Muscle health is integral to Dr. Gabrielle Lyon’s Muscle-Centric Medicine (MCM) approach, which links physical well-being to an individual’s self-worth and the psychological factors that promote sustainable behavior change. In this series, we have examined the nutritional and physiological aspects of muscle health, while critically assessing this emerging paradigm of health and human performance. In this edition, we focus on the crucial role of behavioral science and the psychology of worthiness in cultivating lasting health habits. By delving into the theories and evidence-based practices that underpin the behavioral analysis components of MCM, fitness professionals can address the mental and emotional elements that impact client engagement. This, in turn, can inspire not only physical transformations but also a significant shift in individuals’ perceptions of themselves and their boundless potential.

 Behavioral Change Frameworks: Building a Foundation for Commitment

Several well-established behavior change theories offer insights into how individuals adopt and sustain new health behaviors, particularly those tied to muscle health, such as resistance training and optimal nutrition. These frameworks provide a roadmap for understanding client behavior and crafting strategies to help them embrace a health-focused lifestyle.

The Transtheoretical Model of Behavior Change

The Transtheoretical Model (TTM) identifies five stages of behavior change: precontemplation, contemplation, preparation, action, and maintenance (Marshall & Biddle, 2001). Understanding where a client is in this continuum allows trainers to tailor interventions. For example, clients in the precontemplation stage may require education about the importance of muscle health, while those in the preparation stage benefit from specific, actionable strategies for incorporating resistance training into their routines (Hajivandi et al., 2021).

The Theory of Planned Behavior

The Theory of Planned Behavior (TPB) emphasizes the role of intention in predicting behavior. Intention itself is shaped by attitudes, subjective norms, and perceived behavioral control (Ajzen, 2020). In practice, this means helping clients develop positive attitudes toward resistance training by demonstrating its benefits—such as improved metabolic health and enhanced quality of life (Chilón-Troncos, 2024). Encouraging supportive social networks and addressing perceived barriers can further strengthen clients’ intentions and likelihood of sustaining health behaviors (Newsome et al., 2023).

Self-Determination Theory

Self-Determination Theory (SDT) highlights the importance of intrinsic motivation, driven by autonomy, competence, and relatedness, in sustaining behavior change. Fitness professionals can nurture intrinsic motivation by aligning health goals with clients’ personal values and fostering a sense of mastery through incremental progress (Taghipour et al., 2016). For example, a client who sees resistance training as a way to increase energy levels and enjoy activities with their family is more likely to commit to the behavior long-term (Vrinten et al., 2023).

Self-Efficacy and Its Impact on Adherence

Self-efficacy, or the belief in one’s ability to succeed, is a critical determinant of behavior change. Clients with high self-efficacy are more likely to persist in the face of challenges and setbacks (Kim & Park, 2020). Strategies to build self-efficacy include setting realistic, achievable goals and celebrating small successes, such as completing a week of planned workouts (Stacey et al., 2014). This reinforces a client’s confidence in their ability to maintain healthy habits.

The Role of Worthiness in Muscle Health

Beyond the structured theories of behavior lies the crucial concept of worthiness—a psychological state in which individuals believe they are deserving of health, vitality, and longevity. Many clients struggle with feelings of inadequacy or self-doubt, which can hinder their commitment to adopting healthy behaviors. It is vital to address these emotional barriers to facilitate meaningful and lasting change.

In exploring the holistic principles of MCM as outlined by Lyon (2023) in her seminal book Forever Strong, her approach inherently acknowledges the necessity for clients to feel worthy. By reframing muscle health as a pathway to empowerment rather than merely a superficial objective, clients can transform their mindset regarding fitness. For example, a middle-aged individual who perceives resistance training as a means to set a positive example for their children, instead of simply a strategy for weight loss, may uncover a deeper sense of purpose and commitment in their journey.

Practical Applications for Fitness Professionals

Personal trainers are uniquely positioned to bridge the gap between theory and practice. By integrating behavioral change models and the psychology of worthiness into their coaching, they can create transformative client experiences.

1. Stage-Based Coaching: Use the Transtheoretical Model (TTM) as a valuable tool to assess each client’s readiness for change. For those in the action stage, provide them with comprehensive and personalized resistance training plans catering to their needs. For clients still in earlier stages, focus on education and fostering a trusting relationship. Embrace the wisdom of renowned strength and conditioning coach Mike Boyle, who reminds us that clients “will not care how much you know until they know how much you care.” By demonstrating empathy and meeting clients where they are, you can build a strong foundation of rapport and trust, ultimately facilitating their progression through the various stages of the TTM. This constructive approach empowers clients and enhances their motivation and commitment to change.
2. Positive Reinforcement: Embrace the principles of the Theory of Planned Behavior (TPB) by showcasing encouraging success stories and testimonials highlighting muscle health benefits. Focus on the social advantages of group training and the importance of finding a “workout buddy” to strengthen perceived norms within the community. Training alongside a partner fosters a supportive environment and encourages individuals to challenge and motivate each other, enhancing accountability and commitment to their fitness journeys.
3. Empowering Clients: To nurture autonomy and competence—vital components of Self-Determination Theory (SDT)—it’s beneficial to engage clients in the goal-setting process and encourage them to make their own decisions. This collaborative approach can significantly enhance their intrinsic motivation. One constructive strategy is to have clients create a list of healthy habits they aspire to adopt, utilizing a “no more than, no less than” guideline. For instance, beginners can set targets to work out “no less than twice a week and no more than five times a week.” This method supports clients in establishing clear boundaries and “non-negotiables,” facilitating the formation of new habits while reducing the likelihood of reverting to less favorable behaviors. Maintaining a “minimum threshold” for sustainable success empowers clients to stay committed rather than giving up entirely. These SDT elements can help clients remain focused and motivated, even amidst life’s challenges when combined with other supportive strategies in this list. For more valuable insights into helping clients cultivate new habits and release old ones, be sure to explore Part 2 of this article.
4. Build Self-Efficacy: it’s important to set achievable milestones that boost clients’ confidence. For instance, gradually increasing weights or fine-tuning their form can highlight real progress, reinforcing their belief in their abilities. Another effective strategy is to encourage clients to buy a pair of pants or jeans one or two sizes smaller than what they currently wear, with a set date to fit into them. This serves as a motivating reward and creates a sense of intrinsic accountability, especially if they know they will be trying on the jeans in front of others.
5. Creating a Supportive Environment:  Establishing a culture of support and camaraderie during training sessions can significantly enhance the overall experience for clients and trainees alike. When individuals encourage each other and work towards shared goals, they are more likely to remain committed to their fitness journeys. Recognizing personal achievements and sharing progress can build a strong sense of community, vital for fostering lasting behavioral change and nurturing a growth mindset. A practical way to implement this is by introducing friendly challenges between the morning and afternoon sessions of the same fitness class. Even without direct interactions, these groups can drive one another to excel while enjoying playful exchanges outside of training. This approach helps create a vibrant atmosphere rich in fun, motivation, and a sense of gamification.

Conclusion

Integrating psychological frameworks with Muscle-Centric Medicine creates a holistic approach to client care. By understanding and applying TTM, TPB, SDT, and self-efficacy theories, fitness professionals can address the underlying beliefs and emotions that influence behavior. Moreover, fostering a sense of worthiness empowers clients to commit to long-term muscle health, transforming their lives beyond the gym. As Dr. Lyon’s work continues to inspire, the role of trainers as advocates for both physical and psychological well-being becomes ever more critical. Together, we can help clients see themselves not just as individuals striving for change but as deserving of health, strength, and vitality.

References

Ajzen, I. (2020). The theory of planned behavior: Frequently asked questions. Human Behavior and Emerging Technologies, 2(4), 314–324. https://doi.org/10.1002/hbe2.195

Chilón-Troncos, R. (2024). Predicting willingness to consume healthy brand foods using the theory of planned behavior: The role of nutritional literacy. Frontiers in Nutrition, 11. https://doi.org/10.3389/fnut.2024.1353569

Hajivandi, L., Noroozi, M., Mostafavi, F., & Ekramzadeh, M. (2021). Assessing the impact of an educational intervention program based on the theory of planned behavior on the nutritional behaviors of adolescents and young adults. BMC Pediatrics, 21(1). https://doi.org/10.1186/s12887-021-02784-z

Kim, S., & Park, S. (2020). Garden-based integrated intervention for improving children’s eating behavior for vegetables. International Journal of Environmental Research and Public Health, 17(4), 1257. https://doi.org/10.3390/ijerph17041257

Lyon, G. (2023). Forever strong: A new, science-based strategy for aging well. Simon and Schuster.

Lyon, Gabrielle. (2022, September 13). Muscle-centric Medicine ®. Dr. Gabrielle Lyon. https://drgabriellelyon.com/muscle-centric-medicine/

Marshall, S. J., & Biddle, S. J. (2001). The transtheoretical model of behavior change: A meta-analysis of applications to physical activity and exercise. Annals of Behavioral Medicine, 23(4), 229–246.

Stacey, F., James, E., Chapman, K., Courneya, K., & Lubans, D. (2014). A systematic review of social cognitive theory-based physical activity and nutrition interventions. Journal of Cancer Survivorship, 9(2), 305–338. https://doi.org/10.1007/s11764-014-0413-z

Taghipour, A., Miri, M., Sepahibaghan, M., & Vahedian-Shahroodi, M. (2016). Prediction of eating behaviors among high school students based on the constructs of the theory of planned behavior. Modern Care Journal, 13(4). https://doi.org/10.5812/modernc.58186

Vrinten, J., Royen, K., & Matthys, C. (2023). Development and validation of a short nutrition literacy scale for young adults. Frontiers in Nutrition, 10. https://doi.org/10.3389/fnut.2023.1008971 

Author Bio: Tim Hanway MS CSCS ACSM-EP

Tim Hanway is an accredited Sport and Exercise Scientist, Human Performance Specialist, and Assistant Professor with over eight years of experience in higher education. Having consulted with NFL athletes and Olympians, US Special Forces members, physicians, therapists, business owners, and executives, Tim creates bespoke coaching programs and seminars that blend high-performance coaching with practical skills and know-how. His extensive background includes working with Team USA and Team GB, where he developed and implemented systems and strategies for high-level athletes. Tim infuses his coaching sessions with these same proven methods, empowering his clients and teams to achieve sustained high performance in the office and at home, achieving lasting fulfillment in the process. Through his unique approach, Tim ensures that every individual he works with is equipped to reach their highest potential, both professionally and personally.