The United States spends an astonishing $1.8 trillion a year on health care; this represents 15% of the gross domestic product (GDP). The vast majority of this expenditure is consumed by a relatively small percentage of the population for diseases that are, by and large, behavioral.

For example, 2 million people a year have coronary artery bypass surgery or angioplasty to treat their heart disease, at a cost of $30 million. These procedures, in and of themselves, rarely prevent heart attacks or prolong life, because the affected vessels get clogged up again and again. Doctors tell their patients that if they drink less, eat less, stress less, and get more exercise, they will live longer and not need repeated surgeries. However, research has shown that 90% of all people who have bypass or angioplasty don’t change their behaviors.

Why do we resist behavioral change so tenaciously? Why, even at the risk of death, do we hang on to such dysfunctional behavior? Because the facts speak only to our minds, and the head can always find more reasons to maintain the status quo than it can to make changes.

Behavioral change only comes about when you speak to people’s hearts. It’s feelings, not facts, that move us beyond our old limitations. Dr. Dean Ornish, the distinguished founder of the Preventative Medicine Research Institute in Sausalito California, has a world-renowned program for cardiac patients which includes psychological, emotional and spiritual dimensions. Dr. Ornish finds almost 80% of his patients stick with their lifestyle changes and safely avoid bypass or angioplasty surgery. He says it’s not fear of dying that motivates people to change, it’s getting a new vision of life.

To change behavior you have to speak to people’s souls and convince them they can feel better, not just live longer. Joy is a far more powerful motivator than fear — it’s not change or die, it’s change and live.