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How Permanent Behavior Change Really Works

Iteration is the key to sustainable behavior change.

Key points

  • Traditional SMART behavior change methods often fail in part because they trigger the habenula brain region.
  • The habenula detects feelings of failure and subsequently kills the motivation to put in effort.
  • The Iterative Mindset focuses on continuous and adaptive, ongoing improvements.
  • By treating behavior change as a series of small experiments, one can maintain sustainable results.

What do a former smoker, a successful entrepreneur, and a champion athlete have in common? They’ve all mastered the art of iteration—the key to lasting behavior change.

In a world of constant flux and uncertainty, our ability to adapt is everything. Yet, when it comes to transforming our health habits, we often find ourselves stuck in a loop of negative thoughts and yo-yo results.

We may set lofty goals, dive in headfirst, and expect perfection from the get-go. We’ve bought into the myth that success means never faltering, that progress is a straight line from A to B. But when life inevitably throws us curveballs and our motivation wanes, we eventually backslide into old patterns, convinced we’ve “failed” yet again.

In reality, true change is messy, nonlinear, and full of unexpected detours. The problem isn’t lack of effort or discipline. It’s that our society’s current approaches to behavior change work against groundbreaking new science on our brain (which we will cover later).

That’s where the power of iteration comes in. Iteration is the process of continuously experimenting, assessing, and adjusting our efforts based on real-time feedback. It’s about treating behavior change as a never-ending series of better versions that keep us going long-term—rather than the win-or-lose of fixed goals or tracking. With each tweak and tinker, we learn, improve, and hone our next version—all while keeping our motivation alive.

In my research on many thousands of people, I discovered what I have defined as the “iterative mindset”—an organic process of practicing healthy behaviors, assessing their effect, and iterating on their healthy behavior. From our study findings, this mindset is the most sure antidote I have seen in my career for the backfiring and short-term results that sabotage so many well-intentioned attempts at change.

The brain reason why behavior change backslides

Over 30 years as a public health physician, I have tested every modern intervention, program, or gadget out there. But in the long term, every one of these solutions resulted in high rates of relapse. This high failure rate of current approaches is an open secret in my field.

For example, a recent study on long-term weight loss (six-plus years out) showed that the gold standard of lifestyle change programs, the Diabetes Prevention Program (DPP), yielded a mere 1 percent difference in weight-loss maintenance between the intervention and control groups. No wonder our society, with over 70 percent of people classified as overweight or obese, is turning in droves to the quick fix of injectable and expensive GLP-1 weight-loss drugs. (While these drugs have a role in fighting obesity, merely killing someone’s appetite but leaving them with their old habits of unhealthy eating, without behavior change support, risks eventual malnourishment and poor health.)

Neuroscience reveals what is happening. Traditional behavior change programs all use something researchers call “performance-based” goals or tools, like SMART goals, long-term tracking and counting (of calories, weight, steps, carbs, etc.), financial incentives, challenges, etc.

Although engaging at first, all of these approaches define success so narrowly that it is far more likely that one will fail at their goal in some (little) way or at some point eventually. When this happens, a new brain area called the habenula turns on. When it turns on, the habenula essentially kills one’s motivation to keep doing the healthy behavior—leading to feelings of self-blame, depression, anxiety, or demoralization.

So, people quit trying. But currently, almost no one knows that they even have a habenula—and the motivation loss is often silent and subconscious. Recent research also shows the habenula is a powerful locus of depression, anxiety, OCD, addiction, hunger, and insomnia—and even controls the dopamine rewards pathway and serotonin—making it perhaps the most powerful behavior controller ever found. Once I learned about the habenula, over eight years ago now, I could finally see why every health program or product I had ever prescribed or tried to earnestly help people backfired.

Reaching permanent change

So, how do we tap into the brain’s hard rules for permanent change while avoiding the terminal effects of the habenula? Iteration. In my research on thousands of people who achieve permanent change, they have only this one thing in common: They iterate, i.e., they tweak, adjust, tinker with, and adapt what they are trying as they go, so they never categorically fail. And therefore, theoretically, they also don’t trigger their habenula (which, if turned on, would kill their motivation to keep trying). These people’s behavior change is uniquely evergreen—updating and moving with them as they age—enabling them to live their best life forever.

Iteration is the antidote to the habenula’s motivation-sapping effects. By treating behavior change as a series of experiments, we bypass the brain’s failure detection system and keep our drive alive. Instead of aiming for perfect adherence to a rigid goal, we should instead focus on progress over performance. We can celebrate milestones along our path, glean lessons from setbacks, and adjust our approach based on real-time feedback.

In my research, only those who have an iterative mindset align with the brain’s natural processes and achieve long-term behavior change. Just as babies learn to walk through trial and error, learning, stumbling, and getting back up, our most natural path to mastering new habits is through a process of practice, assessment, and iterating. Each “failure” is no longer a motivation-killer but instead becomes valuable data to inform the next iteration.

If you’re tired of the endless cycle of yo-yo dieting, on-again-off-again exercise, or short-lived self-improvement kicks, build an iterative mindset. Start by practicing a desired behavior, iterate whenever you reach an impasse, and let your setbacks be your teachers. With each iteration, you’ll be one step closer to becoming the unstoppable force of nature you were born to be.


Apolzan, John W., Elizabeth M. Venditti, Sharon L. Edelstein, et al., for the Diabetes Prevention Program Research Group. “Long-Term Weight Loss with Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study.” Annals of Internal Medicine 170 (2019): 682–690. https://

Bobinet, K., Greer, S.M. The Iterative Mindset Method: a neuroscientific theoretical approach for sustainable behavior change and weight-loss in digital medicine. npj Digit. Med. 6, 179 (2023).

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