Minds Over Matter

Pop Quiz! You’re marooned on a desert island with no hope of rescue for several months. Which outlook sounds most like yours?

• A) I’ve watched enough Bear Grylls to figure things out. I bet I could survive until the next boat arrives!
• B) Doh! I’ve never fished with my bare hands or made a fire without matches. I’m probably a goner.

Most folks fall easily into one camp or the other — and these kinds of beliefs about ourselves are called mindsets.

Stanford University psychologist Dr. Carol Dweck, author of Mindset: The New Psychology of Success, proposed two different types of mindsets: fixed and growth-oriented.

People with fixed mindsets tend to avoid challenges. To them, failure suggests that they lack the “chops” required for the task. People with growth mindsets, however, tend to embrace challenges. They believe they can learn to conquer just about anything — even something as tough as behavior change.

At Omada’s annual digital chronic care summit, Mindset 2021, Dr. Alia Crum of The Stanford Mind & Body Lab, expanded on this idea of mindset even further to apply to areas relevant to health, such as stress, exercise, diet, and sleep. That is, a person's mindset can impact how they approach behavior change, and as result potentially impact their health outcomes.  

So do mindsets matter for health outcomes? Let’s find out by trying to measure them.

Mindsets in Omada for Prediabetes & Weight Management

Here’s a hypothesis: Members with growth mindsets will achieve better health outcomes in the Omada for Prediabetes & Weight Management program. Sounds like an interesting idea, but how can we even begin to distinguish between members with fixed and growth mindsets? Sounds like a fuzzy question requiring a fuzzy answer. So let’s dig into the wonderful world of text data.

All of our Prediabetes & Weight Management members are asked the following question in their entry questionnaire: What challenges do you expect to face as you try to change your eating and physical activity habits?

Using natural language processing to correlate the text of the members’ responses with health outcomes, we observed some interesting patterns around grammatical tense:

• Present tense (“this is”, “I am”) correlated with less weight loss. (e.g., I lack willpower. I cave easily. I hate to cook, I like very few vegetables, and I am a somewhat picky eater.)
• Past tense (“I have been”, “I was”, “I used to”) correlated with more weight loss. (e.g., “I used to eat more than one portion of food.”)

Wait, how on earth can grammatical tense relate to a health outcome? Sounds like a lot of pop-science baloney, doesn’t it? As Dr. Dweck mentions in Mindset, people who are growth-oriented often describe traits and tendencies in the past tense, which “releases one from the tendency to expect the same outcome to happen again.” On the other hand, people with fixed mindsets tend to describe traits and tendencies in the present tense as a way of professing their identity. “This is how I have been so far” gives a lot more room for improvement than “This is who I am now”.

Measuring Mindsets

So is there any truth to the power of mindsets in helping members achieve their weight loss goals? Do people who hit their weight loss goals tend to frame their beliefs about behavior change differently than those who don’t hit their weight loss goals?

Here’s an example of two members who differ in their use of present vs. past tense in talking about themselves and their behavior change journey. Remember, members are talking about their perceived challenges to modifying dietary and physical activity habits (red = no weight loss, blue = 5%+ weight loss):

The blue line represents a prediabetes and weight management member who did not see much weight loss, while the orange line represents a second member who did. Individual results, of course, vary from member to member, and these results are not necessarily indicative of what the average individual should expect from participation in the Omada program.

Comparing the two lines above, we see some trends worth mentioning. The member who lost over 10% of his initial weight tended to talk more about the past. Is this a sign of a growth mindset? Someone who sees their challenges in the rear view mirror, and looks ahead to positive outcomes? 

The member who didn’t lose weight, however, saw much greater variation, and far fewer messages written in past tense, on average. Are they stuck with their present tense conceptions of themselves? Is their mindset in the midst of changing somehow?

Perhaps. This is, of course, just one example of the type of information we look at here at the Omada Insights Lab.

As the number of members and data points grows along with our desire to understand what matters and what doesn’t for health behavior change, we plan to leave no data point untouched. Nope. Not even grammatical tense.

Have any thoughts you’d like to add? Highlight some text and leave us a note! We’d love to hear from you.