In my first article, I shared that if you're stressed, it can be extremely difficult, if not impossible to successfully change an unhealthy habit into a healthy one.
I recommended a "homework" exercise to:
- List 20 barriers that you perceive as limiting you from a specific goal.
- Pick the top 1-2 factors on your list that you feel account for 80% of your inability to reach your goal.
- Then, make these factors actionable by meeting three criteria.
1. Extremely small and measurable: if you have trouble flossing just one tooth daily, you'll never get to the whole mouth!
2. High "yield": Hit multiple areas with a single effort. Focus on doing things that take the same amount of effort, but may save time or money later.
3. Controllable: Losing a loved one is not a controllable event.
I know that this process can be difficult! It can be easy to list 5-7 factors but listing 20 can seem impossible!
Here's one exercise that may help you identify hidden lifestyle barriers...
The "5 Why's" Technique
I have found this tactic to be extremely useful with my clients.
All that you do is simply ask a series of "Why?" five consecutive times.
Here's a fictional story about how this may work for you in real life:
"Alicia" is a 45 year-old woman who has recently realized that her health has slowly slipped away over the last 2o years she spent raising her two children, 18 year old Jon, and 20 year old Becky.
Becky has been living at home for two years while attending a local college, and has recently rented out her first apartment with some close girlfriends at school. Jon decided he was going to go out of state for school and just left two weeks ago!
Understandably, Alicia is having trouble enjoying her new-found freedom and is honestly having a bit of "empy-nest" syndrome.
Alicia shares with me that she's slowly gained 20 pounds, feels increasingly tired, notices that she's chronically congested and "fighting off something", and struggles to roll out of bed even after a full night's sleep.
Alicia's 75 year old mom, Mary, and her 77 year old dad, Bill, have a lot of aches and pains and have increasing difficulty getting around. She shares with me that she's fearful of "ending up like them".
She decides to visit me for a nutrition consultation to help herself "get back on track" for the new year.
She tells me that losing 20 pounds is her number one goal.
From my experience, I suspect that her goals run deeper than just a number on a scale.
She remarks: "If I could just lose the weight, I know my joints would feel better, I'd have more energy, and I could start jogging again like I did in high school. Believe it or not, I used to be a great tennis player back in the day!"
How do you think I would handle this case?
- I could start out with a food diary and suggest healthier substitutions such as trying a new snack like Kale Chips.
- I could offer immune and gastrointestinal support such as Vitamin D, Probiotics, and reduced Glutathione
- Perhaps, I could suggest a detoxification program where Alicia commits to strict dietary guidelines over a set period of time to jumpstart some initial weight loss.
- Maybe, instead I recommend that she begin a program of interval training exercise to boost weight loss.
- I might take a combination of some of the approaches listed above.
But first, based on my experience, I decide to dig deeper and ask Alicia "5 Why's"...
The "5 Why's":
1. "Why do you want to lose weight?"
Well I would have more energy, and I suspect that my joint pain would probably go away.
2. "Why do you think you're not as energetic & pain-free as you used to be?"
With the kids and everything, I just didn't have the time. They were my life and the time just flew by!
3. "Why did having kids keep you from living how you wanted to live?"
My schedule was dictated by picking them up and taking them to school, taking them to and from practices, making sure they had meals when they came home, and I have my own job and responsibilities around the house too.
4. "Now that your kids are away, Why do you think you're still struggling to create healthy habits for yourself?"
Well, I never took time to think about what I wanted and honestly I love my kids and I didn't mind that my life revolved around their activities.
And taking care of my parents, well that's a new thing but I have a sister that's been helping to split the responsibility.
If things continue like this, I'm not sure what I'll do!
So, despite my parents' health being a concern, and with the kids out, I really feel that I can finally focus on my health again.
I just don't know where to start, so I called you!
5. "Why do you think you don't know where to start"
Within five minutes of meeting Alicia, and after only asking five questions, I've gotten to some of the core issues of Alicia's health problems.
Eighty percent of my work is already completed!
First of all, I know motivation to change is not Alicia's primary problem.
The research I have reviewed shows that motivation to change is the last reason why we have trouble creating habits!
Educating Alicia on why it's important to lose weight and reduce stress will do nothing to help her create healthy habits!
This is based on the same reason that warning labels on packs of cigarettes do very little to keep you from smoking and, may actually promote the habit!
The research shows that we stick to our guns and voraciously defend our choices and behaviors even when faced with the most compelling evidence that we are wrong.
- Alicia wants to play tennis again without joint pain.
- She wants to be healthy and active in old age.
- She wants to be able to handle new responsibilities like she did when she was young.
BUT more often than not, she will value her ability to play tennis over the taste of a bag of M&M's.
When she associates playing more tennis with not eating M&M's, that's when a new healthy habit can be created and scaled.
(Notice Alicia is doing most of the talking during the consultation!)
"Causes" and "Symptoms"
She may already even be taking some medication for her symptoms as prescribed by her other doctors.
The real "cause" of all of these problems may actually be rooted in LIFESTYLE, and in Alicia's case, the need to establish some new daily rituals to fill the gaps in her schedule that appeared when her kids moved out.
I could list infinite possibilities on how to help Alica, and I could Google the thousands of medical and non-medical ways to:
- give her a diagnosis
- help her lose weight
- "treat" her aches and pains
- offer her recipes
- design a detailed diet program for her.
- tell her to "eat this" and "not that"!
All of these approaches can and do work, but when push comes to shove, my diagnoses, my recipes, and my diet programs know nothing about Alicia!
Neither does Google, Pubmed, or any nutrition or medical textbook you can find.
These are just tools that help guide and track decisions.
Identifying a problem and possible tactics is not enough to solve a problem.
Tactics require the correct CONTEXT to work effectively.
In my experience and observation, the approaches with the most success over the time, come back to filtering out what's right for Alicia and the unique context of her life.
The "5 Why's" Technique is an efficient exercise to establish what's right for Alicia in time and place.
As the saying goes, "There's a time and place for everything".
When you consider most doctors schedule their appointments for only 15-minute time slots, you may begin to understand why lifestyle factors are lost in our healthcare and insurance system.
Giving Alicia new recipes to try or putting her on a strict diet program may give her short-term results at the expense of setting her back more time in the long run.
Recommending individual tactics outside of the correct context has a lot to do with why 90% of people who lose weight, eventually gain it back.
The "Truth" is that sometimes specifically focusing on an issue outside of your specific problem will have a greater impact on it than any individual "tactic" or "strategy".
Now if you have a specific infection, a specific medication may be absolutely necessary. If you sprain your ankle, ice would probably be helpful. These are right choices in time and place...
But after an infection has been controlled, and the sprained ankle has healed, who is asking the holistic questions:
"Why was the infection there in the first place?", "Why am I so prone to ankle sprains?" "How do I prevent future infections?", "How do improve my ankle stability?"
Not too many.
In my practice, weight loss is a secondary benefit to successfully making indirect changes such as:
- Balancing stress
- Supporting healthy blood sugar
- Improving stomach and intestinal integrity
- Boosting immunity
- Removing toxicity
- Breaking up scar tissue.
- Improving movement patterns.
- Or linking together tiny behavioral changes
I have found that focusing upstream on the causes rather than focusing downstream on the effects can dramatically support health and wellness - especially when someone has multiple chronic health problems at the same time.
Alicia's fictional story is a snapshot of how understanding your personal barriers to behavior change can be crucial to creating life-long healthy habits.
If It's All About "Lifestyle", How Does Clinical Nutrition Fit?
If you consider the example of Green Tea, there are active chemicals like catechins that simultaneously support immunity, support detoxification, support mood and stress balance, as well as promote healthy balance of gut bacteria.
It would not be a stretch to say that adding green tea into your lifestyle is:
1: small and measurable
3. and controllable.
Whereas removing something of your life may be much more complicated and outside of your immediate control.
Just by using few targeted nutraceuticals, and some very personalized lifestyle recommendations, I have seen amazing shifts in health over periods as little as two weeks.
This is why I love my work!
Homework and Action Step:
1.) Look at your list of 20 things you identified as being personal barriers...
2.) Find, 1-2 factors that are small & measurable, high-yield, and controllable.
3.) Use the "5 Why's" technique to help identify more barriers and help you decide on the best place to start!
4.) Future steps to creating healthy habits will work to expand and adapt these first behaviors...these first steps are FOUNDATIONAL.