16 ½ weeks. She said the reasons for this astounding adherence rate were attributed to many factors:

  • The group was homogeneous (they were roughly the same weight, age, female and they were only exercising with people from their same group)
  • They carpooled to the classes together (thereby committing them to the class)
  • They enjoyed the social networks
  • They experienced pleasurable feelings associated with increased energy and fitness
  • The leader was a nurse (and allowed the participants to ask her health-related questions)
  • The study was for a finite period of time
  • The participants were committed to an established goal
  • They had a strong desire to change their body image and to change their physical status for improved health

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There is no telling how long this group would have stayed together had the study been for an unlimited length of time, but it shows the possibilities for improved adherence to a program if certain factors are in line, namely homogeneity.

AccountabilityLive Fit : Exercise Adherence

Dishman (1987) found that holding a person accountable for their continued exercise can be successful. The adherence rates of participants who signed an agreement stating they would continue with the program for 6 month was 65% whereas the non-signers were as low as 20%.

Some factors attributing to long-term adherence are social reinforcement from family or friends. This can have a powerful impact (perhaps the most influence) on a person’s adherence to exercise. If a person’s family and friends are giving them encouragement and support their chance of adopting exercise as a lifestyle is far greater. For example; a working mother could use her role and duties as a reason for not having the time to exercise, but if her family and friends offer to help her with certain tasks such as picking up a child from day care, and reminding her that her health will benefit her child, it will be much easier for her to take the time in her schedule for health improvement.

Get A PartnerAccountability partner

Making lifestyle changes by yourself is not easy. Changing behavior is usually most effective when the person has an accountability coach or workout partner. This coach or partner could be a friend, relative, spouse, personal trainer, or health coach.

Your personal health coach can be anyone that can see you, your obstacles, and give you realistic solutions and who can motivate you to push on when the going gets rough. Your partner will be the person who is on your side, but who will also tell you when you are goofing off. A good coach cares about your success, and can help you plan and organize your goals so you can achieve that success.

Commitment and Realism

One reason some people drop out of a program is because they were never committed to it in the first place or their expectations were too high. This phenomenon is called the “false-hope syndrome.” People are not likely to meet unrealistic expectations of exercise results and repeated attempts will often result in self-blame, guilt and frustration. Sears’ (2001) study found that the participants predicted that they would be more satisfied at a later point in the program, but in fact, they were not; they were actually less satisfied. The most likely reason for this is they did not revise their predictions, even given the experience of past failures.

Pleasure and Pain

Live Fit : Exercise AdherenceKnowing this, it may be possible to determine these attitudes in advance and which might be used to compel a person to either be 100% committed or to take more time to mentally prepare before starting on a difficult goal. Studies show there are at least two good ways to improve a person’s commitment if they are not intrinsically motivated: Rewards (pleasure) and Pain (or punishment).

Pleasure or Rewards

Suitable rewards should be given at first to increase extrinsic motivation and then decreased if/when intrinsic motivation takes over. Sometimes recognition of results by either self or others is enough of a reward and incentive for a person to continue. Rewards are especially useful in the beginning, because intrinsic motivators such as improved energy and strength will take some time to develop, Kravitz (1991) said.

Pain or Punishment

This could come in the form of the pain poor health leads to, or not being able to keep up with your kids, to feeling embarrassed to finish last in a 5 k run. Pain or punishment can be any negative result from your lack of participation in regular physical activity. It can come from self or others.

Self Talk and Attitude

Another factor in changing from a sedentary lifestyle to an active lifestyle is the conversations a person has with themselves and others. These conversations can have an extreme impact on a person’s attitudes, feelings and behaviors in regards to the role they may play as mother, father, employee, boss, et cetera and the need to be physically fit. Be cautious, because the subconscious mind does not know the difference between fact and fiction. They should speak in positive terms about themselves to themselves or others. This can also be used as a powerful tool to maintain motivation. For example, if one speaks negatively and puts themselves down, they will feel down. Conversely, one can use positive language to bolster themselves and increase motivation and strength.

Education

Education is not usually a factor in a person’s ability to adhere to an exercise program. Most people know that exercise is beneficial to the body, and most people know ways they could exercise. This fact is the same with dieters. However, studies have shown that people with a higher education, generally care more about their health.

Make the Change Permanent

Live Fit : Exercise AdherenceMotivation is the key issue here and finding a person’s (or your) key motivator is the trick, and the reward. Try to find an activity that you like and feel challenged doing, but not overwhelmed. If you can adopt an intrinsic drive for the activity, or multiple activities, you will not have to worry about “exercise” again for the rest of you life; your hobby will be your exercise.

These studies on adherence are interesting and useful tools in helping a person stick with an exercise routine or active lifestyle, but if all this doesn’t work, it may just come down to telling yourself to stop acting like a baby and do what needs to be done to be healthy. You may not like hearing this, but when the consequences of a sedentary lifestyle are explained – and realized, you just may get it, and get on with it.

The Bottom Line

There are many ways people can change their lifestyle to become fit and maintain fitness for a lifetime. They can use:

  • Intrinsic and extrinsic motivation
  • Pain and pleasure motivation
  • Tools such as contracts, and technology (like FitBit)
  • Groups that exercise together
  • Social reinforcement
  • Accountability partner or coach
  • Positive self-talk

Anything that works, works. Try new things. Try old things. As long as you are moving, you are doing better than sitting. Do your best. I’m sure you can kick butt.

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If you found this article about Exercise Adherence to be worth your time, please share it so others may benefit.  Thank you.

 References

  • The On-line Medical Dictionary. (July, 2002). http://cancerweb.ncl.ac.uk/cgi-bin/omd?action=Home&query=
  • Emery, C. F. (1992). Exercise adherence or maintenance among older adults: 1-year follow-up study. Psychology & Aging, 7(3), pp. 466-470.
  • Gillett, P. A. (1988). Self-reported factors influencing exercise adherence in overweight women. Nursing Research, 37(1), pp. 25-29.
  • Ryan, R., Fredrick, C., Lepes, D., Rubio, N., & Sheldon, K. (1997). Intrinsic motivation and exercise adherence. International Journal of Sport Psychology, 28(4), pp. 335-354.
  • Sears, S. R., & Stanton, A. L. (2001, September). Expectancy-value constructs and expectancy violation as predictors of exercise adherence in previously sedentary women. Health Psychology, 20(5), pp. 326-333.

Self. Journal of Personality and Social Psychology, 35, 63-78.

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