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I think people generally make the decision for one of two reasons: either approach or avoidance. They either want to move towards something--looking good in their bathing suit, looking good for a reunion, improving their quality of life, looking better to the opposite sex, or they want to move away from something--looking out of shape, being in poor health, not having as many dates as they would like, and so forth.
Probably a combination of the two is best for long term fitness motivation, you have to both be disgusted with your current state, and also want an improved one.
I find that the best kind of workout is when you don't even know your working out. For instance i love to mountain bike (when the trails aren't covered by 2 feet of snow) and find that this activity is both invigorating and a good workout. Another plus to this is that I can go with my friends. If you are considering getting off the couch, I would highly suggest that you try to do it with someone who has similar goals, training partners are a huge difference maker.
I think at least a good portion of my fitness regimen is for vanity's sake, and don't see too much wrong with it. I also want to be able to be healthy into my older years and not have to use a walker the day I retire.
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"Religion is the one area of our discourse in which it is considered noble to pretend to be certain about things no human being could possibly be certain about"
--Sam Harris
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