By Elaine Porterfield
You can change behaviors that are bad for your health. Research is showing us what works.
Don't be stuck with behaviors that are bad for your health. Research is showing us how to make positive changes that last.
It's no accident that gyms hum with extra activity in January, and magazines are crowded with headlines about how to lose holiday pounds. But by the end of the month, most of us who have acted on our New Year's resolutions are back to our old habits.
We could all learn from Dave Ekorenrud, whose successful path to weight loss is paved with behavior changes that last, and methods that are backed by research.
Ekorenrud's story began in 2009 when a minor injury brought him to the Group Health Medical Centers clinic in Factoria. When he got on the scale there, he learned he had packed 290 pounds onto his 6-foot 1-inch frame. "I knew I was heavy but I'd pretty much been ignoring it," he says. His blood pressure was also seriously elevated. A nurse at the clinic asked him if he was interested in joining a weight management program that helps people change their behaviors to lose weight. Ekorenrud, then 57, agreed. "I never really had tried to lose before," he says. "I decided it was time to do something."
By the fall of 2010, he'd lost more than 40 pounds, his blood pressure was under control, the nagging pains in his feet and legs were gone, and he had more energy. "My ultimate goal is to lose 100 pounds, to get down to my high school weight of around 180, 190 pounds," he says.
Uncovering what makes people like Ekorenrud change unhealthy behavior is what scientists at the Group Health Research Institute and elsewhere have been studying. What they've found has led to programs that are helping Group Health members make lasting changes that improve their health.
What We've Learned From Research
Psychologist and research investigator Ben Balderson, PhD, says that warnings — like those on cigarette packages — don't change behavior. "There's a myth that fear inspires change. Research has found that positive feedback works better than fear."
Research has also shown that another myth — you can't teach old dogs new tricks — is not true. "Our brains are not static like we once thought," says Balderson. We can learn to change even entrenched behaviors. That includes things like switching from a poor diet to a healthy one to combat diabetes, or quitting smoking.
An analysis by the U.S. Preventive Services Task Force of 1,174 studies on the effectiveness of behavioral counseling sheds light on what techniques work. The analysis found that programs that combine education with counseling or group sessions and additional support through the phone or the Internet, yield better outcomes than programs that don't have these.
Those three things are just what Ekorenrud's weight loss program offers. And they're also the basis of the Free & Clear® Quit for Life™ tobacco treatment program.
Karla Darrell successfully ended a decade-long smoking habit with the Quit for Life program. She learned to avoid bars where she used to smoke (when it was still allowed), to select a non-smoking buddy she could hang out with or talk to when she was overwhelmed with an urge to light up, and to stock plenty of supplies she needed to quit — such as nicotine patches. In previous attempts to quit, Darrell says she'd invariably run out of her patch supply, and would start smoking again before she could buy more.
Darrell also learned to call for additional help when she needed it. The latter was via a phone-based Quit Coach® that's part of the Quit for Life Program. "The coach would talk about what my triggers were, how I was feeling, and what I could change to make my cravings go away," recounts Darrell, who's been smoke-free for two years now.
Research has also shown that it's important to tailor behavior change programs to the individual. For instance, before he began trying to lose weight, Ekorenrud used to frequent the drive-through windows of fast food places, and then eat in his car. And he often skipped breakfast, which caused him to overeat later in the day. His weight loss program took those unique habits into account. He also learned new behaviors: how to control portion size, add more vegetables into his diet, and build regular exercise into his day. All of these things were reinforced via the program's education, coaching, and group sessions. Together, they supported his desire to overhaul his habits and helped him achieve real behavior change. A vacation recently tested his resolve. "We just returned from a cruise where I did not gain any weight and now am back to my weight loss program in earnest," Ekorenrud says.
Group Health employee Leslie Donat, 44, found similar resolve in her quest for weight loss. Through Weight Watchers — another program that uses education, support, and offers an online component — she's lost 86 pounds. Donat says the program nudged her to eat appropriately sized portions of food. "I learned that half of a frozen pizza is not one serving," she says. She also learned how to work exercise into her life, and to understand what triggered her to overeat.
The support of weekly meetings and online chat groups helps her stick to behavior changes. Now, before she puts food into her mouth, Donat asks herself: "Do I really want it and will it taste good? Is it really worth it to have that food?" Overall, her outlook has changed. "For me, being healthy is now more important than having a piece of cake every time I see it."
Seven Steps to Behavior Change
Dr. Balderson offers these tips:
- Before setting goals, develop a strategy. Look at obstacles that hinder you, and how they can be overcome. If you want to exercise four days week, but child care is a barrier, figure out who will watch the kids.
- Set short-term and long-term goals. Long-term goals will motivate you, but short-term goals will get you there. A long-term goal might be reducing your intake of processed sugar to a specific gram level per day; your short-term goal could be to drink water instead of soda.
- Set specific, measurable goals. Research says this will yield better results, and you'll be more likely to stick with your program. For example, a goal of walking 30 minutes on Monday, Wednesday, and Saturday is much better than a vague "I will do more cardio."
- Make goals process oriented, not outcome oriented. Setting a goal of doing cardio five times a week (process) often works better than a goal of losing 5 pounds (outcome).
- Build in fun. If you want to exercise more, plan an activity that you enjoy.
- Set realistic goals. Research shows that moderately difficult goals — those that are challenging but within your capabilities — work best.
- Readjust. If you get sidetracked or need to change goals, cross out the old one and put in the new one.