Talking to patients regarding their health is obviously what I do. I have been a physician for 27 years, a family medicine physician for 18 years and managing obesity for almost 15 years. Especially with obesity management, I have recognized this pattern of thinking in my patients. They are so inspired after the first visit. "I can do this!" And of course, after a few weeks they fizzle out because they solely rely on motivation and get discouraged with the first setback.
We’ve all been there. You set a goal—maybe to exercise five times a week, cut out sugar completely, or stick to a meal plan. But then life happens. You miss a workout, eat a cookie, or have a stressful day that sends your best intentions flying out the window. And suddenly, you think, “Well, I’ve already messed up. Might as well start over on Monday.” That is all-or-nothing thinking in action.
What is All-or-Nothing Thinking?
All-or-nothing thinking (also called black-and-white thinking) is the belief that if something isn’t perfect, it’s a failure. It’s deeply tied to perfectionism, making us feel like there’s no middle ground between success and failure. When we think this way, we set ourselves up for disappointment because, let’s be real—life isn’t all or nothing.
This kind of thinking keeps us from taking the necessary next step to move forward. We see it as a pass/fail test. And if we “fail,” we often stop altogether.
My patients come in for a follow up and say,"I almost didn't want to come in cos I fell off the wagon." Or "I missed the last appointment because I was off-track and I couldn't get back and now I've gained weight."
How It Shows Up in Health and Wellness
All-or-nothing thinking can creep into many areas of our health and wellness journey. Here are some common examples:
Exercise: “If I can’t do a full hour workout today so it’s not worth it, might as well skip it.”
Eating Habits: “I had fries at lunch, so I might as well eat junk for the rest of the day.”
Sleep: “I stayed up late watching TV, so my sleep is ruined for the week. Might as well finish the series!”
Mindfulness: “I missed my morning meditation, so I might as well skip it the rest of the week.”
Sound familiar? These thoughts make us believe that small steps don’t count, but they do!
The Stop-and-Start Cycle
When we fall into all-or-nothing thinking, we end up in a perpetual cycle of stopping and starting. We’re either “on track” (perfectly following a plan) or “off track” (giving up completely). This makes it harder to develop consistent habits because every time we “fail,” we have to start from scratch—again.
But what if there was another way? A way that allowed for flexibility, progress, and self-compassion?
Reflection: Do You Have All-or-Nothing Thinking?
Ask yourself these questions:
Do I feel like if I don’t do something perfectly, I’ve failed, or I feel likeI'm a failure?
Do I give up easily if I make one mistake?
Do I use words like “always” or “never” when talking about my habits?
Do I restart my health journey over and over again instead of adjusting along the way?
If you answered yes to any of these, you might be stuck in all-or-nothing thinking. But the good news? You can break free from it.
How to Refocus When You Feel "Off-Track"
If it’s been days or weeks and you feel like you’ve fallen off the wagon, here are some questions to help you refocus:
What small step can I take today to move in the direction I want? (Instead of waiting for a “perfect” day to restart, just take one action.)
Am I judging myself harshly for being human? (Self-compassion goes a long way in rebuilding consistency.)
What’s one habit that made me feel good before? (Start by reintroducing something simple that worked for you.)
Am I thinking in extremes? (Challenge yourself to see progress in smaller, more flexible ways.)
What’s a realistic plan moving forward? (Instead of “starting over,” tweak and adjust your habits.)
What is the next best decision? (So you ate 4 pieces of pizza at lunch, the next best decision is maybe fiber rich meal at dinner)
How to Overcome All-or-Nothing Thinking
Here’s my go-to strategy: Name, Notice, Normalize, and New Plan.
Name It: Recognize when you’re falling into all-or-nothing thinking. Say to yourself, “Oh, I see what’s happening here—I’m thinking in black and white, I'm thinking in extremes.”
Notice the Pattern: Pay attention to when and where this kind of thinking shows up. Is it with food? Exercise? Sleep? Identifying patterns helps you gain awareness.
Normalize It: Remind yourself that this is common. You’re not alone in this, and it doesn’t mean you’re failing. It just means you’re human.
New Plan: Instead of giving up or waiting for a “perfect” restart, pivot. If you miss a workout, do a 10-minute stretch. If you eat something unplanned, just make the next meal a balanced one. What is the next best decision? The goal is progress, not perfection.
Embracing the Middle Ground
Real, sustainable wellness happens in the messy, imperfect middle ground. It’s about showing up, making adjustments, and keeping the momentum going—even when things aren’t perfect.
So next time you catch yourself thinking, “I already messed up, so what’s the point?”—pause. Recognize that every small action still counts. Because in the end, lasting change isn’t about being perfect. It’s about being consistent in the face of imperfection.
You’ve got this!