Creating Healthy Habits: The Key to Lasting Health
When it comes to health, especially the psychology of sustained positive health behaviours, nothing is easy despite what the fitness fads will tell you. Behavioural change may come easier to some, but generally speaking, the longer we stick to a task and rehearse it, the more likely we are to adapt and change our behaviour accordingly. This is the basic premise of neuroplasticity, practice makes perfect, new neural pathways become increasingly dominant over old ones and a new behaviour is achieved and sustained over time. However, it is the time between learning and practising new behaviours that is fraught with setbacks and possible relapse to dominant old behaviours. Practice is in this case becomes extremely challenging, especially if it involves addictive behaviours such as comfort eating/smoking/drinking/drug taking. But it is precisely this “challenge” element that makes new behaviours stick. Without overcoming challenges that really throw us out of our comfort zones, even to the point of agony and pain (perhaps even near death), can lasting positive health behaviours flourish !
Confronting personal demons that tempt and tempt is only one part of the battle. It is how to exorcize them that matters; stopping comfort eating, reducing sugar intake, cutting back on weekday alcohol intake. Worse still, according to most research on addictive and negative health behaviours, 5 years is what it takes to terminate them. So even when we feel great for losing weight after putting in a huge effort over a few months, there is plenty of time to relapse. For this reason, 5 years is likely the minimum time to which you can truly say “I’ll never go back to that again” according to Stages of Change Theory which forms part of the Transtheoretical Model in Health Psychology .
If we take obesity as the main example of negative health behaviour, what most people find hard to stick to is diet. Physical training is infinitely easier. I see this every day in my line of work and bizarrely, the most obese relapsing clients I’ve had will always turn up and train consistently. However, it is the other 23 hours outside of our sessions, away from the gym and my watchful eye that galvanise the most crucial aspect to our individualised health plan. You can train as hard as you like, but if you go home most nights and munch down on fish and chips washed down with a G&T and some nibbles, no plan will work, full stop. It is here where the battle is won or lost. Fortunately for me, my success rate is high but there are inevitably some people I haven’t been able to help, usually once the realisation of how hard this journey can be sets in. When the wheels for an individual like this do come off, denial initially happens, then excuses and eventually blame. There is no desire to admit failure or overcome adversity, and worse still, the relapse from such half-hearted attempts ends in (for yoyo diets especially) “rebounding”. If we take dieting as the example, research shows that most yoyo dieters will put on even more weight than when they initially started because of something known as the “what the hell effect”. This means with every repeated and failed attempt of dieting an individual will overcompensate on the negative health behaviour (overeating/drinking) for comfort/self-loathing. They effectively overdose to a greater degree and the weight piles back on to a higher level than before they started .
Queue, “Self-Efficacy”. This is the validated, much praised and definitively researched Psychological construct that forms part of Social Cognitive Theory (SCT) and determines “how people feel, think, motivate themselves and behave” [4, 5]. Self-Efficacy itself is “the ability to which an individual can motivate themselves marked characteristically by increased confidence in perceived ability.” .Therefore, the more agency (personal control) we have over our decisions, especially those that bring setbacks which are overcome, the likelier we are to stick to and maintain the desired outcome of behavioural change. We feel empowered when we have conquered difficulty, and this increases our confidence moving forward to the point we feel we can accomplish almost anything. If we also add the encouragement and support from groups, individuals or peers (collective and proximal agency), we are doubly empowered! This creates a lasting process that will eventually lead to the maintenance of new health behaviours and hopefully termination of old ones. Of course, there may be times where we fall back to minor relapse, for example going away on holiday and letting go, but we always come back to the maintenance stage of exercising and balanced nutrition .
So, before you attempt another crack at the whip for training or diet, remember that first off you need to be realistic and second of all, have the support and encouragement of significant others around you. Lastly, it is to have the belief that what you are doing is good and is performed for the right reasons (see my blog on intrinsic versus extrinsic motivation), this is crucial! Once these are in place, you are in a good head space to begin. Just make sure that if you have a PT, they are at minimum qualified enough to understand these intricacies and second of all, provide an individually catered service and plan as you can clearly see it is certainly not a “one size fits all” approach. There will be individual differences to everyone and so the training and psychology behind it must reflect that. Once this is underway, make sure you don’t celebrate too much at every stage of weight loss, as the research shows, these changes take time, roughly 5 years to terminate chronic negative health behaviours [7, 8]. If you get to the end of this tunnel and are one of my clients, I promise to provide you with half price training for the rest of time! How’s that for proximal agency and a good challenge?
- Garcia-Garcia, I., et al., Functional connectivity in obesity during reward processing. Neuroimage, 2013. 66: p. 232-9.
- Schwarzer, R., Social-Cognitive Factors in Changing Health-Related Behaviors. Current Directions in Psychological Science, 2001. 10(2): p. 47-51.
- Ogden, J., Do no harm: Balancing the costs and benefits of patient outcomes in health psychology research and practice. Journal Of Health Psychology, 2016: p. 1359105316648760-1359105316648760.
- Bandura, A., Self-efficacy mechanism in human agency. American Psychologist, 1982. 37(2): p. 122-147.
- Bandura, A., Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 1977. 84(2): p. 191-215.
- Bandura, A., Social cognitive theory: an agentic perspective. Annual Review Of Psychology, 2001. 52: p. 1-26.
- Maddux, J.E., Self-efficacy, adaptation, and adjustment: Theory, research, and application. 2013: Springer Science & Business Media.
- Ogden, J., S. Avenell, and G. Ellis, Negotiating control: Patients’ experiences of unsuccessful weight-loss surgery. Psychology & Health, 2011. 26(7): p. 949-964.