Could you do that? Not likely. Okay, one more experiment: stand up.
Which one of these experiments was the easiest to do? Most people will say the final one. Compared to thoughts and feelings, we have far more control over our behavior. What do I mean by “behavior”? Behavior is something someone else can see you do, like standing up. If there was a reality TV show all about you, behavior is what we’d see you do on the screen. Behavior is not how you feel about your action, or whether you wanted to or felt motivated to do it, it’s the action itself. The fact that we have control over behavior is great news! You can control health behavior—including going to the gym, walking, drinking water, consuming more fruits and vegetables, and integrating them into your life will make you healthier (and perhaps have the side effect of causing you to lose weight). In the next chapter we’ll go over several exercises to help clarify health behaviors.
Health Behaviors Are the Goal
Changing your goal from the weight itself to health behaviors you engage in serves several purposes. First, you’ve created a goal you can actually control. If you work harder at trying to eat green veggies, you will likely eat more green veggies, whereas working harder to lose weight can sometimes have the opposite effect. Fixating on weight can lead to stress, which releases the stress hormone cortisol, and cortisol can interfere with weight loss (Jackson, Kirschbaum, and Steptoe 2017). From an evolutionary point of view, it makes sense that cortisol might prevent weight loss. Our mind interprets high levels of cortisol as being indicative of some type of danger. In cave person times, this might have been something like living through a long winter or a war. Cave people’s bodies responded by conserving energy and storing fat so they’d have the resources to make it through the stressful event. Nowadays, though, stress isn’t always linked to a need to put on weight. So the stress (and resulting cortisol) associated with the pressure one might feel to lose weight can actually prevent weight loss.
Here’s a striking example. You might think that I lost weight when I trained for a half marathon. This was my assumption too. After all, I was running close to thirty kilometers a week. But I was gaining weight, not losing it. My trainer was not surprised. He said that running for more than an hour at a time decreases your metabolism and therefore can lead to weight gain. This makes sense from an evolutionary perspective. My body thought I must be under stress or facing a threat because I was spending a lot of energy running around! So, my body worked to conserve energy so I could keep running.
Second, focusing on behavior instead of weight creates a goal that is healthy. Focusing on health behaviors means you will end up healthier, regardless of whether you lose weight or not. This is important, because there is strong evidence that weight alone is not a good indicator of overall health. For example, consider body mass index (BMI), a method used by health care providers to qualify weight based on height and weight—in other words, it’s another way of measuring weight. Health care providers often use this method to categorize an individual as “underweight,” “normal,” “overweight,” or “obese,” but BMI doesn’t distinguish between a six-foot-two person who’s 260 pounds of fat or 260 pounds of pure muscle. These two people both have a BMI of 33.4 and fall into the “obese” category. In fact, the BMI system categorizes many elite athletes as obese even though by all other methods they are considered extremely healthy. Some research suggests that if you don’t have health complications, then you shouldn’t be diagnosed as overweight or obese at all, regardless of what your BMI indicates. This research suggests that “obesity” is only a condition when excess adipose (that is, fat tissue) causes health complications (Sharma 2017). If you don’t have complications, then you should just be described as having excess adipose but not as obese. (Personally, I like saying “extra fleshiness.”)
Additionally, research has shown that a single session of exercise can result in “healthier” fat cells (Van Pelt, Guth, and Horowitz 2017). Specifically, after exercise the fat cells had a greater ability for blood flow and to reduce inflammation, both of which are related to better overall health regardless of weight. Thus, even if you don’t lose weight, you can be healthier at the weight you’re at by focusing on health behaviors.
Third, changing your goal provides a reason to engage in health behaviors over the long term, and long-term behavior change is really the key to good health. Another study of The Biggest Loser contestants showed that those who continued to exercise after their time on the program were the ones most likely to keep the weight off (Kerns et al. 2017). This is a consistent finding in the literature: continuing to engage in health behaviors is associated with weight maintenance (McGuire et al. 1999). For example, the National Weight Control Registry (http://www.nwcr.ws) is a research study currently tracking more than ten thousand people who have successfully lost weight (at least thirty pounds) and kept it off for at least one year. Studies using this database have repeatedly shown that participants who continue to engage in weight-related health behaviors, such as exercising, following a low-calorie diet, or watching less TV, successfully maintain weight loss in the long run.
Values
So if keeping up weight-related health behaviors is the key, how do we do it? By linking health behaviors with values. Managing your weight in the long run is going to suck. All weight-related health behaviors violate our basic principles of human functioning. So why on earth would you do them? Because engaging in your health behaviors may help you be the person you want to be.
Here’s an example of what I mean. While discussing health behaviors with a woman living with obesity, she said she wanted to start eating more green vegetables. I asked her what eating more green vegetables meant for her. She replied, “It means I’m on a diet and I’m being punished because I’ve messed up again and gained weight.” Well, if eating green vegetables represented “punishment” to her, no wonder she was struggling to eat more of them. Then we talked about why she wanted to lose weight in the first place. She offered the usual round of answers: to be healthier, to be more active, to live longer. But I kept digging deeper: What was she going to do with her improved health, extra energy, and extra years of life? Eventually she got around to the fact that she wanted to be healthier so she could continue to live independently. She didn’t want to have to go to a home or be cared for by others. “I’m very stubborn” she reported. “I like to do things on my own.”
“So it sounds like being stubborn and being independent are really important to you,” I suggested. She agreed. “So, eating green vegetables is actually your way of being defiant. It’s your way of telling the world to f*ck off because you’re not going to a home. It’s your way of being stubborn and independent.”
Her eyes opened wide as she stared at me. “I never thought about it like that.” And all of a sudden she was excited to go home and eat her green vegetables so she could tell the world to f*ck off.
If you flipped to this chapter hoping that I’d give you the magic key to weight loss, go back to chapter 1 and learn about the real secret weapon in life: living a values-based life.
Choice Point
In this chapter I discussed how we don’t control our weight. This also applies to a number of other health outcomes, such as blood pressure, blood sugar, and cholesterol, and many of the goals we set for ourselves, such as “sleep more” or “be healthy.” Our aim is to set a goal for ourselves that is achievable, a health behavior we can actually do, rather than something we don’t control. For the choice point worksheet this week, consider whether your healthy habit is something under your control. Is your healthy habit an outcome or a behavior? Do you need to rethink your healthy habit? (See chapter 3 for more details on making your healthy habit a behavior.) My example of “exercise more” is a behavior and not an outcome. If I had instead listed “feel more energetic” or “be less tired” or “lose five pounds” as my healthy habit, then I would want to think about how I could recast them as health behaviors,
because these are examples that are much less under my control.
Part 2:
How to Be Healthy…Even if You Don’t Want To
Chapter 3:
Passengers on the Bus
In this chapter you’re going to meet the passengers on your “bus” (adapted from Hayes, Strosahl, and Wilson 1999) and learn about the things that get in the way of health behaviors. Imagine you’re a bus driver, and your passengers represent your thoughts and feelings and sensations. Some of the passengers are friendly and nice, but some are bossy and annoying. These passengers often like to tell us what to do. For example, imagine you’re about to give a presentation at work. Your anxious passenger might say, “Oh no, what if you forget all your words? Maybe you shouldn’t give the talk at all. You’re just going to embarrass yourself.” Or imagine you’re about to get on a flight to go on vacation and you hear the announcement that the flight has been canceled and the next flight is two days from now. Your angry passenger might comment, “This is ridiculous! How can they do this? You better go give that airline employee a piece of your mind.”
Sometimes it might feel like these passengers are driving the bus and taking us places we didn’t mean to go. For example, every time I think I should go to the gym, there’s a passenger on my bus who says, “You don’t have time for that.” Or if I think I should pack my lunch instead of going out to eat, this passenger says, “You don’t have time for that.” And sometimes I end up doing what the passenger says, telling myself, Yeah, I have so much to do. I don’t have time to go to the gym! When this happens, the passenger is driving the bus, and I don’t end up engaging in my health behaviors.
This is what passengers do; they take over the bus and knock us off our route when we’re trying to engage in healthy habits. If we want to be a good bus driver and stick to our healthy habits “route,” we need two main skills: to know the route we want to follow, and to be able to deal with passengers in a way that allows us to stick to our route. The good news is you’ve already done some work on determining your route. Your values are your route. In chapter 1 you clarified your values, or the direction you want to head in order to make a meaningful, vibrant, and healthy life for yourself and be the kind of person you want to be. But as you have probably experienced, knowing your values isn’t enough to keep you on your route. Passengers are going to get in the way. So if you’ve ever had a thought or a feeling or a craving that stopped you from engaging in a healthy habit, this chapter is about learning skills to deal with your passengers so you can stick with healthy habits.
How Passengers Knock Us off Our Route
This is one of my favorite exercises (adapted from P. Flaxman, personal communication, February 23, 2016) for learning more about our passengers and how they knock us off our route. Stop for a moment and think about the healthy habit you’ve been working on with this book. When you think about having to accomplish this task and keep it up, what automatic reactions show up? What do the passengers have to say about the likelihood of you accomplishing this goal? Just pause and notice what thoughts and feelings show up. You can download the “How Passengers Knock Us off Our Route” worksheet at this book’s website, http://www.newharbinger.com/43317, which will walk you through this exercise step-by-step.
Did any of your thoughts fall into any of the following categories?
Obstacles
Our passengers point out all the obstacles and difficulties that lie in our path.
Example: I won’t have enough time.
Judgments
Our passengers tell us all the ways we’re not up to the task.
Example: I won’t do it right.
Comparisons
Our passengers compare us unfavorably to others who seem to do it better, have more talent, or have it easier.
Example: My sister can always do this. It’s not hard for her.
Predictions
Our passengers predict failure, rejection, or other unpleasant outcomes.
Example: You know you’re never going to keep this up, so why bother?
Did most of your thoughts fall into these categories? Congrats! You’re a well-functioning human.
Remember our ancient cave person brain? Well, one very effective way to avoid pain and to take the path of least resistance is to avoid doing anything new. Cave person brains work on the principle that “The devil you do know is better than the devil you don’t.” That is, whatever your current circumstances, even if they suck, they’re not killing you and are therefore safer than whatever unknown situation you might find yourself in if you tried something new. Your brain knows you can survive your current situation, but it doesn’t know if you’ll be able to survive some new situation. So the brain evolved to try to stop us from doing anything new, to make us cautious. Your brain isn’t out to get you. It’s genuinely (probably desperately) trying to keep you safe. It just doesn’t know that this new or different thing you’re trying to do isn’t life-threatening in the modern world. So if you noticed your passengers giving you good reasons not to try something new, congrats! That’s a sign of a well-functioning brain, but one that can also knock you off your route.
What to Do with Passengers…
Given that passengers can knock us off our route, how do we deal with interfering passengers on the bus? Perhaps you’d like to kick some of them off! Wouldn’t that make sense? That’s the most common response I get when I ask this question. “Wouldn’t I be a lot healthier if I never had the thought I don’t have time for that?” Of course! But have you ever found a way to permanently not feel angry or anxious? Have you found a way to not have certain thoughts? What I’m asking is, Have you ever been able to kick passengers off your bus permanently?
The answer is no, because the passengers on your bus, whether they’re pain, anger, sadness, or any other kind of thought, are part of the human experience. Do you know anyone who doesn’t experience pain or anger or sadness? (Remember, there’s a difference between experiencing emotions and expressing emotions; I’m referring to experiencing emotions here.) If so, that’s not normal. Emotions are part of the human condition, and we can’t get rid of them. We can’t kick them off the bus. Sometimes you can take a detour to temporarily avoid passengers. For example, when I go to the land of wine and chocolate, I don’t hear my passengers yelling at me quite as much, but this reprieve doesn’t last long, and while on the detour I wasn’t heading where I wanted to go. What else might you try, or have you tried? Let’s look at a few possibilities.
Ignoring the passengers… If kicking passengers off the bus won’t work, maybe we can ignore them. That’s a reasonable idea. But what do you think would happen if, in the real world, a passenger told the bus driver she wanted to get off at the next stop, and the bus driver completely ignored her? The passenger would likely get louder and more boisterous, maybe run to the front of the bus and yell, “I’ve got to get off the bus!”
Here’s an exercise to get at what I’m talking about. Set a timer for thirty seconds. Then, for the next thirty seconds, please do not—I repeat, do not—think about pink elephants. Ready? Go.
(If you’re like me, you probably skipped this exercise. I rarely actually do the exercises in self-help books. So if you decided to skip the exercise, I totally get it, but I invite you to reconsider. When I encounter an opportunity to try something new, one of my passengers says to me, “Oh, I know what that’s about. I don’t need to do it.” Does this happen to you? But consider that it’s impossible to learn a new skill without actually doing it. Right now is an opportunity to actually try something new. So I again invite you to try this brief exercise and perhaps notice what the passengers are telling you that might stop you from doing the exercise—that is, to try to knock you off your route.)
Okay, whether you did the exercise or not, perhaps you noticed that some of your passengers were trying to convince you to not do the exercise. Good job! Even if you didn�
��t do the exercise but noticed your passengers, you’re still actually doing something new!
If you did do the exercise, what did you notice? Most people report that they either thought about pink elephants or had to work really hard not to think about them. And just out of curiosity, have pink elephants been a big topic of conversation for you lately? Have you been texting a lot about pink elephants or chatting with coworkers about them? Is #pinkelephants trending on Twitter? Probably not. But having asked you not to think about pink elephants, you’ll probably be thinking about them a lot more!
Why? Because of what’s called the thought suppression effect (Wegner et al. 1987), which is a rebound effect. When you try to suppress or not think about a thought, you end up thinking about it more. The thought suppression effect makes it impossible to ignore your passengers. The more you try to ignore them while driving the bus, the louder and more insistent they’ll get.
Negotiating with passengers… Maybe we can negotiate with passengers. Have you ever had a debate in your head like this with a passenger: “Oh, look, your favorite: cake! You should have some.” No, I can’t. I’m trying to eat healthy. “Yeah, but just this once. You can be healthy again tomorrow.” But I’m on a diet. “Sure, but a little treat isn’t going to hurt.” I don’t know about you, but I never seem to win these arguments. Not only do my passengers seem to be much better debaters than me, but they are offering much better options. I’m offering broccoli and they’re offering cake; I’m offering going to the gym and they’re offering lying on the couch. Basically the passengers offer behaviors consistent with our cave person principles, and I’m offering something that violates those principles. And while I’m debating them, all my attention is focused on them instead of sticking to my route.
Healthy Habits Suck Page 4