Heart Health, Exercise, and Why Motivation Isn’t the Real Problem
It’s February, which means we’re talking all things heart health and exercise here at the clinic.
Let me start with a little honesty:
If you’ve always struggled to exercise consistently, you are not broken—and you are definitely not alone.
This was a lifelong struggle for me, too.
For years, I knew exercise was important. I understood the science. I told my patients about it daily. And yet… I couldn’t stay consistent myself. I’d start strong, fall off, feel guilty, and repeat the cycle.
That changed about five years ago when I read a book that completely reframed how I think about habits and motivation:
Better Than Before by Gretchen Rubin (and yes—we have a copy in our Worland lending library!).
This is probably the book I’ve recommended more than any other over the past few years, and for good reason.
Why This Book Is So Helpful
One of the biggest takeaways from Better Than Before is that people are motivated differently. What works beautifully for one person might completely fail for another—and that’s not a character flaw.
Gretchen Rubin outlines four personality “tendencies”:
Upholder
Obliger
Questioner
Rebel
Each tendency responds differently to:
Internal motivation
External accountability
Structure
Flexibility
When you understand your tendency, you can stop forcing yourself to use strategies that don’t work for you—and start “hacking” habits in a way that actually sticks.
Why This Matters for Exercise (and Heart Health)
We often tell people to:
Move more
Exercise regularly
“Just be consistent”
But if the way you’re trying to build that habit doesn’t match how your brain works, consistency will always feel like an uphill battle.
Exercise doesn’t need to look the same for everyone.
Accountability doesn’t need to look the same for everyone.
Motivation doesn’t need to come from the same place for everyone.
Understanding this has helped me:
Finally stay consistent with movement myself
Be far more compassionate with patients who are struggling
Help patients find their version of success instead of chasing someone else’s
A Tool I Use Personally and Professionally
This book didn’t just help me meet my own health goals—it helped me become a better doctor.
When I understand how someone is motivated, I can:
Recommend movement that feels doable
Suggest accountability that actually helps
Avoid strategies that will just create guilt or burnout
Gretchen Rubin also has a fantastic podcast called Happier, which I listen to weekly and often recommend to patients who enjoy bite-sized, practical ideas.
The Bottom Line
If exercise has always felt hard, inconsistent, or emotionally loaded for you, the problem may not be willpower.
It might just be that you haven’t been given the right tools for how you’re wired.
And that’s something we can absolutely work with.
💛
Dr. Sarah