Drop-Outs: Nineteen Predictors of Lifestyle Change Failure

Are you shocked when new clients drop out of your healthy lifestyle program? Do you assume they just weren’t motivated, just weren’t ready to make the hard decisions?

Truth is, clients give up on healthy lifestyle changes for lots of reasons.

And you can spot these “drop-out predictors” as early as your first conversation with a potential client.

Then you can take early, targeted action to help them move successfully past these gotchas.

Which predictors did I miss? Email me your “drop-out predictors” and I’ll add them to the list and give you credit.

Client health characteristics

1. Client has risk factors that may lead to a health issue, but no current symptoms. Example: Has high triglycerides risk factor, but no symptoms of cardiovascular disease.
2. Client has a significant health issue but no obvious or alarming symptoms. Example: has high blood pressure but no symptoms, or Type 2 diabetes without any complications.
3. Client has health issues which significantly complicate lifestyle change. Example: summer heat and glare trigger client’s migraines.

Medication side-effects

1. Client’s medication causes low energy levels and fatigue. Example: beta-blockers.
2. Client’s medication which causes weight gain and/or increased appetite. Example: antidepressants like Lexapro and Zoloft.
3. Client’s medication causes physical discomfort. Example: statin-related muscle pain.
4. Client cannot afford medication and thus has symptoms which interfere with lifestyle change. Example: migraine meds are not covered by insurance.

Behavioral and cognitive health considerations

1. Client has situational or chronic depression which is not currently successfully treated. Example: client is full-time caregiver for elderly parent with Alzheimer’s.
2. Client has temporary or permanent cognitive impairment. Example: “chemo-brain” following cancer treatment.

Client perceptions

1. Client lacks belief in benefits of change. Example: feels that lifestyle change will not overcome bad genetics.
2. Client lacks belief that successful change is possible. Example: feels little self-efficacy or self-confidence.
3. Client lacks a sense of connection between client and your business. Example: feels like just an anonymous “number” to your business.
4. Client feels pushed by others to change. Example:feels that partner gave them an ultimatum to get help.

External barriers to change

1. Client’s daily environment poses obstacles. Example: seasonal allergies make leaving the house miserable.
2. Client has difficulty reaching your business. Example: works 20 miles away, often feels that she must unexpectedly stay late at the office.
3. Client is not comfortable with your payment options. Example: client would prefer weekly payments to monthly fees.
4. Client has conflicting commitments. Example: must balance work schedule, kids’ schedule plus parent in nursing home.

Characteristics of your program or service

1. Client’s overwhelmed or confused by the complexity or breadth of your program. Example: feels overwhelmed by expectation that he will spend several hours/week exercising, several hours/week cooking, several hours/week attending lifestyle change classes.
2. Client is not comfortable with cost of your program. Example: perceives similar programs as less expensive but equally or nearly as appealing.