Health and Fitness: Keeping New Year’s resolutions beyond February
February 2, 2009
As a physician, I always enjoy the tradition of New Year’s resolutions. A significant number of these relate directly to physical and mental health issues I address in my practice.
Health related resolutions are really no different than any other habit people hope to establish or change. There is great research showing that we all progress through similar stages during this effort. I’ll take smoking cessation as an obviously important example but the process applies to exercise, diet, or even social goals like recycling or reconnecting with family members.
Stage 1: Pre-Contemplation. This is the stage when you know something is a good idea but have no personal investment in change. A smoker in pre-contemplation hears all about it from their friends but “This is just who I am” they’ll say. As a doctor all I do is make a comment and hope it later influences movement toward the next stage. A favorite is: “Every Cigarette is associated with immediate vasospasm and risk for heart attack while the nicotine is in you system.” End of Lecture.
Stage 2: Contemplation. People with a New Year’s resolutions are at least in this stage. They are aware of the benefits of change but find it hard to get started. This is where detailed education can be effective. Activities such as listing everything good and bad associated with smoking can help people uncover their motivations and move to the next stage.
Stage 3: Preparation for Action. For smoker’s this stage often takes the form of setting a quit date and telling friends about the plan. Positive peer pressure is an extremely effective tool.
Stage 4: Action. The pay-off. Research shows it takes a minimum of six to eight weeks to create a habit, so two to three months is a fantastic intermediate goal on the road to permanent change.
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Stage 5: Relapse. Unfortunately, this stage gets little attention. Nearly everyone relapses, no matter what they are working on. In relapse we can return to any previous stage. The tragedy is feeling so defeated that we regress to pre-contemplation. My advice is forgive yourself and start again. Acknowledge the relapse as part of the process. Most smokers attempt to quit as many as six to eleven times before they are successful.
I hope this description of the process provides a perspective that helps motivate and sustain change.
Here’s to successful resolutions and a happy and healthy new year.