Episode 109 | Dec 12, 2024

Healthspan 101: A New Approach to Longevity, With Ravi Komatireddy

What is healthspan, and how does it differ from traditional healthcare? This week on Health Coach Talk, Dr. Sandi sits down with Dr. Ravi Komatireddy, CEO of Daytona Health, to demystify the concept of healthspan and its role in promoting longevity. Together, they examine the limitations of our current healthcare system and discuss how a proactive focus on lifestyle and well-being—supported by health coaches—can help people live healthier, more fulfilling lives.

“So, imagine the trajectory of our country if most of us spent more time and effort on healthspan… and start focusing on improving ourselves, preventing these diseases, being better at work, and knowing how to deal with stress and nurturing our relationships, which are all really big predictors of longevity.“

Dr. Ravi Komatireddy

Dr. Ravi brings a wealth of experience from both medicine and digital health innovation, coupled with a passion for reshaping how we think about health. Reflecting on his journey from medical school, where lifestyle factors were scarcely covered, to leading a company focused on healthspan, Dr. Ravi shares personal insights into why the current healthcare system falls short for most people. His work is driven by a vision of empowering individuals to take control of their health through a blend of advanced technology, personalized coaching, and behavior change strategies.

In this episode, Dr. Ravi breaks down the key elements of healthspan, emphasizing prevention, longevity, and building resilience in our daily lives. He and Dr. Sandi discuss how health coaches play an essential role in addressing chronic conditions by guiding clients through sustainable lifestyle changes, nurturing self-efficacy, and creating supportive environments for transformation. Dr. Ravi envisions a future where healthcare is less about reacting to sickness and more about optimizing healthspan, with a team-based approach that integrates doctors, health coaches, dietitians, and other specialists.

This episode highlights the power of collaboration in the healthcare ecosystem and how coaches can bridge the gap between data and actionable change for clients. Whether it’s guiding someone through the complexities of metabolic health or helping them build confidence in their ability to manage stress, diet, and exercise, the role of a coach is vital. The insights shared by Dr. Ravi are a reminder of how critical it is to focus on the “why” behind every health decision and empower clients to create lasting change.

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Dr. Sandi: Welcome back to “Health Coach Talk,” and we have a great episode for you today. I am talking to Dr. Ravi, and we got to know each other during the pandemic, I believe. And I believe it was on Clubhouse when we were all on that app.

Dr. Ravi: When that was a big deal.

Dr. Sandi: That was a very big deal and connections through Clubhouse. But now we’re connecting on this podcast. And before we started to record, you were talking about the fact that you were so glad that you are in healthspan and not healthcare. And I love that because that’s what we’re about as well. So, can you start off by talking about what’s the difference between a healthcare professional and being in the business of healthspan?

Dr. Ravi: Yeah, first of all, thank you so much for having me on. I really appreciate it. It’s always a pleasure to talk to you. You’re a thought leader in this field.

So, that’s a great question. The funny thing is, after being in healthcare for so long, and this new word has popped up, I think a lot of people have heard it around either podcasts or ads that are popping up on their Instagram, what is healthspan?

So, healthcare is really good at this number of things. When you get in a car accident and you’ve got to put your bones back together or take out your appendix or deal with a very rare disease that requires specific medications, we’re really good at that or when you have an acute heart attack and you need to put a stent in within 90 minutes, it is amazing that within the United States, you can get… The standard for doing that is 90 minutes from when you have a heart attack at home to when a cardiologist puts a stent in. That’s the standard. So, that’s amazing. A lot of science, and a lot of technology, and a lot of money has been put into that.

But really, we have sick care, right, if you think about it. It’s very reactive. We don’t do what people really want. So, to me, healthspan represents the three buckets of what people really want, and there are three things to us. So, one is they want to prevent or reverse these chronic metabolic diseases, which are mostly preventable or live longer well. The second bucket is we want to be better at work. We spend 90,000 hours of our lives at work, and it really matters to our health and our relationships and everything else. Third, and I think speaking of relationships, we all want to spend more time with the family and friends that we love and avoid burnout. Healthcare does none of that.

So, everything I just mentioned, which is what everyone wants ideally in their life, healthcare doesn’t do any of that. So, we’re like, well, what does do that? What is responsible for healthspan? How can we help with the right team, tools, and techniques together to do that? And that’s what I’ve been working on.

So, imagine the trajectory of our country if most of us spent more time and effort on healthspan every day, every week, every year, and what that would do to healthcare. So, we reserve healthcare. We need those surgeons and those doctors and those immunologists for when those bad things happen or when bad luck happens. But instead of putting all of our money and time there, we go to healthspan and start focusing on improving ourselves, preventing these diseases, being better at work, and knowing how to deal with stress and nurturing our relationships, which are all really big predictors of longevity.

Dr. Sandi: I love that. And that certainly aligns with what we do in health coaching. In fact, I always use that example that, yes, if you are having a heart attack, you don’t need a health coach. You don’t need, at that point, even a functional medicine doctor to be telling you about herbs and supplements and specialized testing. No, you need to get to the best trauma center that’s available to you and the best of acute care medicine.

But what happens when you’re discharged? Who is going to be helping you to address those lifestyle factors like diet, and movement, and sleep, and stress, and relationships so that you don’t land back in the hospital needing another procedure? And yeah, our current system is not set up for that, which is why I’m so passionate about training health coaches.

You’re so right. You put so much emphasis on the doctor instead of on prevention. And instead of looking at… You mentioned the word team sport, that this is a team, which, again, aligns with what we do, seeing the health coach as a key member of that medical care team. So, can you talk about that team sport? What’s your vision for that?

Dr. Ravi: There’s something cultural here and also something pragmatic that’s led to this situation. We, kind of, idolize MDs, don’t we? Someone walks in with the white coat with the MD after the name or the Dr. before the name. They’re like, oh, my gosh, whatever that person says must be right. if Dr. Oz says it, then it must be right, because we do have a lot of training, and we do have a lot of experience.

But I would say that I think we put them at the top of the pyramid when really there should be a level playing field instead of a pyramid in the beginning. And the reason is because when I went to medical school—I started medical school in 2001—we did not have one single class on nutrition or exercise. We had one lecture on sleep, and it was more on just the science of sleep versus how to actually get people to sleep better and the kind of things and challenges people are facing or how to track it at home. That’s changed a little bit. That is incorporated in the curriculum, but those things are not emphasized, even though they are part of the guidelines for most of these diseases that we’re all suffering from like diabetes and high blood pressure and lipid disorders and those things.

So, doctors are really good, and they become even more and more specialized now. But what we have forgotten is that most of these diseases that most doctors are seeing seem like they’re separate, but they’re actually related. They’re all in this category we call cardiometabolic, right? So, insulin resistance and chronic inflammation is driving these causes that are creating things like cancer, dementia, heart disease, diabetes, obesity.

We got to get to the root cause, and the root cause are these lifestyle areas. So, 70% of this healthspan stuff we were talking about comes down to these lifestyle areas that we’re not trained in and definitely difficult to convey over the average… I think the numbers were like… The average visit length in America is 15 minutes, and it takes about 15 seconds before, when you go to that clinic, the doctor starts talking over you, right? And they’re usually looking at a computer screen, and they’re sitting there, and they go, “Hey, you should eat better and sleep better, but I know you’re not going to do it so here’s a pill,” right?

And so they know, and they feel bad about it too. They want to spend that time, but instead of forcing doctors and putting them in this situation where they have to do all this stuff when the machine really doesn’t allow them to, it’s like, why don’t you just pair yourself with people who are really good and they’re trained or experts just as well trained as you are like dietitians and personal trainers and health coaches and executive coaches and life coaches? And they have their own expertise and training and experience, and they’re really good at what they do. So, it’s like, hey, this is more like a soccer game. You got to pass the ball to the people who are able to help those people when you can’t.

This is what I love about when doctors are complaining about other fields or people or AI replacing them. You can’t complain when you can’t be there in the first place. There’s 525,500 minutes in a year, and you go to a doctor even for an hour a month, let’s say, your primary care to check in, that’s still like 0.0001% of the time you spend. Who’s helping you during the other minutes of the year, right, where all those health decisions are being made/ Because they’re being made at home and at work. It’s like, where are you going to eat that day for dinner? Are you going to train that morning or the next morning?

You need a team that’s going to be there for you most of those minutes, and doctors, it’s unrealistic to expect them to be able to pick up that load. So, it’s like, don’t pick up that load. Stop playing racquetball. Let’s start playing soccer and pass that ball off to these people and give them the respect that they deserve. And we work as a team together, and I think that’s a much better way to do it.

Dr. Sandi: It is such a better way. Not only is it better for those patients, but it’s better for the doctor because they’re so stressed and overworked and burned out. When you have a team, they lighten the load, but it’s also going to address the serious problems that we’re facing that will get worse, which is the growing doctor shortage particularly in primary care. Good luck finding a new primary care doctor. They are retiring in droves. New doctors aren’t choosing primary care. They’re choosing specialties like orthopedic surgery and dermatology, for example. They don’t want to go into primary care.

And in the olden days—I read about this in my new book—you had a doctor. You had an old-fashioned family doctor. He knew you. He knew your family. He looked you in the eye. They had bedside manner, which has disappeared. But when you have a team, those people on the team, like the health coaches, like the personal trainers, they will connect with you and address those crucial lifestyle factors. Therefore, you are lowering healthcare costs because then you’re not saying we don’t need doctors. We both agree we do for those acute care situations. So, they are then practicing at the top of their license. The medical doctor is making a diagnosis, doing their specialty for acute care because they’re not trained to deal with the chronic conditions that are an epidemic.

Dr. Ravi: It’s interesting to see how our life coaches, our health coaches on my team, and our executive coaches as well, they know way more about that stuff than I do on how to not just knowledge that is intrinsic to the field but how to apply it and translate it to that specific person to say what they need to hear and the specific steps to personalize that approach. And that would just take a lot of time and nor am I trained in that.

So, sometimes a lot of solving these problems with health is finding who can do it versus how to do it yourself. It’s finding the right people. And I think putting that integration is… And that’s what I was referring to, those cultural things that’s happening. It’s that cultural shift, which I’ve noticed during COVID. As we’ve talked over the years, people are much… There used to be this kind of thing, well, it’s like doctors would, in their mind… You start getting jaded a little bit. So, you can see some primary care doctors, they’re like, “I’m going to tell you that you should lose some weight and you should go exercise 150 minutes a week.” And all these guidelines they’ll spit out at you, and they’ll say, “Well, I just don’t think you’re going to do it.” So, there’s just no trust that you can execute on that. So, I’ve got a couple of minutes here. What’s the best thing I could do for this patient is at least get them on something. “Here’s your Ozempic.”

So, I’m worried that we start blowing Ozempic blow darts at everybody and use that as a substitute for building that base of the pyramid, which is what we really should be doing, is using it as an augmented tool to supplement a better psychological approach to food, how to train, how to rearrange our days so we can sleep correctly. And then you put on the Ozempic, and then you have the top. So, this is, kind of, this… I think it’s probably just from a tribal human thing where there’s always that family doctor you talked about. It’s like there’s always been that shaman figure in every tribe, every group, and there’s nothing wrong with that. It’s just there’s more to that. We’ve seen this cultural shift where people are finding these other experts to get answers to these problems. So, it’s just like trying to integrate those two has been challenging but very fruitful.

Dr. Sandi: You’ve always been a visionary and looked toward future solutions and a big advocate of digital healthcare. And we’re seeing an explosion of direct-to-consumer lab testing, better and better devices, so we can be our own CEOs of our own health.

We can be monitoring. We can do our continuous glucose monitor and guide our Apple Watch and our Oura ring and other devices. And these are just going to get more and more sophisticated. And our consultations, just as we are meeting right now, virtually, not face-to-face, this all can be done without fear from the comfort of your own home. So, can you comment on what you see as the future of healthspan care?

Dr. Ravi: I agree with you and just this incredible… and being part of this revolution in digital health, helping, kind of, design and develop some of these devices and see what they can do, what they’re capable of is absolutely amazing.

So, things that would cost… ICU-level diagnostics or an EKG machine that would cost $15,000, you can get for $200 on Amazon. It fits in your wallet, right? It’s amazing that we can do that. So, we’re going to see a progression of these devices getting better and more accurate, more validated, and used as part of these, kind of, more integrative health functional programs, like what our company does. And we do use those things.

So, I see things like Levels, and we use Levels, for example, and they’re doing an amazing job with the continuous glucose monitoring solution they have with Dexcom to give people insight into how what they eat affects their metabolism. If you want to scare the crap out of most people though, put them on Levels for three months and not give any guidance.

What I see is we’re really good at developing this information multiomics platform that you can just pay money and get all your labs. And what I see a lot of times is people go, “Okay, that’s great. I want to know about myself. Unlock some insight about my body and where it is and how it’s doing.” And then you pay a lot of money, and you get all this data. But the trap we could fall into here is to think that for most people the data alone is going to change their behavior. For 5% of people, especially people like me who start these companies, right, who are the heads of… We always think like everyone’s like us. Oh, if I had that data, then I’d be able to… If I get a smart scale, well, then I’m going to go run more because I want to lose weight. I want to see that number go down. And that could be true.

But there’s that intention-action gap, right, where we had this intention. Five percent of people are able to do that. Ninety percent of people, I think, aren’t. I would include myself in this 90. I need my health coach. I need my personal trainer. I need that personalized accountability partner who can help keep me motivated, who could help combat those negative voices in my head. We all do these things where we talk ourselves out of the right thing to do, right? So, there’s a lot of behavior change techniques that we use to combat that. It’s just really hard to do alone.

So, the trap we could fall into is thinking just more data, give more data, more accurate devices, more reminders and instructions from your Apple Watch. I think if we do that, you’re just going to see people… What’s happening now is just people just turn those notifications off. So, it’s like when we use Levels, and we have one of our dieticians guiding our clients with Levels, that is an amazing combination. So, it’s like, okay, now we know what these 10 gummy bears… I use that example because my cheating food is gummy bears and Reese’s peanut butter cups. And I test out Levels. I love them, by the way. I love their leadership as well and what they’re doing. I was like, oh, my gosh, I didn’t know this was making such a huge difference to my metabolism.

So, it was insightful, but I’m really trained as a physician, and I run a health longevity company. So, you would imagine for me, I know what I’m looking for and what to do, but data alone for most people, even as accurate as it could be, I think, is not going to be enough. I think we need to pair it with a psychological or cognitive-behavioral coaching model that could help coach people, “Okay, now you have this information. What do we do with it? And how do we stick with these steps? What are the next steps you have to take and how do I convince you or persuade you or empower you to take these steps, so you start getting more self-efficacy?”

What we’ve noticed, which was a little bit of a surprise to me after just coaching people for a couple of years now with the team, and it’s the metric that matters the most. I wonder what you think about this. What we’ve noticed is a sense of self-efficacy or agency. People feel like, when they come to us, they’re like the 55-year-old male, hard-charging executive or busy professional, and they’re in control at work, and they’re in control of everything, and they’re doing really well, and they’re successful, and they’ve got everything they want in terms of finances and all that stuff, but they feel like they’re out of control with their health. They feel like they’re always behind the ball. And it’s so overwhelming to figure out all the stuff in the marketplace and what works and what’s true, and that they don’t even know where to start.

What we’ve noticed is, after six months of coaching with various coaching types and modalities, they feel like they’re more in control. They feel like they are on top of it. And I think that is what is the driver of the momentum for them to sustain the changes they’re making and continue to seek more changes that bleed over to everything else in their life, too. It’s the metric we don’t measure very… We started measuring it through, kind of, psychological testing, but it’s something that you can’t get a blood test for, right? It’s like you just need people… You really need to just interact with people to understand where their head space is there.

Dr. Sandi: You are spot on. And in a review of the research on the benefits of health coaching, why does it work? I cannot tell you how many studies come to the conclusion that what changed was increases in self-efficacy. There’s a stronger sense that I’m in control of my health, my destiny, that I can take charge, and it’s a feeling of empowerment.

It’s a feeling like I matter and I can make the decisions. I’m in charge. I don’t have to just swallow whole what the expert—the doctor, for example—is telling me. I can look at these choices and I can decide. But it is overwhelming, and that’s where the coach, a guide, comes in who can help them sort out the research, sort out often confusing information that may be out there.

But absolutely, at the end of the day, it’s the sense that I matter, self-efficacy. And I can’t tell you how many studies I have reviewed. That is the main conclusion. And from there, they have that aha moment: Yes, I’m ready to change. I can do this. I can start small, and I can start to move every day. I can start resistance training, whatever it might be that they would like to do to have a better health status. And it is that self-efficacy, and we found it in our own research as well, very key.

And I love what you said that, yes, there’s so much data coming out, and even from wearables, you could tune it out, and it can be overwhelming. And now there’s this huge push for AI health coaches. Almost every day, there’s another one. Apple, Samsung, they’ve all… Google Quartz. They’ve all got one. OpenAI will have one with Thrive Global.

And my understanding is what they are, they’re not really coaches because what they are doing is providing advice, tips. But you turn that off. It can be annoying. For example, I have a bike that is programmed with AI, and it’ll have a breathing pacer, and it’ll give encouraging interruptions in what I’m doing. And there’s little feedback loops, and I don’t even look at it. I just turn it off. So, I think that’s what people will do. They will turn it off. And it is not that basic heart-centered communication when you have a real human being who is guiding you.

Dr. Ravi: That is so true. And we are also developing an AI model to help us just get the cost down so we can democratize healthspan to more people. I think health coaching and health coaching teams or precision… The thing with this precision medicine-precision lifestyle coaching combination, the future for me, it’s like when you buy an iPhone, you don’t pay extra for Siri. You just get it. It should just come in your phone. Why don’t we have that for health coaching? Imagine a 16-year-old, whenever they get their phones these days—I don’t know—but on smartphone Day 1, it should automatically come with these services installed to start steering people down the right directions, the right decision-making, right thinking patterns from Day 1 and not wait till they’re 50 due to their heart attack.

And I also agree with you. I actually wrote a big piece on LinkedIn on this and on Twitter saying just that and how our AI model’s a little bit different than those just small reminders because reminders, you’ll just turn them off. The abandonment rate of digital health products is 70%…I think 70% to 75% over three months. So, it all sounds good, but after a while, you don’t want to get nagged anymore. I tell people who are prospective clients at Daytona, sometimes I tell them, like, “Yep, sometimes our coaches are going to emotionally blackmail you. I’m just telling you right now,” and they’ll start laughing. I’m like, “No, it’s true.” I talked to them three months later, “Yeah, it does work,” right? It’s like they know how to reach me in a way where we’re not looking for… And no one’s perfect. We’re not looking for 100% adherence to every single recommendation, but you just have to make more good decisions than not for your health, and you will start seeing a difference. And then we start building that self-efficacy and things like that, but it has to be emotionally resonant.

And we’ve had this discussion in the company a couple of times where could we ever just replace the human completely, and we decided no. And this is my personal opinion. I think there’s some people that will really respond to just having a bot or ChatGPT version 7 that is so good. That’s all I need. But I think we should use AI to connect people and not isolate them. And so I think having a human in the loop makes a huge difference. Nothing is as good as just… Even a Zoom call with somebody or having coffee with them like, “How are you doing?” That doesn’t seem to be replicable using just AI because you’re fighting against 300,000 years of hominid evolution where we’re just designed to interact that way.

So, I think it can be a great tool, and we’re going to use it as a tool—these LLMs, for example—but I’d rather pitch it to people who are saying, look, there’s going to be a team that’s going to look after you. This team is going to be like some in vivo and some are going to be in silico. And that’s okay. And they’re going to work together. All you have to worry about is we’ll never lie to you and try to trick you into thinking that this bot is a person, and that they both care about you and they both are looking after your best interest. So, figuring out what that combination is going to be is something that no one actually knows exactly. This is such a new field. We’ll see which combinations work, and we’re excited to be part of that push.

Dr. Sandi: Yeah. And it is definitely that merger. So, it’s not either/or because there are wonderful things that can happen as a result of the power of AI and precision diagnostics, for example. And if you want some general information about your health status, you can get some direct-to-consumer lab testing. The more AI is available, then they can have reports that are tailored to you, that are much better than, for example, any given doctor can do. And that’s what I have heard is a very good use of it and so many ways that people can get information from AI.

But the human health coach can sit down with them and help them sort out where they want to begin…now, given the information that they may have access to as a result of AI, what are they going to do with it? Where do they want to start? What works for them? What are some of the obstacles that may get in their way? And in groups. So, that’s the other thing that AI can never do, and that is getting people together in groups where often the community becomes the medicine, so to speak, and change can really happen. So, helping people with that model as well.

Dr. Ravi: You bring up a really interesting point, which is it can dovetail to this much larger question about what is the human role in AI going forward. And I think what you said, if I could restate it, I’ve been thinking about this a little bit, and there’s two points here, which is answer finding and question finding. And we always ignore question finding, even though in science, it’s really hard. No one really teaches you how to do it.

And health coaches a lot of times are not just answering… Answer finding is what these AI systems will always beat us at. What is the best treatment for chronic UTIs in people over 50 or something? Whatever. It’s getting to the point where it’s not using perplexity at AI to solve that problem. It’s almost malpractice like it can read a thousand more papers than you can.

And so that answer finding is great, “Help me interpret these lab tests to see what’s wrong with me.” But it takes the human coach to do question finding. Question finding is messy. It takes a lot of thought and experience. There’s an art to it that’s hard to explain, this intuition with coaches and other people who have been doing it for a while. Those systems aren’t really good at that question finding. So, when you have a client or a patient who’s been doing well and then has a week that you could tell is just off. Their data on their Oura Ring or Fitbit, that they’re moving less, they seem a little more despondent. It’s like the coach being able to know what questions to ask, and when to ask them, and how to ask them I think is something very difficult for AI systems to figure out. I think that’s where humans really shine, which is where they fit into this, kind of, larger future of AI and humans in general.

Dr. Sandi: Absolutely. Those subtle nuances, the question asking. And that is something that can really help people to evaluate and have that aha moment where now they’re going to commit where they have assessed what really matters to them, they’ve determined that, and they’re ready to go forward because of that human relationship also. I’ve had many people say they’re working with a health coach and they’ll think, “Oh, I was about to open that bag of Oreos, but I heard the coach’s voice in my head or I knew I had to have that encounter.”

Well, that’s a human-to-human connection. If it was somebody who is not real—a bot—I don’t know if they would have that level of accountability if it’s not a real person. Just like if I’m working out with a system now that is AI-based and I’ll get corrections like, “Oh, on that last rep, lower the weight slower.” Okay. Well, if I do it, I’m doing it because I’m making that decision but it’s not because there’s somebody in front of me and I want to please them.

Dr. Ravi: Yeah, it’s going to have to be… The only way to automate it is you use punishment, which we use very rarely. But do you know there used to be a wearable that did that? It was called Zap.

Dr. Sandi: Yes, I remember that.

Dr. Ravi: Do you remember it? I bought it for our office in our previous startup, and it was hilarious. It would electrocute you. So, think of, like, a Fitbit, but when you did something it didn’t want you to do, it would literally electrocute you. I don’t think that’s the society we want to live in. I think it’s empowering people to make those decisions, not punishing them. But yeah, so that’s amazing.

Dr. Sandi: At the end of the day, we’re talking about behavior change and how do you really help people change when… As we’ve talked about that, there is that intention-behavior gap, which is you wake up, “Yeah, I’m going to do it,” and then you have the good intention, and then you don’t follow through. And how do you help people have that motivation to follow through? And what goes through their head and their heart as well, that I’m going to do it because it feels good or they connect with that big why, what they want their health for.

Dr. Ravi: Yeah, that big why is a big deal for us. What we’ve noticed is we call them “captivators” or “captivating.” It’s a bad portmanteau of captivating motivator. Finding out that why, and we will say, “Well, I’m going to lose weight.” I’m like, “Okay, why?” And you go, “Well, I’m going to look better.” “Why?” “Well, I’m going to go to this wedding soon, and I want to…” “Who are you trying to impress?” And we’ll just keep going down this line of questioning. And then you’ll find these really emotional reasons. And when you open up and then you’re building rapport as you do this, when you remind people of those whys, they go, “Oh, I get it. I can visualize this now.” And there’s been a lot of data on this in papers as well about visualizing your future self and understanding, kind of, these deep motivating factors. So, that’s one part of it.

And there’s a lot of these behavior change techniques that can be used, and everyone is so different. Knowing which ones to match with different people is really important. So, some people are very collaborative. They don’t want to be compared to somebody else. They want to feel like they’re inspired by another person that they admire or want to work out with people in a social group, for example. Other people are very competitive, and they thrive off each other in that way.

So, knowing those differences makes a big difference. So, those behavior change techniques end up being bottled into these categories, right? So, one of these is social—like social pressure and doing things in groups and utilizing the power of other people. The other one is… I know no one likes to hear about this, but it’s something that has to be cultivated, which is willpower. It’s like developing willpower and intention. So, doing things with intention so that if you want to go to that McDonald’s, it’s up to you but just make sure it’s an intentional choice and not an impulsive choice. So, that just takes training, and there are several other buckets as well. So, habits are one that gets talked about commonly. But the paper out of Duke that came out a while ago that talked about how habits really only account for 40% of what we do. Habits are about automaticity. There’s no intention. These should just be something that you just do. And habits aren’t everything, but they’re a great thing to always cultivate and create.

And there’s a couple more of these buckets as well, like engineering your environment differently. So, putting that thing of M&Ms in an opaque container versus a clear container, these small things start mattering. When you start implementing them all and you can see, “Oh, okay,” they start making these changes. It starts to click. We’ve noticed it takes about six months of continuous coaching, just a total empirical anecdotal observation, nothing based…no papers we’ve published on this or anything, but for all this stuff to start clicking. Now the habits are solidified. They have that willpower. So, when the habits aren’t working, they can willpower themselves out. We’ve changed people’s routes home using Google Maps so they bypass that strip of the Dairy Queen, McDonald’s, Taco Bell, so that they’re not tempted.

So, like those things, implementing these things with the help of coaches and other experts start making a difference. That’s good news I think. It’s good that we have all these techniques that are able to do this. It does start with that understanding what is the reason, like the real reason. Really open up about it. It’s okay to just open up about it. And we’ve had people who are just like, “I’m overweight, and I’m out of shape, but I have a young son, and I want to feel better about being a better mom.” So, once you get to the bottom of it, I’m like, “What does that mean to you?” She was, “Well, I just don’t want him to see the bad habits and bad behaviors and have him be in the same situation I am with prediabetes in my late 20s.” I was like, “Okay, so you feel guilty as a mom.” That is a really strong motivator. That took time to get to that spot where she was comfortable enough to say that. But when we had that information, in addition to a couple of others, we were able to move forward. And then we could start implementing those different techniques and those different buckets.

Dr. Sandi: So powerful. And what you’ve just described is really the essence, the magic of the coaching process. Thank you so much, Dr. Ravi. Where can people find you? Because I know they’re going to want to know more.

Dr. Ravi: No problem. So, I’m CEO and founder of a company called Daytona Health. It’s www.daytona.health, where we do this for a living. If someone was just having trouble knowing where to start, happy to grab a call. But you could always just—even before that—find me on LinkedIn at Ravi Komatireddy. And you can find me on Twitter at @rkomatireddy. So, feel free to just DM me or send me a message. And happy to pick up the phone and just chat and see how we can help or swap notes.

Dr. Sandi: Well, check him out. And he’s a big supporter of health coaching. So, thank you so much for being on “Health Coach Talk” today.

Dr. Ravi: Thank you for the opportunity, Sandi. Always a pleasure.