One of the courses I teach at USC Aiken is Health & Behavior Change. In it, we identify the major factors that contribute to chronic diseases and discuss how to modify these risk factors to improve health. Throughout the course, the emphasis is on health behaviors and how to change them for the better.
For example, smoking is among the most difficult health-related behaviors to change. Obviously, there is the addictive nature of nicotine that makes smoking cessation challenging. Beyond the drug effect, smoking also has a behavioral component. This includes what a smoker does first thing in the morning, after a meal, or on a work break as well as the act of holding a cigarette in his or her hand. Add to that the social aspects of smoking, including the influence of friends and family members, and it is easy to understand why it is a difficult habit to break.
This same principle applies to other health behaviors, including eating and activity. Like smoking, what we eat and our activity level are complex behaviors that are difficult to change. Because of this, losing weight can be as difficult as quitting smoking for similar biological and behavioral reasons. We think of weight loss as being about a diet or exercise program, but it’s really about changing behaviors and habits.
This is a difficult concept to teach, so I have my students learn through experience. Since almost all of my students are non-smokers and most are active and at a healthy body weight, I have them complete a project in which they change some other behavior. They are responsible for identifying a behavior that has a negative effect on their life, coming up with a plan to change it, and embarking on a four-week behavior change experience. Common topics for my students include getting more sleep, packing a lunch to avoid eating out, and dedicating more time to studying.
One student wanted to change her social media habits. As a compulsive social media user, she spent more hours than she realized checking, posting, and commenting on Facebook, Twitter, Instagram, and others. Her goal was to limit her social media time so that it didn’t interfere with classes or studying. One of the steps she took was to turn off the notifications that alerted her to new activity. This was helpful, but she still found the habit of checking her phone hard to break.
In a conversation, she noted that the one thing that would help more than anything else would be to switch her phone off during the day. This way she would have her phone if she needed it, but it wouldn’t be so easy, or tempting, to use it. Despite knowing the most effective strategy—the one thing—that would help her, she never did it.
I thought this was an excellent example of something that is common in making health behavior changes. In many cases, people probably know the one thing they need to do to be successful but for a host of reasons, they don’t do it. This may lead people to make other changes that aren’t nearly as helpful. While even the smallest behavior modifications can help, successfully losing weight or quitting smoking really does require making big changes.
This goes a long way in explaining why quitting smoking, losing weight, and changing eating and activity behaviors can be so difficult, even when people know what they need to do. There is no easy solution for this problem, but finding someone to hold you accountable for making the necessary changes and sticking to them is a good start.
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