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  • Published on: 14th September 2019
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Why is it so difficult to change behaviour by changing minds?

What implications does this have for policies designed to reduce obesity?

“Change is not made

without inconvenience,

even from worse to better.”

Richard Hooker (1554–1600)

To change someone's mind could prove a challenging task because people tend to cling to values and beliefs that help them “protect” themselves against the views and opinions that are contrary to their own. This phenomenon may be rooted in human biases such as motivated reasoning  and confirmation bias , and could be explained by cognitive approaches like the self-affirmation theory (Steele, 1988) which proposes that individuals adapt to information or experiences to protect their self-integrity; or the cultural cognition thesis (Kahan and Braman, 2006) which stresses that individuals form perceptions of risk and related facts that cohere with their self-defining values.

Furthermore, it could be said this is just half the challenge if the final aim is to change behaviour, because even if you get someone to change his mind there is not a certainty that he will align his behaviour accordingly. This inconsistency between what it is thought and what it is done is explained by the cognitive dissonance theory (Festinger, 1962), from which is possible to infer that despite the feeling of mental discomfort, individuals do perform actions that are contradictory to their beliefs, ideas, or values.

Nonetheless, changing people's behaviour, at least in the short term , does not necessarily imply to change their mindset (Dolan et al., 2010). There is evidence that support that it is possible to influence someone's actions by tapping into psychological shortcuts – heuristics and biases – that rely on automatic responses to contextual stimuli (e.g. nudges  ).

Following Daniel Kahneman's interpretation of the dual process approach to understand human behaviour , the MINDSPACE report on influencing behaviour through public policy (Dolan et al., 2010) asserts there are broadly two models of behaviour change; one is based on individual rationality and the other on the context to which the individual is exposed.

The former presumes people act in ways that reflect their best interests based on the logical analysis of the information they are provided with, therefore it focuses on changes in cognitions to produce intended behaviours , while the latter “recognizes that people are sometimes seemingly irrational and inconsistent in their choices, as a result, it focuses more on changing behaviour without changing minds.” (Dolan et al. 2012: 127)

From Standard Economic Theory to Behavioural Sciences in Policy-Making

To begin with, the designing of public policies needs to recognise that the individuals, target of the interventions, are not the logical creatures depicted by Standard Economic Theory which, among other rational characteristics, have unlimited willpower and self-control, are only driven to best satisfy their needs, and make decisions based on fixed and stable preferences. It will be useless and irresponsible to create programmes having in mind these unreal characters.

That said, policy-makers should start by a) acknowledging that individuals' responses to stimuli are affected by automatic and reflective processes, and that most behaviours are the result of thorough integration of both of them (Camerer et al., 2005); and b) considering social context when making efforts to change behaviours, since behaviours take place in social environments.

Moving forward, to avoid overlooking important factors when designing interventions (i.e. inattentional blindness ), it is prudent to advise the use evidence-based checklists of what is already known to explain behaviour. For this matter, behavioural change frameworks like Nudge  and MINDSPACE , built on years of extensive research in the behavioural sciences, provide simple and grounded toolkits for policy-making.

Equally important, as it poses questions on what and how the government should intervene, is to revise the ethical and normative issues associated with the use of techniques to influence citizen behaviour.

Figure 1. MINDSPACE framework

Messenger

we are heavily influenced

by who communicates information

Incentives

our responses to incentives are shaped

by predictable mental shortcuts

Norms

we are strongly influenced

by what others do

Defaults

we “go with the flow”

of pre-set options

Salience

our attention is drawn

to what is novel and seems relevant to us

Priming

our acts are often influenced

by sub-conscious cues

Affect

our emotional associations

can powerfully shape our actions

Commitments

we seek to be consistent

with our public promises, and reciprocate acts

Ego

we act in ways that make us

feel better about ourselves

Health Policy-Making

Before going into the specifics of obesity, it will be useful to be aware of what is the current problem with health policy-making in general. For that matter, Kelly and Barker (2016) state that changing health-related behaviour is so difficult because policy makers seek simple non-scientific answers to complex problems, and in doing so, they commit six common errors :

1. Assume that common sense is all that is needed to change behaviour, so there is no need to waste resources proving the “obvious” is wrong.

2. Rely exclusively on communication campaigns to get a message across that will ultimately produce the desired behaviour.

3. Privilege the role of information from expert sources as a driver of behaviour change.

4. Believe that knowledge and its rational assessment alone will drive behaviour.

5. Assume that people behave in a certain way merely because they are being irrational, thoughtless or stupid.

6. Base interventions on limited knowledge about the relationships, the mechanisms operating between individual actions and societal patterns.

Implications for policies designed to reduce obesity

Since the obesity problem is mainly caused by an imbalance between the consumption and expenditure of calories – high input, low output – (World Health Organization, 2016), much effort from policy-making should focus on helping people make healthier choices.

From the behavioural perspective, the challenge lies in making obese people eat less, specially energy-dense foods that are high in fat, in favour of healthier options ; on top of making them increase their physical activity to overcome the sedentary nature of many forms of work and modes of transportation.

Even though calorie balance is a direct consequence of individual decisions about diet and activity, our environment have increasingly over the years made it more difficult for individuals to keep healthy lifestyles – in this reality lies the justification for government intervention (e.g. soft or liberal paternalism), in order to change the environment to support individuals in changing their behaviour.

Governments and civil societies that have been addressing their citizens' obesity problem have focused most efforts on clinical and educational factors or on community interventions (e.g. clinical guidelines, nutrition and calorie labelling, social marketing, healthy food subsidising) and, until recently, have rarely addressed environmental drivers of obesity. “As it stands now, the food environment creates a set of defaults that contribute to obesity.” (Novak and Brownell, 2012: 2345)

Evidence from behavioural economics has demonstrated that individuals are strongly influenced by default conditions in their environment (Johnson and Goldstein, 2003), therefore the need to dedicate efforts to improve defaults as a way to facilitate the population make healthy choices. Nonetheless, recent experience suggests that policy interventions to change environmental and systemic defaults (e.g. sugar and fatty taxes, regulation of unhealthy food marketing targeted to children), which will have the greatest population effect on obesity, will also be the most politically difficult to implement. (Novak and Brownell, 2012)

However, focusing on what can be done regarding decisions about diet and activity, the following steps could be considered for designing policies and interventions:  

1. Disaggregate behaviours like eating and exercising into smaller expressions, considering when and where they take place.

2. Identify common preceding conditions for those behaviours.

3. Think about which automatic and reflective processes will activate, by identifying the elements involved in doing the behaviour (practices, infrastructures, meanings, competencies).

4. Look for disconnections between these elements – and analyse whether they should be connected or not.

5. Involve the people doing the behaviours to disentangle those connections, as they are knowledgeable actors of their own conduct.

Finally, according to the MINDSPACE Report, when thinking about the future of behavioural policies, the application of behavioural economics does not imply a paradigm shift in policy-making, and is not a reason to give up on conventional policy tools, such as regulations, price signals and better information, which are still important components of a holistic approach to behaviour change. In fact, “the most effective and sustainable changes in behaviour will come from the successful integration of interventions designed to change cognitions and contexts.” (Dolan et al., 2012 :127)

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