Why We Don’t Take the Things We Say We Need

There is an observation near the beginning of Jordan Peterson’s 12 Rules for Life that has stuck with me.

In Rule 2—“Treat Yourself Like Someone You Are Responsible for Helping”—Peterson discusses something that sounds almost unbelievable at first: medication adherence.

He uses an example in which 100 people receive prescriptions. Roughly a third, he says, may never fill the prescription. Of those who do, many will not take the medication correctly.

The neat division into thirds shouldn’t be treated as a universal medical law. Different medications, diseases and populations produce different adherence rates.

But Peterson wasn’t making the problem up.

A large primary-care study published in Annals of Internal Medicine followed 15,961 patients receiving 37,506 new prescriptions. Researchers found that 31.3% of those prescriptions were never filled within nine months.

Think about that.

A doctor identifies a problem, writes a prescription to address it—and nearly a third of the prescriptions in that study never make it into the patient’s hands.

Then Peterson takes the example somewhere that makes it considerably harder to explain away.

What If Your Life Depends on Taking It?

Imagine receiving a kidney from another human being.

You have undergone major surgery. You understand that your immune system can attack the transplanted organ. You have been prescribed immunosuppressive medication specifically to reduce the risk of rejection.

Surely those patients take their medication.

Not always.

A systematic review of adult kidney-transplant recipients found a median nonadherence rate of approximately 22%. More disturbing, the analysis found that nonadherent recipients had approximately seven times the odds of graft failure compared with adherent recipients.

That deserves a moment.

Because most of us hear that and immediately think:

How could you possibly not take the medication?

And perhaps that reaction tells us something important about human behavior.

Knowing Something Matters Isn’t the Same as Doing It

Peterson uses the example of caring for an animal.

If your dog gets sick and the veterinarian gives you medication with instructions to administer it twice per day, chances are you’re going to make sure the dog gets its medicine.

Yet people frequently don’t demonstrate the same diligence with themselves.

There are plenty of legitimate reasons for poor medication adherence. Cost matters. Side effects matter. Depression and other psychological factors can matter. Forgetfulness matters. Complicated dosing schedules matter.

And pill burden matters.

But after spending more than three decades around athletes, clients and supplement customers, I’ve come to think there’s another variable involved:

How badly do you want the outcome?

Not how important the outcome objectively is.

How important does it feel to you right now?

Those aren’t always the same thing.

Researchers studying medication adherence have described something similar through the “Necessity-Concerns Framework.” A meta-analysis covering 94 studies and more than 25,000 patients found that stronger beliefs in the personal necessity of treatment were associated with better adherence, while greater concerns about treatment were associated with poorer adherence.

In simpler terms:

People are more likely to consistently do something when they believe they really need it.

Six Pills Can Feel Like a Lot—or Nothing at All

I spent years working directly with supplement customers.

I’ve heard the question countless times:

“How many pills do I have to take?”

Six?

“Do you have anything that’s only two?”

In my own experience, women have been particularly likely to ask whether I could give them a gummy, powder, liquid or simply something involving fewer pills.

When I say that in front of groups of women, nobody seems particularly offended. Usually somebody raises her hand and says, “Guilty.”

Interestingly, some research supports the observation. In a study of 1,051 primary-care patients, 37.4% reported having experienced difficulty swallowing tablets or capsules, and swallowing difficulties were significantly more common among women than men.

But here’s where things get interesting.

The same person who thinks six supplement capsules are excessive can have an enormous bottle of Advil sitting next to the bathroom sink.

Not in the medicine cabinet.

Next to the sink.

By the time you’ve been training into your 40s and beyond, that becomes a joke only because so many athletes recognize it.

There may even be another bottle in the car.

Why?

Because pain is persuasive.

When your knee hurts and you already know ibuprofen can reduce the pain, suddenly swallowing a pill isn’t particularly burdensome.

There is a specific problem.

There is immediate motivation.

There is confidence in the intervention.

And there is feedback.

You take something. The pain decreases.

Compare that with:

“Take these capsules every day for general health.”

General health is important, but where is the feedback?

Did your “general health” improve Tuesday?

How would you know?

Motivation Has to Beat Friction

Think about a multivitamin.

You take it for “general health.”

There may be no immediate symptom you’re addressing. There may be no obvious feedback telling you it’s working. There may be no measurable endpoint.

Now imagine your eye doctor identifies something concerning and you become interested in nutrients associated with supporting eye health.

Suddenly the behavior has context.

Or imagine you’re taking something because you want to improve your sleep.

You can evaluate your sleep.

You want to lose body fat.

You have a scale, photographs and measurements.

You want to improve training performance.

You have a training log.

You’re trying to address an elbow that hurts every time you train.

You have an elbow.

This doesn’t mean every intervention will produce the desired result. It means that a specific outcome gives you a reason to keep performing the behavior.

Adherence becomes something of a contest:

Motivation versus friction.

The more important the perceived outcome, the more friction people may be willing to tolerate.

Sometimes the Problem Really Is the Pill

We shouldn’t turn this into an argument that consumers simply need more discipline.

Sometimes the delivery system is genuinely bad.

Swallowing pills isn’t completely instinctive for everyone. I’ve actually coached people on how to swallow pills more comfortably.

Research suggests that technique really can matter.

In a study of 151 adults, researchers tested two different pill-swallowing techniques. A “pop-bottle” technique substantially improved swallowing of tablets in about 60% of attempts, while a lean-forward technique improved swallowing of capsules in nearly 89%.

So sometimes a person who says, “I can’t swallow pills,” may never have been shown a technique that makes swallowing them easier.

Then there’s sheer volume.

At some point an efficacious dose simply contains too much physical material to sensibly put into capsules.

That presents a formulator with a choice.

You can reduce the dose so the label says:

Take 2 capsules.

Or you can change the delivery system.

Those aren’t the same solution.

Gummies Didn’t Become Huge by Accident

The modern supplement industry has figured this out.

Gummies transform supplementation from something medicinal into something closer to a small daily treat.

Powders solve another problem: they can deliver gram-level quantities of ingredients without requiring somebody to swallow a handful of capsules.

Liquids provide another alternative.

Then there is Grüns.

Grüns took the broad daily-nutrition/greens concept and put it into a convenient gummy format.

The company launched in 2023. In April 2026, Unilever announced plans to acquire it. Published estimates put the transaction at approximately $1.2 billion.

Even more interesting for this discussion are the usage numbers.

According to a Shopify case study on the company, more than 90% of Grüns revenue comes from subscriptions. Among subscribers, 94–96% reportedly consume the product at least four to six times per week, and approximately 80% take it every day.

Grüns reportedly ships around 10 million gummies per day.

None of that proves that gummies scientifically cause better adherence.

Marketing matters. Branding matters. Distribution matters. Taste matters. Subscription models matter.

But it certainly demonstrates something:

Consumers place enormous value on delivery systems that make supplementation easier and more enjoyable.

That should matter to anyone formulating supplements.

Start With the Dose—Then Find the Delivery System

This problem has directly influenced how I formulate products.

Magnesium L-threonate presents a simple physical problem. The amount of Magtein® I wanted to deliver was measured in grams.

I could have created another handful of capsules.

Instead, I developed it as a liquid.

Collagen makes the issue even more obvious.

Some of the specialized collagen peptides I work with have effective amounts measured in multiple grams. Once you’re delivering several gram-level ingredients, putting the formula into capsules becomes impractical.

So Specialized Collagen Peptides became a powder.

Fortunately, collagen peptides work extremely well in that format. Put an unflavored powder into coffee, a shake or another beverage without meaningfully changing the experience, and suddenly grams of material are much easier to consume than a handful of capsules.

The principle isn’t:

Fewer pills are always better.

And it certainly isn’t:

Gummies are always better.

It’s this:

Start with the amount of ingredient you actually intend to deliver. Then find the lowest-friction delivery system capable of delivering it.

That is very different from starting with “two capsules” and figuring out how little of everything will fit inside them.

But Consumers Have a Responsibility Too

There’s another side to this.

Nobody has to buy a dietary supplement.

That’s an important distinction between supplements and prescription medication.

If you pick up a bottle and the label says six capsules per serving and you think:

“There is no chance I’m taking six capsules every day.”

Don’t buy it.

That’s a completely reasonable consumer decision.

Choose something else.

But something strange happens when a person knowingly buys the six-capsule formula, decides to take three, and later concludes:

“I tried it. It doesn’t work.”

You didn’t actually test the product as formulated.

You tested your own half-dose version of it.

I’ve seen this firsthand with products I’ve sold.

And this is where consumer education becomes as important as formulation.

Why are there six capsules?

What amount of each ingredient is being delivered?

Could the manufacturer have made it two?

Perhaps.

But what would have had to disappear from the formula to accomplish that?

Fewer pills are better—until getting to fewer pills requires giving up the dose.

Sometimes People Stop Because It Worked

There is an even stranger adherence problem.

Success.

My brother-in-law was using collagen for his joints.

Eventually he told me his joints weren’t bothering him anymore, so he stopped taking the collagen.

From his perspective, that makes perfect sense:

Problem → intervention → problem gone → intervention finished.

But that assumes the intervention was intended to function like something you take temporarily until a symptom disappears.

Connective tissues aren’t static structures.

They are living tissues undergoing continuous breakdown, synthesis and remodeling. Scientific reviews describe connective-tissue proteins as being in a constant state of remodeling, with collagen turnover estimates in some tissues of roughly 0.5–2% per day.

That doesn’t mean every collagen molecule is replaced every day.

It means there isn’t a point at which your joints announce:

“We finished remodeling. We’re done now.”

For an athlete who intends to continue training and loading those tissues, supporting them can be a maintenance decision rather than simply a response to pain.

Athletes often learn this lesson with age.

At 25, many people don’t think much about their joints because their joints aren’t demanding their attention.

Eventually they do.

Among experienced athletes I’ve interviewed and coached, by the 40s joint management frequently becomes part of the conversation. By the 50s, continuing to train at a high level can require considerably more attention to keeping the machinery working.

The goal isn’t really “joint health.”

The goal is maintaining the ability to keep doing what you love.

Congratulations. You’ve Brushed Your Teeth Enough.

This reminds me of another conversation I’ve had more than once.

Someone tells me:

“I worked out for years.”

As though exercise has a lifetime quota.

So I congratulate them.

Apparently they’ve earned the Exercise Medal of Honor.

They’ve accumulated so many workouts that they have officially completed exercise.

They’re done.

Maybe we should do the same thing with dental hygiene.

After brushing your teeth 20,000 times, perhaps your dentist should present you with the Tooth-Brushing Medal of Distinction.

Congratulations.

Never brush again.

Or showers.

Surely after several thousand showers you’ve reached your lifetime cleanliness requirement.

The joke works because we immediately recognize the mistake.

Some problems get solved. Other systems have to be maintained.

You repair a flat tire and you’re finished repairing it.

You don’t finish nutrition.

You don’t finish exercise.

You don’t finish brushing your teeth.

And an athlete doesn’t eventually reach a point where the biological processes maintaining muscle, tendon, cartilage and other tissues simply stop requiring attention.

Pain Is a Powerful Motivator—and a Poor Maintenance Strategy

This brings us back to that bottle of Advil sitting beside the sink.

People can be remarkably adherent when something hurts.

That’s actually part of what led me to develop Tendon Medic.

Years ago, I was watching people with tendon pain repeatedly reach for Advil and other NSAIDs. I wanted to formulate another option for people trying to manage that kind of discomfort.

But there’s an important limitation to anything that makes pain more manageable.

If something makes your elbow feel better and you use that improvement as permission to continually reproduce whatever aggravated the elbow, you’ve misunderstood the intervention.

No supplement gets to repeal mechanics.

And NSAIDs aren’t biologically free simply because they're available over the counter.

One particularly interesting human study examined healthy young men after a 36-kilometer run. Tendon collagen synthesis increased following the run in the placebo group. In subjects receiving the NSAID indomethacin, that exercise-induced adaptive increase in tendon collagen synthesis was abolished.

That does not mean every NSAID at every dose shuts down collagen production. Different drugs, doses and experimental conditions matter.

It does illustrate something important, though.

Pain relief and tissue adaptation are not necessarily the same thing.

The thing that allows you to train through discomfort isn't automatically fixing the reason you're experiencing the discomfort.

Maybe Peterson Was Asking a Bigger Question

Which brings us back to the transplant recipient.

At first the behavior seems incomprehensible.

How could someone receive another person's kidney and then fail to consistently take the medication intended to help prevent rejection?

But perhaps that's exactly why the example matters.

Human behavior isn't governed exclusively by objective importance.

We forget.

We become tired of routines.

We dislike side effects.

We lose motivation.

The problem stops feeling immediate.

Sometimes we stop because we don't think something is working.

Sometimes, remarkably, we stop because it did work.

And sometimes we simply don't understand why we're doing what we're doing.

If all of that can happen when the consequence may involve losing a transplanted organ, it shouldn't surprise us that it happens with nutrition, exercise and supplements.

The answer isn't simply to tell people to try harder.

Design matters.

Education matters.

Motivation matters.

The delivery system matters.

The dose matters.

And the person taking it matters.

Perhaps the best supplement isn't the one with the most impressive label or the fewest capsules.

It's the one that delivers an appropriate amount of the right ingredients, in a form a person can realistically use, for a purpose they understand well enough to use it correctly.

Because ultimately, a formula that stays in the bottle isn't much of a formula at all.

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References & Further Reading

1. Peterson JB. 12 Rules for Life: An Antidote to Chaos. Random House; 2018. Rule 2: “Treat Yourself Like Someone You Are Responsible for Helping.”

2. Tamblyn R, Eguale T, Huang A, Winslade N, Doran P. “The Incidence and Determinants of Primary Nonadherence With Prescribed Medication in Primary Care: A Cohort Study.” Annals of Internal Medicine. 2014;160(7):441–450. DOI: 10.7326/M13-1705.

3. Butler JA, Roderick P, Mullee M, Mason JC, Peveler RC. “Frequency and Impact of Nonadherence to Immunosuppressants After Renal Transplantation: A Systematic Review.” Transplantation. 2004;77(5):769–776.

4. Horne R, Chapman SCE, Parham R, Freemantle N, Forbes A, Cooper V. “Understanding Patients’ Adherence-Related Beliefs About Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework.” PLOS ONE. 2013;8(12):e80633.

5. Schiele JT, Quinzler R, Klimm HD, Pruszydlo MG, Haefeli WE. “Difficulties Swallowing Solid Oral Dosage Forms in a General Practice Population: Prevalence, Causes, and Relationship to Dosage Forms.” European Journal of Clinical Pharmacology. 2013;69:937–948.

6. Schiele JT, Schneider H, Quinzler R, Reich G, Haefeli WE. “Two Techniques to Make Swallowing Pills Easier.” Annals of Family Medicine. 2014;12(6):550–552.

7. Christensen B, Dandanell S, Kjaer M, Langberg H. “Effect of Anti-Inflammatory Medication on the Running-Induced Rise in Patella Tendon Collagen Synthesis in Humans.” Journal of Applied Physiology. 2011;110(1):137–141.

8. Holwerda AM, van Loon LJC. “The Impact of Collagen Protein Ingestion on Musculoskeletal Connective Tissue Remodeling: A Narrative Review.” Nutrition Reviews. 2022;80(6):1497–1514.

9. Unilever. “Unilever to Acquire U.S. Greens Supplement Company Grüns.” April 9, 2026.

10. Shopify. “How Grüns Scaled From a Stanford Dorm Room to a $200M+ Nutrition Brand on Shopify.” Case study.