The majority of patients I see in my practice appear to be struggling with a profound sense of imbalance between intrinsic and extrinsic variables. For example, people who are preoccupied with body image and weight related concerns tends to be extrinsically motivated to lose weight with a focus on external rewards (positive social feedback, increased attention from the opposite sex) rather than internal rewards (improved health, increased energy and a sense of aliveness). In order for a cognitive shift to occur tipping the scales in favor of intrinsic motivators, it is necessary to begin a new way of life, understand the connection between mind and body, and strive for a sense of inner peace, balance and self acceptance. For the person who is intrinsically motivated to lose weight, diet and exercise are a way of life and not a means to an end. The cognitive shift towards intrinsic variables would be further facilitated through an exploration of the underlying factors behind weight gain (e.g., anxiety, loneliness, boredom depression) with positive steps taken to confront the emotional struggle.
