Healthy Habits Suck
Page 13
I’ve spent most of the book trying to help you live a healthier life. But here’s the thing: it doesn’t really matter to me if this book made you healthier. What matters to me is that being healthier has helped you live a more meaningful, purposeful, vibrant life. My question is not do you want to live longer, it’s what are you going to do with your extra years of life? From my perspective, any effort put toward being healthier is meant to be in service of your values, of living a life that matters to you.
When we hit holiday time at the obesity clinic, clients would say that they were just going to skip holiday parties that year in order to manage their weight. Sure, that’s definitely a strategy to employ, but at what cost? You might end up reducing or holding your weight if you skip all social functions, but your quality of life suffers. There are many costs to choosing healthy habits, and you may decide that some are not consistent with your values. For example, when it’s up to me to choose my meals, I tend to make plant-based meals. But if I get invited to someone’s house for dinner, I don’t tell them I need a vegan meal, and I don’t bring a vegan meal with me. That’s because this meal with a friend isn’t just about food. It’s about the host offering something they’ve made; it’s about their efforts to plan and create a meal and to welcome and host me. So I choose not to disrupt those aspects by insisting on following my plant-based diet at all cost.
Best weight (Freedhoff and Sharma 2010) is a weight-management idea based on the smallest number of calories one can consume daily that still allows the person to enjoy each day. Best weight is the weight you can achieve while living the healthiest lifestyle you can truly enjoy. I think this strategy can be expanded to include all healthy habits. You don’t have to pick the healthiest option every time (and beat yourself up if you don’t). It’s okay to choose something just a little bit healthier than what you were choosing before, and to balance healthy habits with living a life that matters.
You may be thinking that I’m suggesting that quality of life and quantity of life are opposites, and if you choose one you can’t choose the other. Often our mind seems to only give us two options to choose from, either quality of life or healthy habits. This line of reasoning is similar to that passenger who tricks you into believing your values are in conflict. But there’s the third option: healthy habits do contribute to quality of life.
I went to a conference where Dr. Kenneth Rockwood, an expert on aging and frailty, discussed the impact of healthy habits on life span (Rockwood 2017). He showed a picture of a ninety-year-old man running a marathon and said this man had died shortly after the picture was taken. He explained that healthy living doesn’t just extend your number of years on Earth, it also extends the number of quality years you have on Earth. He pointed out that a rapid decline at the end of one’s life is actually the ideal scenario. This marathon runner had spent most of his life being able to do the things that mattered to him. He had a rapid decline near the end and spent only a few days in the hospital before passing away. Thus, he only spent a small part of his life having a low quality of life—and this was the effect of his healthy habits.
A New Stick to Beat You With?
I had a client who told me she was really put together. She had a good job that she was good at, and she had good friends and a great family. What she couldn’t figure out was why she couldn’t manage her eating and her weight. She burst into tears as she wondered out loud, “Why can’t I get control over this? I should be able to control my eating! I should be able to manage this!” This is a familiar tale.
Many people who are incredibly successful in most aspects of their life struggle to “control” their healthy habits, and there are many reasons why this is so common. First, smoking, drinking, and sleeping instead of going to the gym are all preferences of your cave person brain. Remember the cave person who chose to rest rather than go for a run, and thus he had the energy to outrun a predator? His choices were beneficial as a cave person but aren’t necessarily the healthy ones in our modern world. When it comes to eating and weight, there are layers of systems in the brain and body that ensure we don’t starve to death (chapter 1), and these systems are difficult to “control.” The moment you stop engaging your frontal lobe, your cave person brain will take over, and you’ll do things consistent with avoiding starving to death (for example, eating when you’re not hungry; eating until the plate is empty; choosing foods high in sugar, salt, and fat). Remember that almost any healthy habit is going to violate the principles of your caveperson brain—that is, your hardwiring!
Second, our environment, especially in developed Western nations, is full of triggers for unhealthy habits—especially those related to food. Driving down the street you’re bombarded with fast-food restaurants and billboards showing foods of every stripe. Practically every commercial on TV sends you signals to eat. Office, school, and social functions are full of the unhealthiest food. Your kids’ sporting events include deep-fried options, rarely vegetables. This extends to most other healthy habits. We have all kinds of machines that reduce our physical activity: cars, washing machines, grocery stores. Most of us have jobs that are sedentary. Alcohol and cigarettes have been adapted by industries to make us like them more. Although you may be very capable of controlling yourself in many areas of life, it shouldn’t surprise you that sticking to any healthy habit is much more difficult.
Third, many “successful” people have used problem-focused coping (chapter 7) to great results in life, rarely needing to use emotion-focused coping. The long-term management of health, however, requires emotion-focused coping, because many aspects of health don’t have a “fix.” For example, quitting smoking requires us to manage cravings on an ongoing basis (no fix). Exercise is only effective when we do it regularly, so we have to keep exercising for it to impact our health (once again, no fix). So if you’ve been successful as a result of using problem-focused coping most of your life, it makes sense that you’d lack the emotion-focused coping strategies needed to manage long-term health. You haven’t needed them to be successful.
And, fourth, there are all the factors we went over in chapter 2 that you have little control over and yet influence your struggle with weight or sticking to healthy habits. How many of them seemed relevant to your struggles? Did you choose your parents or your ancestors? Did you choose your genetics or to be born in a Western culture inundated with unhealthy triggers, including those related to food? Did you choose to have a cave person brain focused on survival? No! Of course you didn’t, but they affect you nonetheless.
Reviewing this information with clients is meant to induce self-compassion, showing them some of the roadblocks to healthy living. I’ve noticed that some of my clients’ passengers hijack this info and use it against them instead. The same “put-together” client who cried about not being able to control her eating was one of these. Knowing about the evolutionary and cultural reasons why she struggled to control her eating made her feel worse. Why? Because now she really knew better, and she’d been taught all sorts of skills from an expert (me, apparently), and she still couldn’t eat healthy all the time. Basically her self-critical passenger found a new stick to beat her with.
This book is not meant to be a new stick to beat yourself with. Just because you’ve read it and (hopefully) gained a new perspective and learned some new skills doesn’t mean that you now are going to be able to “control” your healthy habits permanently. This will always require effort. I have no expectation that going forward you’ll always choose the healthy option. In fact, I’m giving you permission to choose an unhealthy option—just do so because it’s a deliberate choice and not because your passengers have hijacked your bus. It all comes down to personal choice and what quality of life you’re comfortable with. I find the “description, prediction, choice” model (Vallis 2015) useful for creating context for some of life’s choices:
Description: You have diabetes, but you like to eat sweets and tend to avoid testing y
our blood sugar.
Prediction: There will be negative long-term consequences for your health if you don’t manage your blood sugar.
Choice: Are you okay with that?
It’s okay to say, “Yes, right now I’m going to pick the short-term benefit.” Remember, the content of this entire book is in the service of you leading a vibrant, meaningful life, not just to make you skinnier, or have lower cholesterol, or eat healthier, or stop smoking.
Keeping It Going
This book has been about sticking to healthy habits in the long term. By now your choice point worksheet should include a lot of information that you can use to help you stick with your healthy habit, including the values you identified, your SMART goal to help you express your values, the different passengers (for example, thoughts, feelings, sensations, memories, cravings, and tricks) that might get in your way, as well as a range of skills, including mindfulness, present-moment awareness, self-compassion, taking care of feelings, and so forth.
Let’s review the worksheet using my illustrative example of “exercise more.” I’ve now clarified my values about this goal (to be strong) and turned it into a SMART goal (exercise two times per week for twenty minutes). I’ve pinpointed the most common passengers that get in my way, including thoughts like I don’t have time for that or feeling tired. I’ve recognized that my self-critical passenger is likely to criticize me (“It’s never going to work”) and make me feel even less motivated to go the gym. I’ve also documented some of the skills that work best for me to keep me moving toward what matters. Thanking passengers, compassionate hands, putting down the football, and present-moment awareness are the ones that I use most often to help me stick with my healthy habit. So now when a passenger—for example, “I don’t have time for that”—shows up, I can notice it and make a choice about whether to move toward or away from what matters to me. Rather than acting automatically and doing what my passengers are telling me to, I have created a moment of choice. Do I want to follow my “I don’t have time for that” passenger (which will move me away from my values), or do I want to try to move toward my values? This is my choice point. I use various skills (for example, thanking the passengers) to try to move myself just a bit more toward sticking to my healthy habit.
Hopefully by making use of the choice point worksheet and all the skills from this book you can give yourself more choice points—that is, more moments when you can consciously decide to stick to your healthy habit. Healthy living requires effort and a willingness to do the hard work of managing behaviors, even when you don’t want to.
Conclusion
A year has passed since I started writing this book. I still haven’t lost all my “divorce weight.” Yes, I’m sure you were hoping that at the end I would finally give you the magic secret to losing weight, or to quitting smoking, or to exercising more. Sorry! Am I healthier? Hell, yeah. I now work out regularly five to six times a week. It took me three years to get into the habit of going to boot camp three times a week. Now when I don’t go I feel a bit odd. Even still, when the alarm goes off at 5:30 a.m., I still think I don’t want to go to boot camp. I wish I could stay in bed. And while I’m at boot camp I curse my trainers most of the time. (Love you, Mitch and Matt! See https://evolvefitnessltd.fitproconnect.com/transformationcanada.) I remind myself often that it’s my job to do my health behaviors; what my body does with them isn’t up to me. There are still many parts of my body that make me cringe. But I really love what my body can do. It will dance when I want to dance. It will climb when I want to climb. And it will run when I want to run. So I’m grateful to my body for the things I can do, for the ways in which my body and my health help me live the life that really matters to me.
So as you embark on this lifelong journey, I don’t wish for you to be happy or to have high self-esteem. As we’ve already discussed, happiness and self-esteem are unhelpful life goals. I do hope you have opportunities for joy. I hope you are as healthy as you can be. I hope your health helps you live a vibrant, purposeful, and meaningful life that really matters to you. I hope you are kind to yourself for all the ways you will fall off the wagon. (Congrats, you’re human!) I hope when you get to the end of your life you look back and think, Damn, I lived a good life. So thank you for spending time with me and this book. I thank you and all your passengers for being with me. May you be well.
Acknowledgments
Thank you to my family and friends for supporting me, including my parents, my sister, and “the girls.” To my son for making me want to be a better person every day. To all my mentors and teachers for helping me grow. To the ACBS community for being the most welcoming and supportive professional community I’ve ever known; you’ve helped me succeed in ways I never even dreamed possible.
References
Abramson, L. Y., M. E. Seligman, and J. D. Teasdale. 1978. “Learned Helplessness in Humans: Critique and Reformulation.” Journal of Abnormal Psychology 87 (1): 49–74.
American Heart Association. 2014. Heart Disease and Stroke Statistics—At-a-Glance. December 17. https://www.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_470704.pdf.
Bartle, N. C. 2012. “Is Social Clustering of Obesity Due to Social Contagion or Genetic Transmission?” American Journal of Public Health 102 (1): 7.
Bowen, S., N. Chawla, and G. A. Marlatt. 2011. Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician’s Guide. New York: Guilford Press.
Bowlby, J. 1969. Attachment and Loss. Vol. 1: Attachment. New York: Basic Books.
Bowlby, J. 1973. Attachment and Loss. Vol. 2: Separation, Anxiety, and Anger. New York: Basic Books.
Cappuccio, F. P., F. M. Taggart, N. B. Kandala, A. Currie, E. Peile, S. Stranges, and M. A. Miller. 2008. “Meta-Analysis of Short Sleep Duration and Obesity in Children and Adults.” Sleep 31 (5): 619–626.
Carmichael, C. L., H. T. Reis, and P. R. Duberstein. 2015. “In Your 20s It’s Quantity, In Your 30s It’s Quality: The Prognostic Value of Social Activity Across 30 Years of Adulthood.” Psychology and Aging 30 (1): 95–105.
Carver, C. S., M. F. Scheier, and J. K. Weintraub. 1989. “Assessing Coping Strategies: A Theoretically Based Approach.” Journal of Personality and Social Psychology 56 (2): 267–283.
Centers for Disease Control and Prevention. 2018. “Adult Obesity Facts.” Last updated August 13. https://www.cdc.gov/obesity/data/adult.html.
Chaput, J. P., Z. M. Ferraro, D. Prud’homme, and A. M. Sharma. 2014. “Widespread Misconceptions About Obesity.” Canadian Family Physician 60 (11): 973–975.
Christakis, N. A., and J. H. Fowler. 2007. “The Spread of Obesity in a Large Social Network over 32 Years.” New England Journal Of Medicine 357 (4): 370–379.
Ciarrochi, J., A. Bailey, and R. Harris. 2013. The Weight Escape: How to Stop Dieting and Start Living. Boston: Shambhala.
Clear, J. 2014. “How Long Does It Actually Take to Form a New Habit? (Backed by Science). Huffington Post. April 10. https://www.huffingtonpost.com/james-clear/forming-new-habits_b_5104807.html.
Coan, J. A., H. S. Schaefer, and R. J. Davidson. 2006. “Lending a Hand: Social Regulation of the Neural Response to Threat.” Psychological Science 17 (12): 1032–1039.
Coughlin, J. W., P. J. Brantley, C. M. Champagne, W. M. Vollmer, V. J. Stevens, K. Funk, A. T. Dalcin, G. J. Jerome, V. H. Myers, C. Tyson, B. C. Batch, J. Charleston, C. M. Loria, A. Bauck, J. F. Hollis, L. P. Svetkey, and L. J. Appel; Weight Loss Maintenance Collaborative Research Group. 2016. “The Impact of Continued Intervention on Weight: Five-Year Results from the Weight Loss Maintenance Trial.” Obesity 24 (5): 1046–1053.
Cozolino, L. J. 2010. The Neuroscience of Psychotherapy: Healing the Social Brain. 2nd ed. New York: W. W. Norton.
Dahl, J. and T. Lundgren. 2006. Living Beyond Your Pain: Using Acceptance and Commitment Therapy to Ease Chronic Pain. Oakland, CA: New Harbinger.
Day, A
., and D. Lee-Baggley. 2017. ACTion: Awareness and Commitment Training in Organizations and Networks. Participant Manual. Halifax, NS: Day and Lee-Baggley.
Depue, R. A., and J. V. Morrone-Strupinsky. 2005. “A Neurobehavioral Model of Affiliative Bonding: Implications for Conceptualizing a Human Trait of Affiliation.” Behavioral and Brain Sciences 28 (3): 313–395.
Dulloo, A. G., J. Jacquet, and L. Girardier. 1996. “Autoregulation of Body Composition During Weight Recovery in Human: The Minnesota Experiment Revisited.” International Journal of Obesity 20 (5): 393–405.
Eisenberger, N. I., M. D. Lieberman, and K. D. Williams. 2003. “Does Rejection Hurt? An fMRI Study of Social Exclusion.” Science 302 (5643): 290–292.
Flaxman, P. E., F. W. Bond, and F. Livhelm. 2013. The Mindful and Effective Employee: An Acceptance and Commitment Therapy Training Manual for Improving Well-Being and Performance. Oakland, CA: New Harbinger.
Fothergill, E., J. Guo, L. Howard, J. C. Kerns, N. D. Knuth, R. Brychta, K. Y. Chen, M. C. Skarulis, M. Walter, P. J. Walter, and K. D. Hall. 2016. “Persistent Metabolic Adaptation 6 Years After ‘The Biggest Loser’ Competition.” Obesity (Silver Spring) 24 (8): 1612–1619.
Freedhoff, Y., and A. M. Sharma. 2010. Best Weight: A Practical Guide to Office-Based Obesity Management. Edmonton, AB: Canadian Obesity Network.
Gangwisch, J. E., D. Malaspina, B. Boden-Albala, and S. B. Heymsfield. 2005. “Inadequate Sleep as a Risk Factor for Obesity: Analyses of the NHANES I.” Sleep 28 (10): 1289–1296.