So, you’ve decided to get healthier and fitter.
Now what?
I’ve alluded to this as my “Aristotle was right, not-right” observation. The ancient Greeks wrote in a way that basically said, How could it be otherwise? If a man knows what to do to get well, why, of course he will do it.
Our understanding of human nature has come a long way since the 4th century BCE.
Some people don’t know what they need to do, but help them to understand and off they go.
Some people know exactly what they need to do, they just don’t care. I know that the booze is gonna kill me, doc, but if I die, I die.
But a goodly number of folks fall in the middle.
They either don’t know what to do, but once they find out, they’re stuck and they don’t want to be. Or they know what they need to do, but have tried numerous times to get there and failed.
If you fall in the very first group, awesome: avoid ultraprocessed food and cigarettes like they’re poison, move your body regularly and progressively, sleep plentifully, socialize outdoors like a maniac, examine and detangle your inner life, and see me for a checkup periodically. High-5 me on your way to the Olympics, and please refer your friends.
If you fall in the I-don’t-care category, I get it, that’s a thing, bruv. Hugs and hand holds, and let me know if you change your mind.
If you fall into the final category, I’ve got a thing or two to say right now.
Goals are fine, systems are final
With a tip of the hat to Wyatt Earp, having a goal is a great starting point, as I noted in my last post. But it’s usually not enough, particularly in the realm of health and fitness.
Relying on goal setting works, for a small subset of the population. That’s often the same subset as the folks suffering from a simple knowledge deficit: the Formula 1 superstars who just need a touch of clarification.
They already have infrastructure in place to make things happen, they just need a direction to aim themselves, and away they go.
“You mean running at 90% maximum heart rate 12 hours a week is inflaming my body and increasing my physiologic stress? I had no idea — thank you, I will throttle back to 79.4% for 30 minutes, every other day at 12:07 PM immediately.”
There are people like this, and they are both amazing and a little scary.
Most of the rest of us need more than a goal. Most already know what should be done.
– See a doctor periodically? Not a mystery
– Eat real, unprocessed foods? A mystery 50 years ago, no excuses now
– Don’t puff cancer sticks? Beyotch, please
– Exercise, socialize, and do inner work regular? Again, please
Yet the majority of Americans are overweight, obese, and/or prediabetic/diabetic, and chronic conditions are the norm rather than the exception.
What separates most people from that tiny subset that can take off like a rocket?
In a word: systems
A system is a set-up that relentlessly moves you towards a goal, no matter how you feel, and no matter what else is coming at you in life. In fact, a system works better, the less you’re involved with it.
A trivial example: your car’s cruise control.
Set it to drive on the freeway at 65 mph, take your foot off the accelerator, and the cruise control maintains your speed, unless you tap the gas or brake. No matter what’s on your mind, day or night, dry or rainy, it’s 65 mph until the cows come home or you tell it otherwise.
Unlike manually maintaining your speed, cruise control is a set it and forget it proposition. Your undivided attention is no longer a requirement for success.
In a world competing tooth-and-nail for your attention, where prolonged focus is as rare as unicorns, you want a cruise control (system) for your set speed (goals).
Examples
As we come to the close of the 2026 Winter Olympics, there’s coaching. Or Lindsey Vonn and her medical team — say what you will about the wisdom of competing weeks after completely tearing her ACL, as an elite athlete she had systems supporting her Olympic efforts: family, ski and conditioning coaches, and an entire team of high-level medical personnel. It’s virtually impossible to compete at the Olympic level, in any sport, solely by yourself as an athlete.
If you have a personal trainer, they provide motivation, accountability, and specific goals for each session. Coming up with those things on one’s own is frequently the deciding factor in working out or not.
Another example: saving for retirement. Either by setting up automated withdrawals from a paycheck into a retirement account, or meeting regularly with a financial planner to make investments, retirement planning is largely an automated system that puts money away, regardless of how tired or hungry you are, or who’s at the top of you social media feed on any given day.
In either case, there’s a mechanism that grinds along, so that the things you need to happen repeatedly aren’t sabotaged by the variability of daily life.
That mechanism can be internal or external to you.
External systems are like a coach, an automated withdrawal you arrange once with your bank, or a financial planner.
You may do your own random dancing, but you arrange (pay for) someone or something besides yourself to do their job: making something repeat, whether it’s building a nest egg in a bank account, or progressively whipping your butt into shape.
Internal systems are personal habits that you create, like flossing your teeth every night, going to the gym after work, or eating a big salad every day. The thing that is happening is an action that you perform regularly, and the push for this comes from within.
My example: scheduling workout time
My system: arranging for a midday jiu-jitsu class during the workweek.
I had finally DECIDED, at the ripe age of 58-not-getting-any-younger, to get serious about proficiency in a martial art (Brazilian, aka Gracie, jiu-jitsu). The minimum effective dose — the goal — was training 3 times a week.
The challenge: everything else in life, as a busy physician, medical director, family man (to parents, wife, and kids), and Yorkie butler. No shortage of voices, mostly self-imposed, to float X, take care of Y, or help with Z.
The system: pick 3 days a week to train, and make attending class as low drag as possible:
1. Proximity (10 minutes away; used to be 45)
2. Protected time (midday lunch hour, least likely to be called dibs on by work or family; used to be after work or as the house woke up)
3. Grab bag (change of clothes, wipes for post training, easily packed the night before)
After a few weeks, changing and heading out at lunchtime became a habit requiring zero thought.
Kind of like flossing.
Sidebar: flossing at bedtime
An example that I found highly instructive: making a durable flossing habit.
Yes, I flossed. No, not as much as I should have. Like most of us who know what the goal should be, want to do it, but somehow can’t seem to.
All kinds of excuses at bedtime, but mostly boiling down to God, I’m so tired (see reference to doctor, director, and Yorkie butler), to heck with the biofilm between my choppers. If I mustered the energy to consider reaching for the string, more detailed excuses bubbled up from the subconscious: By the time you finish it’ll be so much later, and You can do this tomorrow, and even After flossing you’ll have to fire up the electric toothbrush and it’ll wake up the house.
One day, enough was enough, and I flossed fully before bed.
The thoughts came up — couldn’t stop them, didn’t try. Up down/back forth went the string, done.
I realized pretty quickly: in the time it’d take me to go through all the excuses and try to counter them with thoughts and arguments, I’d be long done with the flossing.
For 2 weeks, I pushed through the excuses with string. Until ultimately, I noticed a change: the flossing had become automatic. Regardless of how I felt, what had happened at work, or what was on my mind for the future, the string had become a thing “of itself.” Instead of an action I had to fight to perform, it was now a habit that would continue indefinitely until I took action to unwind it.
Like going to the gym.
Call it what you will
System, habit, it matters naught.
Life has ups and downs, and the human attention span is fleeting, and getting more so every day with social media in the AI era.
If consistency is needed for the win, you need something that blows past all that.
A system built to produce a repeatable action, no matter what.
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