May 6, 2026

How “all-or-nothing” thinking deters physical activity-and what clinicians can do about it

By Michelle Segar, PhD, MPH, MS, FSBM University of Michigan behavioral scientist and Health coach

By Michelle Segar, PhD, MPH, MS, FSBM University of Michigan behavioral scientist and Health coach

Many patients abandon physical activity plans when life gets in the way, not because they lack motivation, but because of “all‑or‑nothing” thinking. This article explores why this mindset is so pervasive, how it undermines health, and how clinicians and health coaches can foster flexibility so patients learn that “all‑or‑something” movement truly counts. 

Stephanie, my 52-year-old coaching client, had planned to walk for 45 minutes after work. But by the time she got home—15 minutes late, tired, and with dinner to prepare—her plan felt impossible. The result? She decided to drop her activity plan completely. Stephanie’s choice reflects the “all-or-nothing thinking” that commonly occurs with physical activity decision-making among our patients, and maybe even ourselves.  

What is all-or-nothing thinking?   

All-or-nothing thinking is when individuals evaluate physical activity in binary terms: It has to be done “right” in terms of time, type, or imagined ideal (i.e., “the all”) or it’s not worth doing. In this binary, when the all isn’t possible or desirable, the only option is nothing.  

Surprisingly, this extremely common phenomenon is sorely under-researched. In fact, the first focused study on this topic was not published until this year by my colleagues and I. The lack of research on this topic with physical activity is even more surprising given that it is a well-established barrier to adaptive healthy eating and weight-loss maintenance.  

Why do people use  all-or-nothing thinking with physical activity?    

Decades of messaging, from physical activity guidelines to the media, and even our own patient counseling, has emphasized the need to achieve specific criteria when being active (e.g., minutes, intensity, modes). Inadvertently, this prescriptive approach transforms physical activity plans into rigid internal standards that don’t adapt to the dynamic realities of everyday life. This is what happened with Stephanie.  

The consequences from all-or-nothing thinking are clinically relevant:  

• Missed opportunities for “good enough” movement that is health-promoting  
• Loss of other important benefits (boosted mood, reduced stress, positive connections)
• Reduced self-efficacy after perceived failures to do the “all”  
• Avoidance of activity among those with chronic pain, obesity, or time constraints  

Replacing “all-or-nothing” with “regulatory flexibility”  

The solution I’ve been using for decades within my own coaching practice, and which my co-investigators and I are now starting to research and develop a theory about, is “regulatory flexibility” or the ability to dynamically adapt physical activity plans when they become undesirable or unfeasible. But to support regulatory flexibility, patients need to change their mindset from all-or-nothing to all-or-something.  

The research showing that even very small amounts of movement are health-promoting is so conclusive that in 2018 and 2020, the Physical Activity Guidelines for Americans and World Health Organization’s Guidelines on Physical Activity and Sedentary Behavior, respectively, removed the past criterion stating that movement had to last for 10 minutes. More recently, ACLM featured findings from a Lancet study showing that just five minutes of activity confers health benefits. 

Here’s how you can guide your patients to adopt the “all-or-something” mindset:   

1. Redefine what “counts.”  

Help patients expand their definition of meaningful physical activity. Short, low-intensity, or modified movement still delivers value physiologically and psychologically. When we give ourselves (and our patients) permission to do what is feasible or desirable, we feel successful with our efforts, and that supports being motivated to stay active.  

2. Normalize doing less  

Over time, doing any amount of physical activity add ups to more physical activity than doing none at all. Yet, for many patients, “doing less” feels like failure. Help them understand that this strategy is  the  pathway that many people need to create behavioral resilience and sustainability.

3. Promote “activity swaps.” (Hint: this is regulatory flexibility)  

Encourage your patients to use “activity swaps” (dynamic activity substitutions and modifications) whenever their plans break down. Examples of this are turning a planned 30-minute run into a 10-minute walk or dancing at home with your children instead of driving to the gym for a workout. This aligns physical activity with real-life variability.  

Ultimately, supporting physical activity is less about prescribing the “right” amount of movement and more about helping patients flexibly adapt when their plans fall apart. By recognizing all‑or‑nothing thinking and actively promoting regulatory flexibility’s “all-or-something mindset,” clinicians and coaches can help patients see movement as an activity that harmonize with their other daily priorities—instead of competing with it.