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As a practicing physician, I often joke with my patients that I am really a glorified cheerleader. After all, they come to me for advice on how to make their health improve. Of course I give them what the latest guidelines say about what their goals should be for their weight, exercise, cholesterol, blood pressure, etc.
What the guidelines don’t do, ever, is to give doctors or patients the tools that you need to make the right changes, and to make them stick.
So today I thought I would share with you some tips I give patients, and have personally used, to make changes in behavior that will help to improve our lives. This article is adapted from a talk I gave in January of 2020 on the same topic.
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PLAN
Anytime you read an article about changing your habits, you are going to see that planning will hold a prominent spot in the discussion.
If you are going to exercise, you can’t just say, “ok, I am going to exercise.” You need to get granular about it.
-When will you exercise? What day? What time? How long?
-Where will you exercise and what type of exercise will you do?
You need to give this the same priority that you would give to a meeting that you would have with your boss. If your boss said “I need to meet you three days a week for 30 minutes” would you say no? That's doubtful. So put this on your calendar and treat it like an appointment.
START SLOW AND BUILD EVEN MORE SLOWLY
Changing behaviors is a marathon and not a sprint. One of the worst things that you can do is to try to tackle too many things at the same time. So maybe you want to start exercising, quit smoking and stop eating fast food. My advice is to pick one of those things, devise a plan, and work on it.
If we use the example of exercise, try exercising for 15 or 20 minutes three days a week. Once you've done that for a week or two they maybe increase it by five minutes every week or so until you build up your total time exercising to reach your goal. And oh by the way, don't be married to the calendar, your body doesn't know what day of the week is, it only knows that you're exercising or you're not!
If you've had some success with the exercise, move onto the next item on your list that you're willing to tackle. Instead of going cold turkey with the smoking maybe the plan is to decrease your cigarette consumption by half a pack every week or two.
WHEN YOU MEET AN OBSTACLE, “WOOP” IT UP
Mike Tyson famously said, “everybody has a plan until they get punched in the face.” I never thought I'd be quoting Mike Tyson when it came to changing habits, but his quote is very apropos. So what will you do when you meet an obstacle, because you surely will.
Well, you need to "WOOP it up"!
Dr. Gabrielle Oettingen has a program where she and her associates studied people who have plans for how to deal with obstacles and came up with the following construct. WOOP stands for -
Wish - What do I want? Eg. to lose 20 pounds
Outcome- by doing that I know I will be more active and feel better about myself
Obstacle-I travel a lot. How will I handle eating on the road?
Plan- She uses an “if …then” or “when….then” scenario. “If I travel, then I will pack healthy snacks to take.” “When I eat out with clients, then I will avoid eating bread or desert.”
And yes, there is an app for this if you like!
SHOUT IT OUT
I had a bucket list wish to run a marathon. I've been running for a long time but I had never done one. So when I began my training, I told everyone about it, and I mean everyone.
Why did I do that? Because the science shows that the more people you tell about what you're trying to achieve the more likely you are to not give up and to finish what you started. So I told my friends, my family and my coworkers. They were probably sick of hearing it from me.
But when I got to mile 19 and hit the proverbial “wall” where my body was physically shutting down, I remember telling myself, “you told everyone you were going to do this, so you've got to finish.” Mentally I broke the rest of the race down into 1 mile runs from rest station to rest station until I finished. It was the hardest thing I ever did mentally or physically in my life. But this little tip about shouting it out actually helped me get to the finish line.
BUDDY UP
If you're trying to achieve something it's often easier when you have someone else trying to do the same thing and you pair up. They are going to be days where you don't want to go to the gym but if you know that your partner is waiting for you you are less likely to not show up. And don't worry, they'll be times when your partner doesn't want to go either, but they'll go because they know that you're there waiting for them.
I'm lucky because my wife is also very health conscious and exercises daily. So we do it together and I get what I call the "drag effect”. I don't like to exercise but I know that I must for my own health as well as to be a role model for the patients that I see. So by getting dragged along to exercise I get it done and of course I don't want to let my wife down about it either!
TRIGGERS
James Clear, the author of “Atomic Habits” and other books, talks about triggers and how they affect our behaviors and how to modify them. Let me give you an example about myself.
About two years ago I started taking cholesterol medicine. That's the only medicine I take, thankfully. But it was a new habit for me. In the first month that I was prescribed the medication I honestly think I took it less than seven times.
Why?
Because I kept the medicine bottle in the cabinet where I could not see it. So I realized that I needed to have a visual trigger to remind me to take it.
My solution? I took the bottle out of the closet and put it by my chair where I have coffee in the morning. This way I was sure to see it and it would remind me to take it. If that doesn't work for you maybe you can go ahead and put a reminder on your cell phone, or put the medication by your toothbrush. Hopefully you brush your teeth at least once a day!
FRICTION
Friction means making things more difficult for you to have access to them. James Clear refers to this as “priming the environment”.
Let me give you an example. Let's say that you know that double stuffed Oreo cookies are your downfall, your kryptonite. Then don't buy them and bring them home. If they are not in your pantry you are unlikely to get up from your chair, get in the car, go to the supermarket, buy them, come home and eat them. It's just way too much trouble. That's friction.
And if you're willing to do all that for Oreo cookies, you have much bigger problems and need to speak to your doctor!
The opposite is also true. If you're trying to incorporate a healthy habit, you want to reduce friction.
So maybe getting in your car and driving to the gym that's 15 miles away just takes too much time. So ask yourself, "Do I really have to go to a gym to exercise?” Maybe getting some exercise equipment for the house and doing some free videos that you can find online would be the solution. That's a lot easier than getting in the car and driving that far.
By removing obstacles, thereby removing friction, you are more likely to be successful.
STACKING HABITS
This tip, also from James Clear, is one of my favorites. You're going to combine something that you like to do with something that you want to accomplish but you are having trouble getting some momentum.
So maybe you want to start a walking program and you're not really very enthusiastic about. But you do like to learn by listening to podcasts. So, you guessed it, every time you go for a walk put on your headphones and listen to a podcast or audiobook or music or whatever you like. In this way you're making the new behavior be associated with something that you like and therefore or more likely to be successful at it.
REWARDS
I mentioned above that this is a marathon and not a sprint. So plan for short term as well as long-term rewards for yourself.
Maybe if you reach your goal of losing 50 pounds, there's that cruise waiting for you that you wanted to take for years. But also plan for small rewards along the way. Maybe if you reach the eight week mark for exercising, you get yourself a new pair of running shoes. Maybe if you lose 10% of your weight loss goal, you get yourself some new clothes.
I think you get the idea. We respond to rewards. But we need them to be spaced out and not lumped up at the end of our journey.
If you are interested in more details about changing behavior, I recommend the aforementioned “Atomic Habits” by James Clear as well as “Good Habits, Bad Habits: The Science of Making Habits That Stick” by Wendy Wood. If you would like to hear an interview with her, I recommend the podcast episode from Hidden Brain, and here is a link
Hidden Brain Creatures of Habit
I hope you found this information helpful. If so, please subscribe or share it with a friend. And good luck on getting your healthy habits started.
Disclaimer- the words and opinions expressed are the author’s, and his alone, and are not those of his employer.