By DAVID SHAYWITZ
Agency (the belief that I can shape my future) is a vital driver of human health and potential.
It is also the factor that most digital health platforms overlook.
Psychologist Martin Seligman of the University of Pennsylvania, who has spent decades studying this, says Agency boils down to the belief that “I can make a positive difference in the world.” People high in agency believe that there is something they can do next that might help, and then they try it.
Like Seligman emphasizethe moments when “we strive… we persist against the odds…[and] making new and creative outlets” are accurate when agency is at play. That extra effort and sustained determination (not just mindset) manifests as better performance, greater achievements, and better health. It also manifests as resilience, allowing us to not only bounce back from adversity but (ideally) bounce back as an even better version of ourselves.
GLP-1s highlight the power and promise of a newfound agency. For many people living with obesity, previous attempts to lose weight reinforced a “cycle of despair”: trying harder meant failing again. With the advent of GLP-1 medications, many found that their weight dropped and stayed off. Oprah Winfrey called the feeling “a relief, like redemption, like a gift.”
The most profound change is psychological: for the first time in years, the effort is rewarded. The GLP-1 unlock a agent dividend: The boost of motivation that comes from finally being able to take control of your health. That excess sense of possibility can be channeled into familiar health basics (moving more and sleeping better) but also, often more importantly, into how we show up in our relationships and communities, into the enthusiasm we bring to our hobbies and activities, into the totality of the experiences that make life so meaningful.
The agency is motivational coin of health, the ATP of behavior change: allowing success in one area to drive progress in others.
Connected fitness platforms have a similar opportunity. Every discrete accomplishment—finishing a class, riding a bike three times in a week, noticing that walking up the stairs is easier, or that my back hurts less—is a little proof that “I can do this.”
In looking closely When it comes to performance metrics, platforms like WHOOP, Oura, Peloton, and Tonal are leaving agency on the table. The opportunity here is to help people recognize, name, and accumulate their achievements, compounding the agentic momentum that arises from each small victory and facilitating the translation of that confidence into the rest of life.
There are techniques that seem to support agency: cognitive reframing, elements of motivational interviewing, healthy conversation skills that help people generate their own plans, positive psychology exercises that increase feelings of control and possibility.
But there is no well-validated manual. The Duckworth-Lechero 2021 mega exercise studio and a 2022 Feig review and their colleagues point in the same direction: many carefully designed interventions, when rigorously evaluated, have produced, disappointingly, only modest and usually short-lived behavioral changes; In the case of the mega-study, the observed effects were on average almost ten times smaller than the experts’ predictions. Cracking this nut remains one of the biggest opportunities in health and technology.
Furthermore, as public health thinkers like Michael Kelly and Mary Barkerand Angela Duckworth in her emphasis on “situational agency“Remind us that behavior is always embedded in social practices and daily routines, not floating in individual mental space. Kevin Hall work on obesity underscores the same point from a metabolic angle: in environments saturated with ultra-processed, hyperpalatable, high-calorie foods, many people will overeat and gain weight. Our environmental breaches can make it much harder for individual agencies to gain traction.
Powerful emerging technologies: from AI to connected devices and “greetings“Platforms – they now give us a new lever to solve this problem, but only if we use them carefully. So far, most of the efforts have been made. focused in treating people as objects to be managed, with platforms competing to orchestrate every moment and compress our lives into increasingly granular scores and rankings.
I would argue that the real white space is a platform that can reliably cultivate agency at scale. Building something like this would mean putting our most sophisticated artificial intelligence and connected health tools at the service of human agency: helping people see real options, achieve early victories, recover from failures, and let small successes accumulate into a lived identity of capability.
None of this (from GLP-1 to digital health platforms) facilitates behavior change, but it does make sustained, structured support more possible than before for patients, consumers, and employees trying to stay well while working.
While we don’t have all the answers, agency design will likely emphasize:
- Early, undeniable victories that are small but meaningful (“It hurts less,” “the stairs feel easier”).
- Guided choices instead of scripts or chaos, so people feel like they’re choosing, not just complying.
- Feedback that links progress to individual effort (“because you did X, you are now experiencing Y”), rather than to the brilliance of algorithms or the wisdom of doctors.
- Ways to accumulate progress so that actions add up to a lived story: “I am someone who appears.”
By focusing technology on enhancing our intrinsic potential rather than simply reducing our extruded numbers, we can strengthen our agency and, with it, our ability to live healthier, healthier lives. completely realized lives.
In a year when technologically advanced health platforms compete to incorporate the most agentive AI, our greatest challenge and our most important opportunity may be discovering how to harness these increasingly powerful emerging technologies, with wisdom, humility and humanity, to nurture the development of the most agentive people.
Dr. Shaywitz, a physician-scientist, is a professor at Harvard Medical School, an adjunct fellow at the American Enterprise Institute, and founder of KindWellHealth, an agency initiative focused on promoting health through science.. This piece was previously published on the Timmerman Report
