Leave Me Alone!

Lots of people resonate with the idea of involving other people in behavior change efforts. But not everyone does. And they have some pretty good reasons.

Sparkpeople, the online support community for diet and exercise, has an article titled, “Get Others Involved in Your Goals: Don’t Be a Weight-Loss Loner“. Over the past few years, it seems to have been featured a few times, each time prompting a bunch of user comments. For the first couple of years, those comments were mostly positive, but they have become increasingly negative. I’ve gone through those comments and identified five themes.

But first, what does the article say? It gives reasons to involve others: positive peer pressure, a team that’s pulling for you; information resources and a source of enthusiasm you can tap; boring activities can be more fun if done together with others. And it makes some suggestions of what people should ask others to do: check in on you once a week; be there when you need to upload; keep you upbeat; serve as photographer for before and after pictures; pass along inspirational reading; etc. All fairly innocuous at first blush, hardly the kind of thing that should lead to an emotional backlash.

Many of the comments assert that the writers are “loners” who do better on their own. It is hard to tell how much of this is a defense mechanism against painful but helpful things, and how much of it is truly describing a personality trait that does worse at behavior change when other people are involved. To the extent that people have been constructed identities as loners, incessant advice to not go it alone is an attack on that identity that can itself be destructive. One comment begins, “Surprise, once again we are told not to be the way we are. I am a loner, and I like being that way.”

Some of the negative responses focused on problems with face-to-face relationships. Other people are not reliable as workout buddies because they let you off the hook instead of keeping you accountable, it’s hard to coordinate times with them and they don’t workout at the same pace. Most importantly, workout buddies don’t stick with it: the workout buddy drops out and it’s hard to keep going your self.

Perhaps the most interesting theme was that real life friends and family are often also not very good members of support networks. They are saboteurs who work against your goals (“come on; it’s just one piece of cake”, “you’re fine the way you are and your husband loves you, so why do you want to put yourself through all of this?”) They judge you (“you’re going to eat that? I thought you were on a diet.”) They let you off the hook. They give you unwanted advice (“if you really want to lose weight, here’s what you really need to do”), sometimes conflicting or just plain bad advice. Or they flaunt their own successes and make you feel bad.

Many writers expressed that they rely on online interactions at SparkPeople that are truly supportive, but keep quiet with real life friends and family. One person concluded her comment, “Between all the conflicting/overwhelming information and the just plain meanness of some people I have decided to keep diet info to myself.”

As an interesting side note, one of my colleagues, Prof. Tiffany Veinot, recently presented a paper titled, “Health information behavior in families: supportive or irritating?” The study found that both the prevalence and effects of information and advice from  friends and family can vary by disease condition. Among people with Type II Diabetes, which often runs in families, information and advice sharing are frequent but are not always so positively received, for the same reasons described above. In contrast, among people with HIV/AIDS, fewer got advice and information from friends and family. But when they did receive forwarded articles or other information, they appreciated it. Even when the information or advice was not perceived as helpful (and it often wasn’t), it was perceived as an expression of concern and caring, and a willingness to engage in discussion about a stigmatized condition.

So what are the take-aways and agenda suggested by the comments at SparkPeople? First, further research is needed to understand whether there are identifiable personality characteristics that correlate with effective use of different social tactics such as doing activities with others, using others as inspirational models, competing with others, using others as accountability monitors, etc. Second, there may be opportunities for tools that make interventions with friends and family to help train them to be better supporters. These might be very explicit, as in SuperBetter, where you ask supporters to do specific actions as part of fantasy role playing. Or they might be far more subtle, such as supportiveness meters that give people feedback about how (un)supportive they are actually being.