Self-determination theory (SDT) is a theory of motivation
that may provide some insight into why weight loss
interventions emphasizing financial incentives have struggled
to achieve successful maintenance [21, 22]. At the core of
SDT is the concept of autonomous motivation, characterized
by feeling free and acting for the sake of rewards that are
inherent to the activity itself. This inherent reward could
be positive emotions, such as interest and enjoyment (i.e.,
intrinsic motivation), or the satisfaction associated with
action that is personally meaningful (i.e., identified extrinsic
motivation). Importantly, an emerging body of evidence
shows that autonomous motivation is positively related to
persistence and maintenance of healthy lifestyle changes.
Specifically, self-reported autonomous motivation has been
shown to predict greater maintenance of physical activity and
weight loss [23, 24]. In a 3-year randomized controlled trial,
Silva and colleagues contrasted an intervention designed to
promote autonomous motivation for exercise and weight
management to a general health education control condition
[25–28]. After 3 years, the intervention designed to support
autonomous motivation produced significantly better maintenance
of both exercise and weight loss, relative to control,
and the effects were mediated by autonomous motivation
(both intrinsic motivation and identified extrinsic motivation)
[29].