I don't know about you, but I have never sent a letter to the White House. Yet, it is now my turn. Why? Because of First Lady Michelle Obama's leading role in health promotion for children. As she said last year at the launch of her Let's Move campaign against obesity: "The physical and emotional health of an entire generation and the economic health and security of our nation is at stake." It is a crucial campaign, and it is my concern for its success that led me to send this letter:
"Dear First Lady Obama:
I am writing this letter in support of your Let's Move campaign against obesity. As you well know, traditional recommendations for physical activity and good nutrition have met with failure in the United States. According to the Center for Disease Control, rates of adults who engage in no leisure time physical activity have been in the range of 20-30% for over 20 years. Moreover, over 75% of individuals do not engage in regular physical activity, and obesity is now at epidemic proportions in the United States.
An essential flaw in recommendations for physical activity is the distal link between exercise and consequent health payoffs. To encourage and promote a new behavior, especially an effortful one, the behavior needs to be tightly linked with reward. This does not occur with exercise for fitness, where weeks and months of effort are required to achieve a meaningful difference in relevant outcomes - e.g., loss of weight, improved cardiac fitness, and greater resilience against diabetes. Although some individuals are able to delay gratification enough to achieve slimmer, fitter, and more healthful bodies, this is usually not the case. Accordingly, when viewed from the perspective of research on learning and motivation, the failure rate of exercise promotion in the United States makes good sense; people should fail at high rates in the adoption of effortful behaviors when the rewards for these behaviors are especially distant from the effort.
Fortunately, there is an alternative approach to rewarding health behaviors. Unlike the physical health benefits of exercise, the mood benefits are immediately linked to exercise. Population-based studies and well-controlled clinical trials have provided consistent evidence that exercise improves well-being; decreases depression, anxiety, and hostility; and offers greater feelings of social connectedness. In controlled clinical trials, programmed exercise can provide depression relief that rivals that provided by antidepressant medication. Indeed, depending on the intensity of exercise, mood benefits are often felt within a few minutes of completion of exercise, providing the tightly-linked contingency important for behavior change.
The implication of this research is that attention needs to be placed on the mood benefits of exercise; using these benefits as the motivating force behind regular exercise. These benefits are available for everyone, but are even stronger among individuals with mood disruptions. As you know, mood disruptions are more common among overweight and obese individuals, providing the potential for even stronger mood benefits for these individuals following each exercise session. I am writing today to encourage this approach as part of your efforts to improve the health of the people of the United States - to use exercise prescriptions for mood as a central motivating force in your efforts to help Americans become more healthy..."
Ok, so there you have it: the core of my first letter to the White House. The essential message captures what we have been emphasizing in this blog. Focus on the mood benefits of exercise, and use pleasure to stay motivated. And whether it is your intent or not, exercise will then have additional payoffs for your overall health and longevity. It is a good deal!
Copyright Michael Otto
Drs. Michael Otto and Jasper Smits are authors of Exercise for Mood and Anxiety Disorders: Proven Strategies for Overcoming Depression and Enhancing Well Being.