Why it’s hard to change unhealthy behavior — and why you should keep trying
Many of us think about changes we’d like to make in our lives. When it comes to health recommendations, we mostly know the drill: Exercise most days of the week; eat a varied and nutritious diet; keep your body mass index between 18.5 and 24.9; get enough sleep; keep up with medical screenings for blood pressure, cholesterol, and blood sugar; get mammograms and Pap smears at recommended intervals; don’t smoke; and limit alcohol to seven drinks a week. Reducing stress, improving relationships, and developing new interests or hobbies also contribute to healthy living.
Making healthy lifestyle changes affects not only our risk for disease and the way we feel today but also our health and ability to function independently in later life (see “Lifestyle factors reduce the need for nursing home care”). What we do for ourselves is often more important than what medicine can offer us. Yet making healthy changes is easier said than done. Even when we’re strongly motivated, adopting a new, healthy habit — or breaking an old, bad one — can be terribly difficult.
Considerable research has been aimed at identifying factors that contribute to successful lifestyle change as well as more effective tools for clinicians — especially in the context of a brief office visit — to counsel their patients on adopting healthier habits. One problem may be that we’re motivated too often by a sense of guilt, fear, or regret. Experts who study behavior change agree that long-lasting change is most likely when it’s self-motivated and rooted in positive thinking. In October 2006, the Economic and Social Research Council, a British research group, released findings on 129 different studies of behavior change strategies. The survey confirmed that the least effective strategies were those that aroused fear or regret in the person attempting to make a change.
Studies have also shown that goals are easier to reach if they’re specific (“I’ll walk 20 minutes a day,” rather than “I’ll get more exercise”) and not too numerous (having too many goals limits the amount of attention and willpower you can devote to reaching any single goal). Another recurring theme is that it’s not enough to have a goal: You also need practical ways to reach it. For example, if your goal is to stick to a low-calorie diet, have a plan in place for quelling hunger pangs (for example, keep a bottle of water or cup of tea nearby, or chew sugarless gum).
Research has also produced models that help account for success and failure, and explain why making healthy changes can take so long. The expert conclusion is that any effort you make in the right direction is worthwhile, even if you encounter setbacks or find yourself backsliding from time to time.