A basic outline for prevention has existed for more than thirty years, but wellness has had a hard time making real headway. Old habits are hard to break. Our society has a magic bullet fixation, waiting for the next miracle drug to cure us of every ill. Doctors receive no economic benefit from pushing prevention over drugs and surgery. For all these reasons, compliance with prevention falls far below what is needed for maximum wellness.
Rather than feeling gloomy, my focus has been on getting the individual to take charge of their own wellness. This can be a considerable challenge, since we are each unique in our bodies but also unique in our pattern of bad habits and poor lifestyle choices. More than 40 percent of American adults make a resolution to live a better life each year, and fewer than half keep their promise to themselves for longer than six months. Conditioning is hard to break, but the key is that the power to break a habit belongs to the same person who made it—the turnaround amounts to giving up unconscious behavior and adopting conscious new patterns.
Once your mind begins to pay attention, your brain can build new neural pathways to reinforce what you learn. Much is made of the brain’s ability to change and adapt—the general term is neuroplasticity—but I think science has been slow to catch up with wise experience. It has always been true that applying awareness in any form, through such things as resolve, discipline, good intentions, and mindfulness, has the power to create change. The practical dilemma is how to use your strengths and motivation to help yourself remain committed to wellness as a lifetime pattern.
Step 1: Set Goals by Baselining Your Health
The first step in taking control of your well-being is to set goals, and a sensible way to do this is to “baseline” your health. Gather some basic facts that realistically inform you about your body: weight, height, family history, exercise habits, general diet, and a self-assessment of your stress levels at work and in your home life.
Some experts would add medical measures that only a doctor can fully determine, such as blood pressure, cholesterol and other lipids levels, and bone density. My difficulty with these tests is that they encourage worry. Being in an anxious state is a bad motivator for most people. It can motivate you for as long as you remember to be afraid, but after that, people tend to give in to impulses, make erratic choices, and increase their own stress levels. With that in mind, I go against the grain of standard medical advice, at least partially, by saying that heeding these medical markers should come second, after you have already set yourself on a good wellness program for at least six months. Give consciousness a chance before you undermine it with potential anxiety.
How do you actually set your goals? Start thinking about the big picture. Changing poor lifestyle habits is rarely easy, especially if they comfort you, as smoking or overeating do for many people. You need a strong vision of what you want to achieve in order to succeed. I’d say the strongest vision comes from knowing about a simple trend: the latest research shows that more and more disorders, including most cancers, are preventable through a good wellness program. The benefits are increasing with every new study.
Step 2: Set Priorities
Making lists of your hot spots and your sweet spots will help you to set your personal priorities. The hot spots are weaknesses, the sweet spots strengths that crop up during an ordinary day. You can’t attack every bad pattern all at once; it’s good to achieve a series of small victories at first.
Hot spots: List the times you feel unhappy or most agitated—fighting a futile battle to get a good night's sleep, perhaps, or recriminating yourself for ordering dessert when you were already full. Identify with clear sights your biggest challenges, such as getting to bed on time, reducing food portions, resisting sweets, choosing the couch over the treadmill, and so on. Doing this will help your mission take shape and direction.
Sweet spots: List the things that give you joy and satisfaction, for instance, spending time with your family or enjoying a favorite hobby. Recapture in your mind what it feels like to resist ordering dessert or to spend half an hour walking outdoors. Appreciating the sweet spots in your life is a source of strength as you embark on your habit-changing mission.
Step 3: Identify Harmful Patterns
To change your negative habits, you have to know what they are. Some bad habits, like smoking and excessive drinking, are obvious, but others may be less so. Sitting all day is damaging to your health, even if you get half an hour of exercise or more before or after work. Depriving yourself of eight hours’ sleep for even a short period is also hard on the body in ways that sleep researchers are just beginning to fully recognize.
Forming a new habit takes repetition and focus, and if your attention is elsewhere you may have a harder time adjusting to new behaviors. For that reason, some experts advise against planning big changes if you are going through a particularly stressful period. I think that reasoning is wrong. Although it’s true that you are likely to have more setbacks at such times, it’s just as true that people change as a result of meeting challenges and crises: “Aha” moments occur quite often when somebody hits bottom.
Visualizing your desired outcome is a useful tool in your journey. “Seeing” yourself as you wish to be has helped smokers quit, obese people lose weight, and sports champions achieve their goals. In order to change the printout of the body, you must learn to rewrite the software of the mind. This truism is reinforced by brain scans that show a decrease in certain higher functions (making good decisions, following reason over impulse, resisting temptation) when a person falls into a pattern of giving in to a wide range of lower impulses, such as fear, anger, or simply physical hunger. You need to implement a healing regimen that encourages and rewards your good choices if you want brain pathways to follow suit.
Step 4: Make Steady Changes
Even though you are working on the big picture, for psychological reasons a series of small victories is desirable. In essence, you are training your brain to succeed. Most of us, having been defeated by old conditioning, take the course of least resistance, not realizing that we are training our brains into pathways that rob us of free will over time.
So begin with a victory you can define and which means something to you. Skip red meat for a week. Take the stairs, not the elevator. If you’re very out of shape, walk 10 minutes every day and gradually build up your time. Put down your fork halfway through your meal, take a few deep breaths, and ask yourself if you’re still hungry. If you work at a desk, make it a rule to always stand or pace when you’re on the phone. Over time, what seem like baby steps produce new physiological changes in every cell of the body. Trillions of cells are eavesdropping on your every thought and action. Instead of pretending that your body doesn’t know what you’re doing, make yourself the gift of delivering good news to your cells.
In my view, the most important victories occur in awareness, however. If you tend to procrastinate, be aware of the reasons you do it. We get comfortable in our warm, fuzzy old routines, and making changes, even small ones, feels threatening psychologically, as if even a positive change is a risk. Predict when you will procrastinate and invent a strategy to outmaneuver your future self. For example, if you know you’ll be tempted to hit the snooze button instead of getting up for an early morning jog, put your exercise clothes across the room from your bed—with your alarm clock on top.
Step 5: Reinforce Good Decisions
Sometimes brain research underlines the obvious, but it is a breakthrough to observe MRI scans and see for yourself that good decisions “light up the brain in ways that are different from bad decisions. In the larger scheme, when you undertake a wellness program, you will be faced every day with the choice to stay the course or abandon your mission. How does your brain make choices, then?
Executive control, which means choosing a thought or action to meet an internal goal, is managed by the brain’s prefrontal cortex. The orbitofrontal cortex and amygdala play roles in regulating decision-making based on the memory of feelings. Regions of the midbrain in which the neurotransmitter dopamine is predominant also influence decision-making. Some of the choices that trigger dopamine's release: eating sweet foods, taking drugs, having sex.
We may overindulge in chocolate cake because we tend to value the short-term outcome we know (deliciousness) over the long-term outcome we have never experienced (weight loss and increased energy from better nutrition). One way to break that cycle is to reward ourselves in a different way. Instead of eating cake, we can go play a game or listen to music.
How long does it take to form a new habit? An average of 66 days, according to a 2009 study from University College, London. Repetition and giving yourself time to adjust are the main factors in forming a new behavior pattern.