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Your Checkup: Patient Education Health Podcast
Ever leave the doctor’s office more confused than when you walked in? Your Checkup: Health Conversations for Motivated Patients is your health ally in a world full of fast appointments and even faster Google searches. Each week, a board certified family medicine physician and a pediatric nurse sit down to answer the questions your doctor didn’t have time to.
From understanding diabetes and depression to navigating obesity, high blood pressure, and everyday wellness—we make complex health topics simple, human, and actually useful. Whether you’re managing a condition, supporting a loved one, or just curious about your body, this podcast helps you get smart about your health without needing a medical degree.
Because better understanding leads to better care—and you deserve both.
Your Checkup: Patient Education Health Podcast
93: The Motivation Checkup: Episode 2: Why Willpower Fails
In this episode of Your Checkup, we unpack why relying on willpower alone so often fails — and why that failure isn’t a personal flaw. Willpower is a limited resource that gets drained by stress, decision fatigue, and daily demands, making it unreliable for sustained health change. Instead of asking ourselves to try harder, real progress comes from designing systems that work with our brains: reducing friction for healthy behaviors, increasing friction for unhelpful ones, and anchoring habits to existing routines. By shifting the focus from discipline to supportive environments, we can build changes that last — even on hard days.
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Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN
Artwork Rebrand and Avatars:
Vantage Design Works (Vanessa Jones)
Website: https://www.vantagedesignworks.com/
Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr
Original Artwork Concept: Olivia Pawlowski
Hi, welcome to your checkup. We are the Patient Education Podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine doctor in the Philadelphia area.
SPEAKER_01:And I'm Nicole Rufo. I'm a nurse.
SPEAKER_00:And we are so excited you were able to join us here again today. All right. Well, we are this this was a much needed weekend that we'd have no plans. And here we are executing it in fantastic form.
SPEAKER_01:Yeah, we were really horizontal all of yesterday. And it helped that it rained a lot. So we watched our shows. We even took a nap. We both fell asleep on the couch for a little bit.
SPEAKER_00:How long did that end up being?
SPEAKER_01:Not very long, I don't think. But because Ollie was barking, I think, and woke us up.
SPEAKER_00:He's a good boy. Um, we uh someone needed to get the arc yesterday. Jeez, like it exclusively from like sun up to sundown. It just rained the entire time. Two of every animal get in line.
SPEAKER_01:Ollie did not like that.
SPEAKER_00:Oh my gosh. Wasn't that funny? That was so funny.
SPEAKER_01:Gook him out for his last walk of the night. He like went out, kind of went out to the corner and then just like turned around and ran back up to the door.
SPEAKER_00:His like ears pinned back, his snout down.
SPEAKER_01:I was trying to follow him with the umbrella, but he's also kind of scared of the umbrella, so you know. I did what I could. Yeah, just like he also like won't wear a rain jack, like he won't put on clothes, he's afraid and he doesn't like them.
SPEAKER_00:So it would be so cute if he did. I see lots of dogs in the area sporting clothes and like hates it. We would have such fun doing that. Um, so that was great. And then for some reason, like same atmosphere today, not a whole lot going on. We planned to to not do anything. We did have an impromptu guest. Um, got the the pop-in from Chris Nicholson. I don't know if he'll ever listen to this. He better listen. He better listen. But he um he gave a random call and was gonna pick up something in Philadelphia and happened to be in the area, so he popped in. So that was a nice little little trip. Got to see him eat a pastrami sandwich. So that was good. And then any new shows? Let's see. Uh well, we are traders and stranger things was really how we spent our time. You you really like Stranger Things.
SPEAKER_01:I do like it. I'm liking it. Are we on season four or three? This is three. Ending season three.
SPEAKER_00:Ending season three. Yeah. Um, we'll see how we use the TVs tonight. I know the Eagles are coming on soon enough. Um, the time this is recording, this is wild card weekend, and there's gonna be lots of activity. Um, you know, now that we've been here a couple years, we understand how things go when the Eagles play in a playoff game. Jesus.
SPEAKER_01:Jesus.
SPEAKER_00:That was crazy. When they won the Super Bowl, that was that was a lot.
SPEAKER_01:I know it's so cute. You're like, oh my gosh, I'm an Eagles fan.
SPEAKER_00:That's no at all. That's funny. It's a fun thing that you like explained that you you posted on your Instagram for the world to see say a picture of me exclaiming that, but it's false and you just took everything out of context.
SPEAKER_01:It's fine. One day you'll leave those wretched giants.
SPEAKER_00:Well, we'll see. We'll see. Maybe next year. That's always maybe next year. There's always next year.
SPEAKER_01:It's always on the table, you know.
SPEAKER_00:Yeah. Maybe next year.
SPEAKER_01:Um, and then we watch because for as long as I've known you, every like football season, you're like, you start out, you have this like hope that the Giants aren't gonna suck this year, and then they suck, and then you're like, oh, well, now they're just losing, so that they're gonna get like a better draft pick. But then they like don't lose correctly. And we go in this vicious cycle every single year.
SPEAKER_00:You're I'm really happy that you pay attention in that way. Yeah. I have my time. Maybe it was what is this, 10, 15 years ago now? Now it's 15 years ago and 2007, 2008. Almost like 18, 19 years ago when they won. It's time.
SPEAKER_01:Who do you think is gonna be in the Super Bowl?
SPEAKER_00:Oh, um I I tend to think. Let's see, the Rams are kind of bagged up. I don't like them. The Seahawks are playing good football. Um could be the Eagles again. Um Seahawks have Sam Darnold. I don't really think he's gonna lead them all the way. Um you know when it when push comes to shove, it might be the Eagles again. Yeah, I think it's the Eagles, and then let's see, hopefully. You know, it's a very it's a very different group in the playoffs this year with lots of injuries and stuff. I'm rooting for the Bills. I would love to see Josh Allen win, and he just, as we record this, just had a really spectacular victory.
SPEAKER_01:Helly Steinfeld's husband.
SPEAKER_00:Hilly Steinfeld. Steinfeld or Seinfeld?
SPEAKER_01:Like I think Steinfeldfeld. I think.
SPEAKER_00:Like, you know, the show?
SPEAKER_01:Yes. I understand.
SPEAKER_00:Does he have any offspring? I don't know if he has any offspring. Uh who do you think is gonna win the Super Bowl?
SPEAKER_01:I don't know.
SPEAKER_00:It's like a weird season, so there's no favorites. Like the Chiefs aren't in it for the first time, and as long as I can remember, the Ravens aren't in it.
SPEAKER_01:What are the Ravens less in the Super Bowl?
SPEAKER_00:Well, the Ravens are always in the conversation because there's a well-run, good team, but they ran into some trouble this year. Yeah, so I don't know, we'll see. Maybe my pick is Eagles Bills. We'll put it there.
SPEAKER_01:That sounds good.
SPEAKER_00:I guess what's gonna happen. I also won't be surprised if the Eagles fumble tonight and lose at home because they've had some trouble this year.
SPEAKER_01:Yeah.
SPEAKER_00:Um, do you have anything from Nikki's corner or are you just stimming on your puzzle over there?
SPEAKER_01:Well, I am stimming on my puzzle. Um, everyone's making a big deal because Fetty Wap got out of prison. Have you seen this?
SPEAKER_00:Oh, well, we need to back it up a little bit because I didn't realize that Fetty Wap was in prison.
SPEAKER_01:I also didn't realize he was in prison. But like, you know, one could assume. Sure. He would end up there. You know, I was actually thinking about him not too long ago.
SPEAKER_00:He was at a party at Rowan when I was there. I had to say it out loud fast enough so that I didn't forget.
SPEAKER_01:Mainly because like the trend online now, um, like with the new year in 2026, people are like, 2026 is gonna be the same vibe as 2016.
SPEAKER_00:A good year.
SPEAKER_01:It was a great year, great music year, like all of those vibes, blah, blah, blah. So then he just got released from prison, and then everyone's like, it's happening. 2026 is the new 2016.
SPEAKER_00:Yeah, that'd be great. Um, let's see. Any music? I mean, I feel like these days we listen to a lot of Taylor, and she like is the the center of our music world right now, which is not a bad thing, of course.
SPEAKER_01:I feel like I don't listen to a lot of music now.
SPEAKER_00:Become like exclusively a podcast because of the case.
SPEAKER_01:Yeah. I usually am listening to a podcast to and from work.
SPEAKER_00:Or cooking.
SPEAKER_01:And my walk to work is like 10 minutes. So like I don't know.
SPEAKER_00:Yeah.
SPEAKER_01:I also can never get my phone to connect to the sound bar. Oh, really? So I feel like I that's why I never play music because then it just doesn't sound good coming from my phone.
SPEAKER_00:Oh.
SPEAKER_01:I didn't know you had that problem. I feel like it's a user error.
SPEAKER_00:Probably, but I didn't know you had that problem.
unknown:Huh.
SPEAKER_00:We could take a look at that. Okay. All right. Um, I feel like was there something I wanted to bring to the table here?
SPEAKER_01:Um, you want to talk about traders?
SPEAKER_00:We could talk about traders. It's so potential spoilers for anyone listening or watching traders, so skip ahead here. Three, two, one. All right. I well, I actually don't want to spoil it. Um what I would say is I was shocked and I like what they're doing.
SPEAKER_01:We can talk about it. By the time this comes out, it would have been out for like a couple of days. Just fast forward a minute if you don't want to hear any spoilers from the first three episodes.
SPEAKER_00:All right. I'm shocked that they clocked her that fast.
SPEAKER_01:I know.
SPEAKER_00:Yeah.
SPEAKER_01:Should we say it?
SPEAKER_00:Go ahead. Yeah.
SPEAKER_01:Well, Donna Kelsey was a secret trader.
SPEAKER_00:Right.
SPEAKER_01:So this year, so all the other seasons, there's a group of, I don't know, 20-ish people, and then usually three people are the traders, and the audience knows that. But then this year there was three traders and a secret trader that no one knew about. Like the audience didn't know that the cast didn't know.
SPEAKER_00:I liked it.
SPEAKER_01:But they all clocked. So Donna Kelsey was the secret trader, and they clocked her during the first or the second elimination. Really the first one.
SPEAKER_00:The first one. They were talking about her a lot, but then Michael Rappaport was just being a knucklehead.
SPEAKER_01:And I don't know how they did it. I don't know how they did it either.
SPEAKER_00:Maybe she was so starkly different before and after the first. Yeah, maybe like the the ceremony in the beginning.
SPEAKER_01:Yeah. Well, they who said it after so they like secretly showed you in the beginning if you were a secret traitor, if you were a traitor, or if you were a faithful.
SPEAKER_00:A normie, yeah, faithful.
SPEAKER_01:And so someone she had like no, you know, everyone does their best to have like no emotion, and she was like stone cold, and someone was like, That's how you raise professional athletes.
SPEAKER_00:Oh, that was um that was Rob from Love Island. Oh, yeah. That's how you raise professional athletes.
SPEAKER_01:But then they were all saying they all clocked her as being a traitor because she wasn't like talking about anyone or like who she thought. I really just thought it because she's been like media trained by Taylor Swift's camp, you know?
SPEAKER_00:Yeah.
SPEAKER_01:So she like, you know, she like doesn't talk about her, or like, you know, like none of them do. And like they're all media trained.
SPEAKER_00:And is that a thing?
SPEAKER_01:Media being media trained.
SPEAKER_00:Well, I like loosely know about that, but like they don't talk about her specifically.
SPEAKER_01:Not that it's like a rule, but there was one time when Taylor and Travis like first started dating-ish, and they spent like some holiday or birthday together. It was like the first kind of like family gathering that she was at. And I forget what like show or something that Donna Kelsey was on, but she was asked, like, oh, how was it have like having Taylor Swift? And she just gave a very like neutral response. And everyone's like, Oh my god, she hates her, like she doesn't like her. And everyone's like, No, like she's giving like a neutral media trained response. Like it's because she doesn't want like that. Well, I think they also do too, because I saw an interview with Kylie and they like brought up Taylor. She said nothing bad about her, but like it's kind of like okay, let's like I'm here for the interview. We're gonna like, you know. Oh, like we're not here to we're not here to talk about Taylor Swift.
SPEAKER_00:Right.
SPEAKER_01:Yeah, yeah.
SPEAKER_00:I get that. All right.
SPEAKER_01:Anyway.
SPEAKER_00:Well, we were surprised.
SPEAKER_01:I we were shocked. I thought that it was going to be Dorinda because she was back and she got out the first round last time. Yeah. So I thought they were gonna bring her back, make her a secret trader. Or I thought it was gonna be Tara Lipinski or Johnny Weir, one of the two because they're like low-key besties, which I can't believe no one else knows, but whatever. So I thought one of them was gonna be the secret trader, and then someone was gonna like clock or like call out how close the two of them really are, and then that was gonna be like some sort of something, but neither of them are traitors.
SPEAKER_00:Oh well, for now. Yeah, Chris is really into the show too, apparently.
SPEAKER_01:Chris Nicholson? Yeah, oh yeah.
SPEAKER_00:So, what are we gonna talk about today, Nick?
SPEAKER_01:Today we're continuing our little motivation series, and we're talking about willpower and why it works or why it doesn't work.
SPEAKER_00:There we go. So, so I want to start with a question. Have you ever said to yourself, if I just had more discipline, things would be better? Maybe it's late at night, you're standing in the kitchen, you're exhausted, your phone's buzzing, tomorrow's alarm is already on your mind. And in that moment, it feels like this decision of what you're gonna eat is the test of whether you're good enough at taking care of yourself. And I hear this a lot when I'm taking care of patients during the day. And I would argue that I want to gently challenge that today. Because the problem usually isn't that you don't have enough willpower. It's that willpower was never designed to carry this much weight. Today we're going to talk about why willpower so often fails when it's used alone and what actually may work better for long-term healthy changes. So I wanted to reframe the problem and explain that maybe we look at willpower as a limited resource. It seems like we tend to think of willpower like a muscle. If you train it enough, it'll hold up, it'll get stronger over time, much like muscles do when you train them. But I would argue that we switch the paradigm and think about willpower actually more like a battery. And it drains over the course of the day. And every decision that you make takes energy. What to eat, when to exercise, how to respond to stress, whether to stick to a plan when life gets busy. All of that takes energy. And by the time most people are making healthy decisions, or they're prompted to make healthy decisions, evenings, weekends, stressful moments, their battery is already low. So when things fall apart, it's not a moral failure. Like many things we discuss on this podcast, it's biology plus environment. So asking yourself to just be better late in the day is like asking your phone to work at 1% without charging it.
SPEAKER_01:That was a good one.
SPEAKER_00:Thank you. So I want to introduce why willpower may fail in real life because realistically, relying on willpower alone doesn't work. You can't just like force yourself through these changes. The first reason is stress. When you're stressed, your brain prioritizes short-term relief, not long-term goals. I'm even thinking when we're running and we're doing like a hard class in Peloton and they're like, keep going, keep doing it, don't stop, don't stop. I'm like gasping for air. I'm like, this sucks. I want to stop. But if you don't, it is better for you. Right? Yeah. Stress doesn't just make things harder emotionally. You can think of it like it drains your battery that much faster. So stress isn't great for willpower. The second, I would argue, is decision fatigue. The more choices you have to make, I would argue the harder each one becomes. The second is decision fatigue. I would argue that the more choices you make, the harder each one becomes. Even good decisions get harder to repeat over the course of time, which in and of itself is challenging. The third thing that makes willpower fail in real life is friction. If the healthy choice requires effort, planning, and constant resistance, it's going to lose. And this is why people can be incredibly disciplined at work and then feel undisciplined, if you will, at home. Because the rules change when the battery is low. If you take one thing from today's episode, I want you to think that sustainable health change isn't about asking more of yourself. I think what we're trying to say here is that it's actually about asking less. And instead of relying alone on willpower, which we've just discussed for a number of minutes, is designed to fail alone. We build systems and habits and environments, things that work with your brain, not against it. And this is the shift that we're hoping to make this week when you think about making healthy changes in your life. So I've been a little doom and gloom, but it was more of a realistic setting of expectations that like just willpower isn't going to get the job done. We have to make these things, systems, habits, and environments. Can you share with us our argument for like what actually works when you're designing a system for success?
SPEAKER_01:I can. So there are three parts to the system for success. Right. Is that how you would say it?
SPEAKER_00:I like it.
SPEAKER_01:The first one is reducing friction for your helpful behaviors. So essentially making things easier for you to do. Um, that way it's not so much of a heavy lift. You just make it easier for yourself. So, like if you want to work out in the morning, layer clothes out, it makes it easy. It's right there for you to get dressed. Um, pre-cutting like vegetables or pre-making healthy foods, that way you can just grab. I mean, we just did this now. So you have a healthy breakfast in the morning, you just cut it, heat it up. You have chicken to bring for lunch or have for dinner, veggies, all of those sorts of things. It makes it very easy for you. Um, if you're trying to be better with any sort of like medications, you can have them out. If it's say a med you should take twice a day, have it by your toothbrush, so you brush your teeth in the morning, you take your medicine, vice versa. Or yeah, vice versa. Yeah. I guess morning and night. Um, the second is to increase friction for the unhelpful behaviors. So I guess you would say this is making it less accessible to do the poor behavior. Um, so maybe like if we're talking about diet, not bringing junk food into the house, not having that so readily available.
SPEAKER_00:Um that's a big one.
SPEAKER_01:I yeah, I feel like that's a big one.
SPEAKER_00:Like not even just like not. Buying the food that you know is not good for you.
SPEAKER_01:Yeah, like not even bringing it into the house.
SPEAKER_00:Back to my tortilla chip days.
SPEAKER_01:Yeah. Then there are some of you having like a treat once a week. Like we have a little thing of ice cream in the fridge for us tonight.
SPEAKER_00:But those tortilla chips are staring at me and they're calling to me now, whispering my name.
SPEAKER_01:Yeah, well, gotta have willpower. It's designed to fail. Yeah. Um, if you're trying to maybe not so spend so much time on your phone, you can. I think there's a way you can set a time limit on the app, like the social media apps that you use, or like a game app or something like that. That way, like you physically can't open it until the next day or whatever. Yeah, that's nice. And then the third one is anchoring a behavior to your already existing routine, which is something we I think did talk about last week. If I remember, I should remember. I was here when it happened. Um, but this is a huge part. So instead of saying like I'll exercise when I feel motivated to exercise, which may mean that you'll never get to the exercise, say I'm going to go for a walk after dinner. Or I'm going to even like go for a walk at lunchtime during work if you can.
SPEAKER_00:Yeah, but I'm going to wake up. Like when I wake up, I am going to first exercise.
SPEAKER_01:And just like make it a part of your day.
SPEAKER_00:I, quick aside, I like actually the way you said it of like stop bargaining with yourself in the morning and knowing that when you do this thing, you will feel better. That's how I like popped myself up out of like probably exclusive greater than 50% of the time. That like I just got up Monday morning and went for it. And then I had more time in the morning because it's tight, like timing-wise, between that and getting to work. And I did. I was like, I knew I know I'm gonna feel better when I'm on the tread and I'm just like doing something.
SPEAKER_01:Yeah. And it's like you're not like you're not doing something that's bad for you. It's only going to be better for you. Yeah.
SPEAKER_00:No, that was so good. So I just wanted to give you kudos to that because that was even living in my mind.
SPEAKER_01:Oh, well, you're welcome.
SPEAKER_00:So I wanted to connect these things to motivation, like we talked about last week. And I think it fits directly into what we talked about. Motivation as a summary, um, you should go listen to it, but a summary of motivation grows when people feel capable, like I can do this, in control, meaning this was my idea and I'm gonna do this because it was my idea. And they don't feel pressured or they feel supported and they don't feel shame doing something. We would argue that a system supports all three of these things. They protect your sense of competence, they preserve your autonomy when you make the system yourself, and they reduce reliance on guilt or force or a negative feeling. And it turns out you're not pushing yourself harder, you're just creating a system that supports yourself better. So I wanted to give some real life examples to how to change from just a willpower approach to the systems approach. If we think about exercise, a willpower approach would be I just need to push myself harder. And systems might look like what makes movement easier to repeat? Or what's the easiest thing to do? For nutrition, you could think willpower. Oh, if I just have more self-control, I need more self-control. And a systems approach might be what's already in my kitchen that I could eat. We literally did this last night. So responsible.
SPEAKER_01:On Saturday, we ate the food that we had in the house.
SPEAKER_00:Oh my gosh, yeah. Instead of going and doing the right thing and getting poly Gs.
SPEAKER_01:Yeah.
unknown:I love poly G's.
SPEAKER_00:But it is good. Or for medications, willpower. I just need to remember. But if you actually set something up for yourself, do what you said and say, where can this live so I don't forget? It's the same goal, but they're different outcomes. And I want to make this sound real, right? I want to make this seem normal because if you've ever fallen off track, here's the important part. It wasn't because you didn't care enough. It's probably because the system around you wasn't supportive enough. And systems can be changed, and you need to be a part of that solution and build that system. It can't be built for you. So here's a little simple exercise. Pick one habit you've been struggling with and ask yourself where is willpower doing all the work? Where could I reduce friction for healthy things? And what one small system could support me instead of do the opposite? And what one small system could support me instead of doing the opposite? You don't need a total overhaul of things, but one small change is enough to get started. Health change isn't about being tougher, it's about being smarter and kinder to yourself. I'm always trying to tell people to be nice to themselves. And something we wanted to really hammer home today is that willpower tends to fade. But systems that you build for yourself stay. And when you build the right support around yourself, motivation has a chance to show up, even on hard days. All right. Well, that's all we got for you guys today. We're going to continue on this journey next week, and we're going to talk about how making small changes can be even more effective than looking up at the mountain to make big changes. So thank you for coming back to another episode of Your Checkup. Hopefully, you were able to learn something for yourself, a loved one, or a neighbor. You can find us on our website. You could send us some fan mail or an email. You could find us on Instagram or threads. You can share us with a loved one or a neighbor. But most importantly, stay healthy, my friends. Until next time, I'm Ed Deleski.
SPEAKER_01:I'm Nicola Rufo.
SPEAKER_00:Thank you and goodbye.
SPEAKER_01:Bye.
SPEAKER_00:This information may provide a brief overview of diagnosis, treatment, and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments, or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor. I am not your nurse. And make sure you go get your own checkup with your own personal doctor.
