{"id":10347,"date":"2025-12-19T06:59:00","date_gmt":"2025-12-19T06:59:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=10347"},"modified":"2025-12-19T06:59:00","modified_gmt":"2025-12-19T06:59:00","slug":"to-improve-health-design-for-agency","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=10347","title":{"rendered":"To Improve Health, Design for Agency"},"content":{"rendered":"
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By DAVID SHAYWITZ<\/p>\n

Agency \u2014 the conviction I can shape my future \u2014 is a vital driver of human health and human potential.<\/p>\n

It is also the factor overlooked by most digital health platforms.<\/p>\n

University of Pennsylvania psychologist Martin Seligman, who has spent decades studying this,\u00a0says<\/a>\u00a0agency boils down to the belief \u201cI can make a positive difference in the world.\u201d People with high agency believe there is something they can do next that might help \u2013 and then they actually try.<\/p>\n

As Seligman\u00a0emphasizes<\/a>, the moments when we \u201ctry hard\u2026persist against the odds\u2026[and] make new, creative departures\u201d are precisely when agency is at work. That extra effort and sustained determination \u2014 not just the mindset \u2014 shows up as improved performance, greater achievement, and enhanced health.\u00a0 It also manifests as resilience, enabling us not only to recover from adversity but (ideally) to bounce back as an even better version of ourselves.<\/p>\n

GLP-1s highlight the power and promise of newfound agency<\/a>.\u00a0 For many living with obesity, past attempts at weight loss reinforced a \u201ccycle of despair\u201d \u2013 trying harder mostly meant failing again. With the advent of GLP-1 medicines, many found that their weight would come down \u2014 and stay down.\u00a0 Oprah Winfrey\u00a0called<\/a>\u00a0the feeling \u201ca relief, like redemption, like a gift.\u201d<\/p>\n

The deeper change is psychological: for the first time in years, effort feels rewarded. GLP-1s unlock an\u00a0agentic dividend<\/a>: the motivational boost that comes from finally being able to take control of your health. That surplus sense of possibility can be channeled into the familiar health basics \u2014 moving more and sleeping better \u2014 but also, often more importantly, into how we show up in our relationships and communities, in the enthusiasm we bring to our hobbies and pursuits, into the totality of experiences that make life so meaningful.<\/p>\n

Agency is the\u00a0motivational currency<\/a>\u00a0of health, the ATP of behavior change \u2013 it lets success in one domain drive progress in others.<\/p>\n

Connected fitness platforms have a similar opportunity. Each discrete achievement \u2014 finishing a class, riding three times in a week, noticing that the stairs feel easier or the back hurts less \u2014 is a small proof of \u201cI can do this.\u201d \u00a0<\/p>\n

<\/span><\/p>\n

In\u00a0fixating narrowly<\/a>\u00a0on performance metrics, platforms like WHOOP, Oura, Peloton, and Tonal are leaving agency on the table.\u00a0 The opportunity here is to help people recognize, name, and bank their achievements, compounding the agentic boost that comes from each small win and making it easier to translate that confidence into the rest of life.<\/p>\n

There are techniques that seem to support agency \u2013 cognitive reframing, elements of motivational interviewing, healthy conversation skills that help people generate their own plans, positive-psychology exercises that increase a sense of control and possibility.<\/p>\n

But there isn\u2019t a well-validated playbook. The 2021 Duckworth\u2013Milkman\u00a0exercise megastudy<\/a>\u00a0and a 2022\u00a0review by Feig<\/a>\u00a0and colleagues both point in the same direction: many thoughtfully crafted interventions, when rigorously evaluated, have disappointingly yielded only modest, generally short-lived changes in behavior; in the case of the megastudy, the effects observed were on average nearly ten times smaller than expert forecasts. Cracking this nut remains one of the biggest opportunities in health and technology.<\/p>\n

Moreover, as public-health thinkers like\u00a0Michael Kelly and Mary Barker<\/a>, and Angela Duckworth in her emphasis on \u201csituational agency<\/a>\u201d remind us, behavior is always embedded in social practices and daily routines, not floating in individual headspace. Kevin Hall\u2019s\u00a0work on obesity<\/a>\u00a0underscores the same point from a metabolic angle: in environments saturated with ultra-processed, hyper-palatable, calorie-dense foods, many people will overeat and gain weight. Our environmental defaults can make it much harder for individual agency to gain traction.<\/p>\n

Powerful emerging technologies \u2014 from AI to connected devices and \u201chealth OS<\/a>\u201d platforms \u2014 now give us a new lever on this problem, but only if we use them thoughtfully. So far, most effort has\u00a0focused<\/a>\u00a0on treating people as objects to be managed, with platforms competing to instrument every moment and compress our lives into ever more granular scores and rankings.<\/p>\n

The real white space, I\u2019d argue, is a platform that can reliably cultivate agency at scale. Building something like that would mean putting our most sophisticated AI and connected-health tools in the service of scaffolding human agency \u2014 helping people see real options, notch early wins, recover from lapses, and let small successes accumulate into a lived identity of capability.<\/p>\n

None of this \u2014 from GLP-1s to digital health platforms \u2014 makes behavior change easy, but it does make sustained, structured support more possible than before, for patients, for consumers, and for employees trying to stay well while they work.<\/p>\n

While we don\u2019t have all the answers, designing for agency will likely emphasize:<\/p>\n

Early, undeniable wins that are small but meaningful (\u201cI hurt less,\u201d \u201cstairs feel easier\u201d).<\/p>\n

Guided choices instead of scripts or chaos, so people experience themselves as choosing, not just complying.<\/p>\n

Feedback that links progress to individual effort (\u201cbecause you did X, you\u2019re now experiencing Y\u201d), rather than to the brilliance of algorithms or the wisdom of clinicians.<\/p>\n

Ways to bank progress so actions add up to a lived story: \u201cI am someone who shows up.\u201d<\/p>\n

By focusing technology on enhancing our intrinsic potential rather than just crunching our extruded numbers, we can strengthen our agency and with it, our capacity to live healthier, more\u00a0fully realized<\/a>\u00a0lives.<\/p>\n

In a year when tech-forward health platforms are vying to incorporate the most agentic AI, our greatest challenge, and most important opportunity, may be figuring out how to leverage these ever-more powerful emerging technologies \u2014 with wisdom, humility, and humanity \u2014 to nourish the development of the most agentic people.<\/p>\n

Dr. Shaywitz, a physician-scientist, is a lecturer at Harvard Medical School, an adjunct fellow at the American Enterprise Institute, and founder of KindWellHealth, an initiative focused on advancing health through the science of agency<\/em>. This piece was previously published<\/a> on the Timmerman Report<\/em><\/p>","protected":false},"excerpt":{"rendered":"

By DAVID SHAYWITZ Agency \u2014 the conviction I can shape my future \u2014 is a vital driver of human health and human potential. It is also the factor overlooked by most digital health platforms. University of Pennsylvania psychologist Martin Seligman, who has spent decades studying this,\u00a0says\u00a0agency boils down to the belief \u201cI can make a…<\/p>\n","protected":false},"author":0,"featured_media":10344,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-10347","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/10347"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=10347"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/10347\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/10344"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=10347"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=10347"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=10347"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}