Get out of debt—health debt—in 2019.

Getting out of debt is a worthwhile goal and a common New Year’s resolution. This almost always means financial debt, which is a burden for millions of Americans. Many individuals and families have gotten themselves into debt by spending too much and not saving enough. For most, this situation has been years in the making, has no simple solution, and will have an impact lasting years into the future. Reducing this debt is essential for achieving financial health.

This is not the only type of debt we face—many people are also in health debt. Poor eating habits and increasingly sedentary lifestyles have led to an obesity epidemic. The problem is widespread, since most Americans are overweight, fewer than half of US adults meet minimum recommendations for physical activity, and about one in six adults smoke. Alone and especially in combination, these poor health habits are the major causes of the most common, and preventable, diseases including diabetes, heart disease, and some cancers.

Even if we have not been diagnosed with diabetes or heart disease or other health problems, our lifestyle has put us on that path. Small changes in what we eat or how active we are have added up over the years to create a condition of poor health. And our overall health and potential complications get worse year after year, so the longer we are overweight and inactive, the worse our health is likely to be in the future. That is our health debt. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Putting it in these terms, the pathway out of our health debt is clear—spend more energy by being more active and cutting back on the calories we eat. Like the financial crisis, even though the solution is easy to identify, putting it into place requires making some difficult choices.

The first step to making successful health behavior changes is to identify what needs fixing.

Have you become less active? Are you eating more? Do you smoke? Be specific. An honest assessment of your health and lifestyle is key to your success. Look at this as the equivalent of adding up everything you owe in order to start repaying a financial debt.

Next, be realistic about what you are willing to change. The majority of chronic health conditions can be prevented and treated by making dietary changes, becoming more active, and quitting smoking. Some things aren’t negotiable—you must quit smoking if you are serious about improving your health. But you can make some choices about others. Are you willing to join a gym and start an exercise program or would making time for a 30 minute walk each day work better for you? If you won’t consider skipping your favorite coffee drink every morning, what will you give up instead? It’s okay to have a few things you don’t want to change, but you have to be willing to make changes elsewhere.

While this can be difficult, keep in mind that even small changes in activity and diet can lead to weight loss and improved health over time. Make it a priority to be active every day and try to spend less time sitting. Pass on second servings at meals and skip desert once in a while. And if you smoke, quit—no excuses.

Remember, this health debt didn’t develop overnight. It was the result of small changes, some of which we may not have noticed, adding up over time. Fixing it will take time, too. But the time to start is now, before the health debt gets any bigger.