The Road to Well is Paved with Good Intentions
Nov 02, 2014 01:33AM
● By Claudia Harsh
Claudia Harsh, M.D.
Metabolic syndrome is the term used if three or more of these symptoms occur simultaneously: insulin resistance, high hemoglobin A1c, high triglycerides, high blood pressure, low HDL cholesterol and a waist-to-hip ratio of more than 0.85, and this diagnosis is linked to breast cancer recurrence rates that are three times higher than normal. The good news is that metabolic syndrome can be reversed with healthy eating, weight loss and exercise. The bad news is that it is increasing at alarming rates in this country due to our love affair with sugar, which is difficult to overcome. We tend to celebrate with food that is calorie-rich and nutrient-poor.
For strategies to change lifestyle habits like smoking, poor nutrition and inactivity, setting intentions is a good way to transform our lives, yet 60 percent of New Year’s resolutions are broken during the first half of the year.
Three psychologists, James Prochaska, John Norcross and Carlo Diclemente, studied “self-changers”, or people that successfully stopped smoking, lost weight or started an exercise program, and found that they pass through six stages of change that are distinct and measurable. Their book, Changing for Good, is a guide for anyone interested in setting intentions or resolutions.
The six stages are pre-contemplation, contemplation, preparation, action, maintenance and termination. The authors describe the process of change as a spiral, not a linear, step-by-step progression.
People in the pre-contemplation stage of change are usually not making New Year’s resolutions. They don’t see their health habits as problems, and if they show up in therapy, it’s usually because they were pushed to go by a spouse or friend. They need additional insight and education.
Contemplators are aware that they have a problem and may have a degree of frustration with feeling stuck, but are not quite ready to change. They think if they read just one more book or just one more website they will find that there’s a dream therapy that will curb the urge to smoke or a new supplement that will burn fat. Contemplators are essentially stuck in the interminable research phase of understanding their problem and aren’t stepping forward yet with an action plan.
On the other hand, those in the preparation stage have chosen an action plan and set a time frame within the next month to begin. They are more likely to be successful with their habit change by coupling it with a strategy for success. For example, if weight loss is the goal, clear out empty calorie foods and make sure cookbooks with fast and easy organic vegetable and whole grain foods are already read and marked with bookmarks. Then, have a shopping list made up and ready and enlist the support of family and friends.
In the same way, the action stage is a result of planning and effort, and that is when our behavior is outwardly changing. This stage works hand-in-hand with maintenance, because slipping into old habits will occur unless we’re aware of how stresses and pressure in our lives pull us back into them. Alcoholics in 12-step programs use the awareness of a daily choice and recognize that even one drink is too many.
On the other hand, many of us know someone who has quit smoking and started again, and statistics on long-term weight loss for any program are not encouraging. People in the action stage of change will do well to make weekly goals and assess progress at the end of the week and either celebrate or forgive prior to setting the next week’s goals. This deceptively simple strategy keeps the intention or the goal at the forefront of our awareness and makes it easier to avoid relapsing. We are so prone to self-judgment that if we recognize this at the outset, we will be more able to acknowledge the power of choice in our lives.
Claudia E. Harsh, M.D., practices medical acupuncture and integrative medicine at the Integrative Medicine Program at Baylor Health Systems’ Cvetko Integrative Medicine Center, and performs gynecology surveillance and survivorship with Texas Oncology at the Baylor Sammons Cancer Center. See ad on page 4