It’s a form of lifestyle failure that we’re all familiar with. You decide that you want to be healthier—exercise more, eat better, lose weight, feel less stressed or get a health problem under control. You set a health goal, such as walking 30 minutes every day—and for a while you manage to stick with your new habit. But before you know it, you’ve reverted to your old ways.

Where most people get tripped up: Just deciding that you want to be healthier doesn’t work—if it did, we’d all be healthier! What does work is connecting with your deepest inner wants and needs—with a motivation that can compel you to make and sustain a lifestyle change. That’s where a health coach comes in.

A health coach is trained to ask the type of “open-ended” questions that will help you connect with your inner motivations for change—the real drivers of your day-to-day behavior. Their nonjudgmental questions get you to think deeply about your goals in life and why you are motivated to achieve them. A close-ended question such as “Did you have a successful week?” allows you to answer “yes” or “no.” An open-ended question such as, “What about last week made it successful?” provokes thought and reflection. And once the questions are asked, health coaches know how to listen in attentive, companionable silence, letting you think and talk about what you really want.

Example: A 60-year-old ­woman with type 2 diabetes knew she had to eat better and lose weight to control her disease and stay alive—but she kept failing at doing it. Through in-depth conversation with her health coach, she realized the biggest reason she wanted to live a longer life was to spend time with her grandchildren. Once she identified that as her inner motivation, she was able to make permanent changes to her diet.

Another common scenario is that a person thinks he/she has one reason for seeing a health coach—but discovers that he really has another. 

Example: A man hired a health coach to become more fit. Through working with the coach, he discovered that he is overcommitted in his work and social life—and has no time for himself, including time to exercise. So first, the coach and the client focus on prioritizing self-care and time management—and “exercising” the right to say no. 

Studies show that working with a health coach can help individuals achieve and maintain an impressive array of better-health benefits—­including fewer hospitalizations and better lung capacity in patients with chronic heart failure…better adherence to a medication regimen…and a reduced number of emergency room visits among “super-utilizers” of emergency care. In cancer ­patients, health coaching has been proven to have particularly strong psychological benefits.

Even for people without life- threatening illnesses, a health coach can help make lasting changes. Health coaches work with people who would like to better manage their stress, improve their eating habits, increase their cardio fitness, improve their sleep, reduce the time they spend sitting and more. In addition, health coaches help clients find creative solutions for situations in their lives that are impacting their well-being.

What you need to know about working with a health coach…

STAGES OF BEHAVIOR CHANGE

Most health coaches use a ­science-supported and widely ­accepted model of behavior change called The Transtheoretical Model of Change, which addresses six distinct stages of change…

Precontemplation: You don’t even know that you want to change, but you know something isn’t right, such as always feeling tired.

Contemplation:You’re thinking about change but haven’t made a commitment to act and are ­researching pathways to change—such as seeing a health coach.

Preparation:You decide to act, and you gather information and plan. Most people skip this stage when they try to make changes on their own—often leading to failure after a few weeks.

Action: You begin to change your behavior and lifestyle. 

Maintenance:You’ve sustained the change for at least six months. 

Termination: The change is permanent. You’re no longer tempted by your former behavior.

Example: The client’s “contemplation” is to eat more fruits and vegetables. The health coach helps the client prepare to reach his goal—perhaps by looking at his current consumption of these healthy foods, understanding what’s keeping him from eating them and then helping him figure out how to eat one more serving per day for the next two weeks—that is a realistic and achievable goal. 

Next, the coach helps create a plan of action—such as planning a weekly visit to the grocery store’s produce department and finding enticing, yet easy recipes. 

New topics or ideas tend to surface over time as the level of trust and rapport between the client and the coach deepens, and the client spends more time reflecting on his life and well-being to figure out the drivers to change. 

FINDING A HEALTH COACH

The best place to start is at the website of the National Board for Health & Wellness Coaching (NBHWC.org). This organization collaborates with the National Board of Medical Examiners to provide a rigorous board-certification examination. Health and wellness coaches who hold the National Board Certified Health & Wellness Coach (NBC-HWC) credential have had a minimum of 75 hours of training and education. In addition, they have passed a 4.5-hour exam that is provided in partnership with the ­National Board of Medical Examiners, and they have completed at least 200 hours of coaching sessions. 

There are other resources to help you find a health coach. Many doctors work with them, and many employee-wellness programs offer access to one. 

Or try your hospital, health system or insurance company. Gyms and fitness facilities such as the YMCA or Life Time also offer health and wellness coaching. 

CHOOSING A HEALTH COACH

Interview at least two or three coaches, and choose the one with whom you feel the most rapport—someone with whom you’ll feel comfortable sharing your deepest thoughts about your life and your need for improvement. You want a coach who really listens and doesn’t dominate the conversation.

Be sure to ask where the person received his/her training—and confirm that it’s a program approved by NBHWC. A list of approved programs is on its website.

Before you hire a health coach, you also should be sure of what services are offered. Personal trainers and nutritionists are very directive—if you want to run a
10K, for example, a personal trainer tells you exactly what to do…a nutritionist will tell you what to eat. A health coach, on the other hand, is trained to partner with you on many different aspects of your life, including your diet, exercise, stress, mood, relationships, work and spirituality. 

HEALTH-COACHING SESSIONS

Most people meet with a health coach virtually—this was so even before the pandemic. Sessions typically are 50 to 60 minutes, held weekly or every other week, reviewing the previous week (or two) and setting goals for the next time period. This encourages you to be accountable—another key step in achieving goals. 

Many coaches offer a six-month program—that’s the amount of time it takes to establish and master a new life skill. The cost per session tends to range from $50 to $150. 

E-Coaching: Your Virtual Guide 

Most health and wellness coaching is face-to-face, in conversation, even if it’s via a video call. But there’s also e-coaching
—no face-to-face interaction or ongoing relationship but only interaction through an app, chat, text or e-mail. 

Noom is a psychology-based platform that empowers users to make healthier choices. It offers individual and group coaching included in the $59/month fee. Fitbit Care—a health and wellness program available to employees through their employers—uses an app but has no face-to-face interaction.