March 07, 2024
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The benefits of behavior change are getting increased attention as chronic illnesses like obesity and type 2 diabetes increase among Americans. But building healthy habits, including eating healthy and exercising, are hard. But it's not impossible.
Good habits are at the core of healthy lifestyles. Finding the motivation to act and then moving from unhealthy practices to more positive routines focused on diet and exercise is a common pathway.
The process of altering daily rituals to achieve better health and well-being is most often expressed as behavior change, a theory that is getting increased attention with the accelerated growth of behavior-influenced diseases like type 2 diabetes, obesity – which has reached epidemic levels – and heart disease, which has been the leading cause of death of Americans for a century.
American culture and economics make unhealthy behavior unconsciously easy and cheap while healthy habits require attention and discipline. Ultra-processed snacks and fast food exemplify this point, playing on the attraction of immediate satisfaction. Healthy practices require more thought and planning, and most importantly, consideration of the long-term benefits.
The state of disease in the nation demonstrates the difficulty of thinking about the future when temptation is at our fingertips. Even the emergence of new weight-loss drugs does not appear to eliminate the need to consider healthy behaviors to keep the weight off. Fortunately, there is a concerted effort underway among scientists to help people adopt and maintain healthy habits. The effort can serve as a model for anyone seeking to live healthy.
As anyone who has made a New Year's resolution knows, changing behaviors is hard stuff. Experts agree.
In a 2020 paper, psychologists Angela Duckworth, of the University of Pennsylvania, and James Gross, of Stanford University, succinctly acknowledge that "behavior change can be astonishingly difficult." While citing the benefits of a good diet and exercise, they note that almost half of premature deaths in the U.S. can be linked to a failure to practice a healthy lifestyle.
Megan Call, a psychologist at the University of Utah highlights the complexity of behavior change and the disruption experienced when moving from familiar routines to new actions. Further straining the ability to maintain new habits is the time it takes to fully assimilate them into one's lifestyle. "Something as simple as drinking an extra cup of water a day can take an average of two months to be a consistent, habitual behavior," Call says.
The Mayo Clinic offers a number of common reasons why people give up on behavior change. The health system suggests people often overestimate the difficulty of exercise and give up too soon. Psychological messaging that stresses the convenience, economy and flavor of fast foods creates a toxic eating environment. And taking on too many changes at a time can result in an "all or nothing" approach that is doomed to fail.
Recognizing that behavior change is "fundamental to modern human health," the National Institutes of Health created the Science of Behavior Change program in 2009 to provide national leadership and coordination, and advance research by examining processes that drive behavior change. The program is currently focusing on an experimental approach. Its platform is designed to accelerate research, because, as stated by Duckworth, researchers have not "coalesced into a unified understanding of the basic mechanisms of behavior change."
Donald Edmondson, of Columbia University's Irving Medical Center, explains that SOBC is working to uncover why certain behaviors may help people start and maintain behavior change. One study at Columbia examined why people tend to value immediate, small rewards over larger rewards in the future, what is known as delay discounting. By employing an intervention called Episodic Future Thinking, researchers hope to find a way to overcome this tendency.
Weight-loss drugs like Ozempic and Wegovy are a hot commodity. They represent the answer to the decades-old struggle to lose weight, and early indications are that they are effective. The ability to curb one's appetite and drop pounds quickly has attracted much attention, boosted by the number of celebrities that have revealed that they use the drugs.
However, initial studies out of Vanderbilt University indicate that most patients using weight-loss drugs stop within a year due to their cost, side effects or other factors. When they do, the weight is very likely to come back, according to experts from the University of Copenhagen.
One of their researchers, who was part of a study that examined people who stopped taking weight loss medication, says "people who stop taking the drugs have difficulties maintaining the beneficial effects. Within a year, they will typically have gained more than two-thirds of the lost weight. However, our study shows that people who exercise during treatment do not have the same propensity to put on weight post treatment."
So, if you were counting on these new medications, you might want to consider coupling it with an exercise program. Either way, these findings show that healthy behaviors and associated behavior changes remain at the center of long-term health.
What does this all mean for people looking to live healthy and adopt better habits? In short, you do not have to be a scientist to practice the science of behavior change. Take the lead from the experts and think of your life as a laboratory of behavior change where you'll try different experiments in diet and exercise and see what works.
Use the laboratory analogy to reinforce the point that trial and error is part of the process. If you find that an early-morning trip to the gym doesn't work for you, try alternative times. If you're struggling with the logistics of a healthy diet, maybe team up with your spouse or others to access healthy meals on a regular basis. And, if you need a source of motivation, make a conscious effort to spend more time with your children or grandchildren to reinforce the long-term benefits of a healthy lifestyle.
Whatever your pathway, put on your virtual white coat and dig deep into the motivation, medicine and social elements that can help you start and maintain a healthy lifestyle. It's a journey, but one with major benefits when you reach your destination.
Louis Bezich, senior vice president and chief administrative officer at Cooper University Health Care, is author of "Crack The Code: 10 Proven Secrets that Motivate Healthy Behavior and Inspire Fulfillment in Men Over 50." Read more from Louis on his website.
