In the medical world 'lifestyle' is an all encompassing term that refers to what you eat, how you sleep, whether you exercise, if you use alcohol, drugs, or smoke and so on (click here to read What is a Healthy Lifestyle?).
At different times in our lives we have different Lifestyle Profiles. For one reason or another our habits are a certain way. And that way might be good....or it might be bad. In fact most of us have covered all the different profiles - remember the first year you moved away from home? Or when you broke up with whats-his-name? Or after you had children? Exactly.
Our Lifestyle Profile is ever-changing. It's dynamic. Our habits now may not be the same as they were in the past or how they might look in the future.
Ultimately the only person you have to please is yourself. But you may recently have been confronted with information that is making you think about changing a few things. Perhaps you were diagnosed with a new condition and told you might need medication. Or you realize that your skinny jeans are a very very distant memory and now your "big" jeans are getting tight. Maybe you just feel crummy. Or you read some new health info and want to know how to integrate that into your life.
So the question is what to change and how to go about doing that? Most people don't have a huge knowledge deficit. As new information comes out we all need to update and evolve. But generally we know that smoking a pack of cigarettes a day, eating Cronut Burgers, or 36 hour couch marathons are not going to produce great health results.
The challenge isn't knowing. The challenge is doing and putting what we know into action. The challenge is integrating behavioural change into our daily lives.
To figure out what you might change and how to do that it's helpful first to do a self-assessment. Where are you at right now? What about your lifestyle is working for you and what isn't? What could change and how ready are you to do that? What is your current Lifestyle Profile?
You are very far away from a healthy lifestyle. You have terrible eating habits. You don't exercise. You won't go somewhere if you can't park your car within 10 feet of the front door because it would mean walking. You don't get much sleep and if you do it's disturbed and doesn't make you feel rested. Maybe you smoke or drink too much alcohol. You measure your daily coffee intake in "pots" not "cups". Your body hasn't seen a glass of water since 1996. It's been so long since you had any screening tests that you no longer remember your Doc or NPs name. You are so far away from a healthy lifestyle....you are in outer space.
The lifestyle Astronauts that I meet sometimes have a knowledge deficit and simply don't know what is healthy or have never paid attention to the details. But this is rare. Usually something has happened to these folks that has completely derailed their life. That can be something simple - a life change like having a baby or changing jobs - or something complicated - a major illness or death of a family member. Or maybe, day by day, they just drifted into unhealthy habits. They got in with a bad crowd.
But there's good news for the Astronauts. When your lifestyle is this far off the mark there is huge room for improvement. You guys are spoiled for choice. Change anything and you will probably see a difference. When I have patients from this group we sometimes agree to start with the smallest change and see incredible results very quickly. For example I have many patients who have stopped drinking sugary drinks (pop, sports drinks, fruit cocktails, power drinks, sugary coffee). Without doing anything else they quickly drop 25 pounds and reduce reflux and stomach pain.
Astronauts benefit from keeping it simple. Overwhelm yourself with multiple changes all at once and you will quit everything. Pick one thing that you would like to change and when you feel you've slayed that dragon....move on to the next thing. Research shows that when we are successful at changing one behaviour we are more likely to be successful at changing other behaviours. People who have quit smoking know a thing or two about cutting out the nightly four litres of ice cream.
You think you have a pretty good lifestyle. You try to eat well, you usually drink water, you like to exercise. You only treat yourself to dessert once in a while or smoke and drink socially. You head to bed early most nights. You are pretty sure you had your cholesterol checked a few months ago. You would keep a food journal but you are too busy. You would like to join that yoga class but you can't afford it. You would go to that nutrition class but you already know what you have to do. When anyone in your life makes a suggestion about things you might try you've got an excuse for why it can't happen. "Ya but....I'm busy/tired." "Ya but....that doesn't work for me/I've tried everything." "Ya but....it's too cold/hot/wet to walk outside." Yabut Yabut Yabut.
The Yabuts either truly believe they are living a healthy life or they are deceiving themselves because they aren't ready to make any changes. Any tracking program that records their lifestyle quickly shows that they routinely "fall off the wagon" and then throw themselves underneath it. Yabuts often end up in the NP or Doctor's office with a plethora of complaints that they feel powerless to change.
But luckily for the Yabuts we all have the capacity to change. Sometimes we are completely unaware of this. I have patients who have overcome major challenges in their lives. They have shown that they have excellent coping skills, they are strong, committed, and resilient. But somehow they haven't integrated that data into their self-image. They believe themselves to be weak and convince themselves that changes are worthless or too difficult.
Yabuts benefit from doing a little homework on themselves and then asking for help. You need to figure out what motivates you to make change and then remind yourself of successes you have already achieved. Tap that info and use it when looking forward. Major therapy is not necessarily required here. Take a few moments to write down some thoughts about making change, your experience with that, and how and why you want to apply it to your future. Then figure out a game plan. Are there resources to help you? Does your clinic or community offer any programs that would support your change? Where are the people with positive attitudes that have made change and will help you do the same?
And like the Astronauts - pick one thing you want to change and work on that. When that's done move on to the next thing.
You have a decent, if not excellent, lifestyle. You are actively working on your health and are paying attention to all the things that impact it. You probably act as a resource to other people like your family and friends. You are interested in nutrition not diets. You get moving either by exercising on your own or by participating with a group. You rarely stray from your lifestyle plan. You often employ tools (eg. smartphone apps) to help you achieve what you want. You might be so good a living a healthy lifestyle that people secretly dislike you (but probably not). You are devoted to a healthy lifestyle and enjoy the benefits of living healthy.
The Devotee has got it going on. They get the big picture. Often, taking care of themselves is a priority for their own happiness but also because it keeps them healthy to be good parents, grandparents, children, siblings, workers, friends, community members and all the other roles that they play. They often have had challenges in the past (obesity, smoking, illness) but they've sorted that out long ago.
Happily I also see a lot this gang in practice. Sometimes they teach me something new or let me know about a new resource. They have often tried new things and are telling me about the results before I know anything about it! The gluten-free / whole foods movement is a perfect example. There are many patients who had tried this to help with arthritis, irritable bowel syndrome, psoriasis, weight loss, diabetes, allergies (the list goes on) before I even knew anything about it. After my patients told me about the good results and my own trainer started that conversation I educated myself.
But the Devotee may still wants to make changes. Sometimes they want to adopt some new info into their personal plan. Other times they are doing all the "right things" but aren't getting the results that they want. This happens because either the information they have just isn't right (e.g. food guides that tell people to eat 11 servings of grains a day) or because their plan isn't the right fit for them. Despite what we have been told we are not all alike. It isn't one-size-fits-all when it comes to health. Each of us has unique biological features and what works for one person doesn't necessarily work for the next.
Devotees benefit from personalized plans and professional advice. Nutrition experts can help you to find the right nutrient balance for you. Trainers can develop an exercise program that suits your body and your goals. Social workers are an excellent resource for working on relationships and life balance. It's surprising how available these experts are even in small towns. You can access expert advice in person or it could be over the phone or on-line. Perhaps you would consult some of the really excellent books and written resources that are out there. The Devotee is 90% there and they will be happy to get that last 10% by tailoring a plan specific to their individual body, age, and life stage.
I am certain one could create lots of Lifestyle Profiles. You may not fit into one of the profiles I've written about above. You might be somewhere in the middle of 2 profiles. Or maybe you used to be a Devotee and became a Yabut. But here's the thing.... Astronauts can become Devotees. I've lived it. I see it every day in my practice. It's possible for each and every one of us.
Watch for upcoming posts on Making Change: Getting Started and Making Change: Local Resources. Thanks for reading Getting Healthy with NP Sam. Comments are welcome - please click the pencil icon below.
"Your genetics load the gun. Your lifestyle pulls the trigger".Dr. Mehmet Oz
Dorland, J. & McColl, M. Ed. (2007). Emerging approaches to chronic disease management in primary health care. Kingston, Can: School of Policy Studies.
Rollnick, S. Mason, P. & Butler, C. (2004). Health behaviour change: a guide for practitioners. Churchill Livingston: Philadelphia, USA.