Medical Director, St. Vincent Healthcare Weight Management Clinic, Billings, MT
Professionals often have busy, hectic lives and their stress levels are typically quite high. Many want to slow down, have more personal time, have better relationships with their families, lose weight, stop smoking, drink less alcohol, start exercising, and on and on. The heavy commitment to work can wreck havoc on one’s health and well-being. Yet – what to do about it? How does one even begin? Changing behaviors and developing healthier habits do not happen overnight. Consistent and life-long changes can be difficult to make and do take time. Good intentions are not enough and pass by the wayside rather quickly. Actually, psychologists have identified six different stages involved in the change process. These stages do not always involve a linear progression as people pass through various stages many times during the journey of change. These behavior stages can be described as follows:
Contemplation is when you are aware of a behavior that would benefit by change and you are seriously thinking about making that change. However, you are not yet ready to take the steps to do so. Given the above example, you realize that your spouse is becoming more distant and that you have missed all of your children's games. You have developed heartburn and insomnia due to the stress. You know you should cut back on the hours but it really is part of the culture of the firm and besides "I like what I do and what I do is important."
Preparation is when you are ready to make a change and begin to do so in small steps. For example, you commit to being at home by 6 P.M. one night a week. You turn off your cell phone and spend time with the family. You are testing the waters so to speak and intend to take more serious action in the near future.
Action is when you now make the commitment to change and begin doing so. For example, you now are at home three nights a week and even agree to coach your son’s soccer team. You and your spouse commit to a date night each week. You find yourself relaxing and actually enjoying time with our spouse and your family. Your heartburn is improving and so is your sleep.
Maintenance is when you have incorporated the new behavior into your day to day life for the long-term. Thus, you have developed a new habit that helps you to meet your goal. For example, you are now working 55-60 hours a week. The boss is happy with your work. You actually find yourself using your time more efficiently and you have a happy family and an improved marriage!
Relapse is when you “fall of the wagon.” Those old patterns creep back. This can so readily occur. You become discouraged and your family is not too happy with you. This is where you do not want to give up. You make yourself get back on track even with one small baby step at a time and surround yourself with those that will be supportive of the change you are trying to make.
Ask yourself the following questions:
Do you desire to make a change?
Are you prepared to make a change?
What will motivate you to change?
What are your barriers to change?
What has worked for you in the past?
What is working for you right now?
What is not working for you right now?
How does making the change benefit you?
How does not changing benefit you?
Because I am a specialist in the field of obesity, I will share how the goal of weight loss might look during these stages. Let’s take a person and name him Nicholas. Nicholas is about 50 pounds overweight, and he has diabetes type 2, hypertension, and severe reflux disease. Nicholas really is not that concerned about his health and doesn’t mind his weight. He "gets around o.k. and is a very successful partner in a large law firm. His wife has been on his case to loose weight, go see the doctor, and start exercising. He is not interested and has no intention of changing. He continues to work long hours, skipping breakfast and surviving on many cups of coffee. Many of dinners are eaten at his desk and then he relaxes with a couple of martinis when he gets home at 10 p.m.
One evening, while at work, Nicholas experienced some chest pain. It wasn’t “too bad” and he brushed it off. About a week later, this chest pain came back and was unrelenting. He swallowed some TUMS and kept working. The pain though did not go away and by the next morning, he was pretty uncomfortable. So…his wife took him to the E.R. Fortunately, Nicholas did not have a cardiac emergency but his reflux had developed into an ulcer - thus, the source of his chest pain. The doctor had a long talk with Nicholas and suggested that he lose some weight and start eating in a healthier manner.
Well… Nicholas thought that was probably a good idea but didn’t know what to do about it. Besides, he rationalized that he was just too busy to eat breakfast in the morning and to take time out for exercise. He put the past behind him and went on with is busy work load and poor eating habits. By the end of the year, he had gained another ten pounds.
Soon, thereafter, Nicholas experienced the death of a very good friend due to a heart attack brought on by stress and obesity. This served as a wake up call for him. He realized that his lifestyle was not serving him or his family well. He was ready and motivated to change. However, it was overwhelming. What do you do when you have sixty pounds to lose and it is becoming harder to move around and you like to eat and drink?
Nicholas decided to work with his doctor in earnest. He took small steps to reach his overall goal of losing 25 pounds in one year. Now wait! 25 pounds you say? Nicholas needs to lose 60 pounds. Remember, the weight did not come on overnight and a slow and steady loss is the motto. Making change is hard and it is so easy to slip back into old habits.
Nicholas began by eating breakfast every morning. He began to appreciate that he had a bit more energy during the day. He cut back on the caffeine and found that his stomach pain receded; that was motivation to continue this routine. He then began to build on this. Instead of the drinks in the evening after he got home from work, he went for a two mile walk each evening. His wife began to join him and they both benefited by this couple time.
Over the course of a year, Nicholas had dropped 25 pounds by making these small and doable changes in his daily life. When he next saw his doctor, he found out that is blood sugars had improved and he was able to go off of his diabetes medications. Nicholas was thrilled and made the commitment to loose another 25 pounds within the next year or so.
During the next six months the holidays came and Nicholas had many social obligations. He stopped his evening walks and started to “eat on the run.” His alcohol consumption also increased. He then realized that he had gained back 10 of those lost pounds. He checked in with his doctor. The two of them developed a plan to help Nicholas get back on track. Another year went by and Nicholas lost those 10 regained pounds along with another 10 pounds. His total loss was 35 pounds! His blood pressure had normalized as had his diabetes. This was such positive feedback that he was motivated to continue and “not go back.”
Change is difficult but can occur when you want it to happen. Many people will rotate though these various stages of change before the new habits become permanently established. Remember, changing behaviors is a process and a journey. The changes need to benefit you and you need to be invested in the work/life balance process. Be patient with yourself. Congratulate yourself on the small changes you make and have belief in yourself that you can make a positive healthy lifestyle change. Do not let bumps in the road derail you. Keep moving forward knowing that even small changes can lead to big results.
Dr. Baskett can be contacted at: firstname.lastname@example.org