How to Change Our Wicked Ways!

Have you ever wanted to make a change in your diet or exercise program, but after a few short days, found yourself flustered with your efforts or quitting altogether?  You are not alone!  Many of us attempt to change behaviors such as our diet or exercise program, but struggle to make the changes real.

I worked as a Registered Dietitian in an inpatient hospital setting for many years.  As a young and eager dietitian, I was often frustrated and disheartened when my patients did not share my enthusiasm after their "diet instruction" and did not drastically change their behavior that had contributed to their medical condition.  After all, it was for their own good.  As my experience in clinical nutrition and wellness evolved, I was reminded of a behavior model that I learned in college and is certainly worth sharing.

The way we habitually behave is considered to be our lifestyle.  Some of our habits tend to be very positive, while others can definitely use some improvement.  Many times, we are able to easily identify a behavior that needs to be changed.  For example, "I need to exercise" or "I want to eat healthier to improve my cholesterol".  Everyone has probably had the thought cross their mind at one point or another that they would like to change a behavior to improve some aspect of their lifestyle.  So why is not just enough to want to make the change and just simply do it?   Because according to Prochaska's Transtheoretical Model of Change , we must go through certain steps to modify problem behaviors such as not exercising, overeating, smoking, or even problem drinking.  It is important to recognize that each step must be resolved before going to the next step or the change will be ineffective.  Some of the steps can take weeks, even months to accomplish.

The Stages of Change:

The following are the steps of change in the order they must be processed.  In addition, statements or examples of behaviors are included that demonstrate each step (for the changed behavior of beginning an exercise program is demonstrated in this example).

1.  Precontemplation:  This is the stage where the individual is not considering a change.  For example, "I don't exercise and have no intention of starting".

2.  Contemplation:  This the stage where the individual is considering a change.  This usually is sparked by reading something, hearing a speaker, being motivated by a negative outcome, or even a doctor's visit.  Pros and cons of the "changed behavior" must be weighed.  In every changed behavior, there will be something given up and something gained.  It must be decided by the individual that the gained behavior is more attractive than what is being sacrificed.  For example, "I know that I should exercise to lose weight and improve my cholesterol levels, but if I do begin an exercise program, I will have less time to watch television".

3.  Preparation:  In this stage, the individual is getting ready to make the changed behavior.  Let's say that we are getting prepared to start an exercise program, several decisions have to be made before starting the change.  For example, "Which exercise program?   Have I signed up for the program?  Do I have proper clothing and shoes?  Do I need to adjust my schedule to get up earlier or to participate after work?".  All of these questions must be answered to successfully move to the next stage.

4.  Action:  This is the stage where the "changed behavior" is actually occurring.  I think that it is notable that action doesn't occur until the fourth step!  Think about how many times that we have been frustrated with ourselves and others for not immediately going from "nothing" (precontemplation) to "everything" (action).  In this stage, the example would be, "I am at the gym (on time) in the boot camp class (dressed appropriately) doing the class".

5.  Maintenance:  This is the stage of behavior where the action becomes part of our normal or typical behavior. "I exercise everyday and I enjoy it.  I feel better, I have lost weight, and my cholesterol has improved".  We have to go through action in order to get to maintenance. 

6.  Relapse:  Although relapse was not an "original stage" in Procahska's model, I think that it is important to acknowledge that returning to our "wicked ways" or slipping back into a negative behavior sometimes does occur.  Sometimes relapse happens because of triggers such as an emotional responses, temporary time constraints, or travel, to name a few.  For example, "I did not exercise today because I had to be at work early and I could not go to my exercise class".  This does not mean that the exercise is over forever.  Relapse does not have to equate to failure.  In fact, it can be an opportunity to anticipate and resolve barriers to success.  In this example, the exercise time could be changed to the evening, and even alternatives to the exercise class could be found.  Again, this is a great opportunity to learn from a failure and determine feasible alternatives when obstacles occur.  When relapse occurs, it is important to move back to "action" as soon as possible.

Changes in our behavior leads to improvements in health, quality of life, and often even the quantity of life.  I encourage you to think of an area of your life that might benefit from change and work earnestly to accomplish them. 

For more information on Nutrition Counseling and how to incrementally change your eating habits,, please contact Leslie Goudarzi, MS, RD, LD at 903-239-1551.