A Marathon a Month | Why the Incentive Isn't as "Brilliant" as Believed 🫠

I've seen a lot of excitement about NHS England's new "Marathon a Month" challenge, which will reward people for walking around 30 minutes a day through discounts and incentives.

And I genuinely hope it helps some people become more active. Walking has enormous physical and mental health benefits.

So why am I NOT excited about it? 🫠 

Firstly, there's the obvious issue of accessibility. 

Not everyone can walk for 30 minutes a day. Many disabled people, people with chronic illnesses, chronic pain, fatigue, etc. can't participate in the same way. 

Public health initiatives should encourage movement in ways that are inclusive, not inadvertently rewarding only certain bodies. 

Secondly, as someone who works in eating disorder recovery, I worry about how schemes like this interact with exercise addiction and compulsive movement. The incentives could be downright dangerous.

For many people recovering from anorexia or other restrictive and compensatory eating disorders, "earning" rewards for movement can reinforce the belief that exercise is something to maximise and that being active makes you more deserving. The daily streaks, badges and incentives that make these programmes engaging for many people are the very mechanisms that can become incredibly difficult to disengage from for someone whose illness already revolves around compulsive exercise. Or where it triggers this compulsion.

Recovery often involves learning that you don't have to "earn" rewards (often food, rest) through movement, missing a day doesn't mean you've failed, and your worth isn't measured by streaks, step counts or consistency.

Can you see how they contradict each other?

And then finally: the data. The digital tracking.

The programme relies on logging activity through a smart device in order to receive rewards. It’s reasonable to question what data is collected, how it's used, who has access to it and whether participating should require that level of monitoring.

Again: none of this means encouraging movement is a bad idea. Obviously. (I’ve already blown up the internet with my controversial opinion, so it’s worth reiterating.)

But the challenge isn't designing programmes that work for the average person. It's designing them so they don't inadvertently harm the very groups who are already vulnerable. It’s designing them so they improve health without increasing shame, surveillance or exclusion. That's the standard we should be aiming for.

What do you think? Can we encourage healthier habits without making health more conditional and competitive? Because while this new challenge has all the best intentions, there’s just so many holes?