Friday, June 10, 2016

You can only do what you're going to do

I'm continuing on my series of posts on advice I share with patients who are interested in losing weight or starting a healthy lifestyle. Today, I'm going to share my most used motto that I tell all my patients interested in lifestyle modification. They've all heard it at least once, but probably more, because it is represents my most firmly held core belief in approaching behavior change: You can only do what you're going to do.

I've heard colleagues complain about how patients never do what they tell them to do, particularly for diet and exercise. In my head, I think, "I feel like a lot of patients do what I tell them to do..." and then I realize, "Oh yeah, that's because I never tell them to do anything." That makes it a pretty easy goal to reach! However, as lazy as that sounds, this is more than me just lowering my standards of success.

When a patient asks me what they should do to be healthier, I won't answer. Instead I ask, "You tell me, what can you do to be healthier?" I want people to tell me what they think they can realistically do to be healthier. Maybe I'm just cynical, but I feel like if I tell someone what to do, they're not going to do it anyways, so I don't see the point. Sure, I can spout out the American Heart Association's recommendation of 150 minutes a week, or 30 minutes a day for 5 days a week, but if only it were that easy, all of us would be doing what we were supposed to be doing. Being un-athletic myself, when I first started exercising, hearing something like 150 minutes a week would have floored me. Someone might as well have told me to train for the Olympics to get a gold medal in men's gymnastics. In my mind's eye, both would have been equally impossible and unobtainable, so why bother trying?

Instead of giving recommendations that might seem unrealistic, I try to get people to tell me what they'll actually do. And that's when I say it: You can only do what you're going to do, so tell me, what is it that you're going to do? I never care how small the goal is, someone could tell me they'll eat 1 more raw baby carrot a week for 2 weeks. Fine. I'll take it.

It isn't about having good habits, it's about learning you're capable of making changes to develop better habits. It's about shifting the internal monologue from I can't, to I can, one baby step (or baby carrot) at a time. One might think that my general reluctance to educate patients on diet and exercise is absurd, but my other philosophy is: Patients aren't stupid. For the most part, people know some foods are healthier than others, or that exercise is good for them. They don't need me to tell them that. Granted, there are exceptions, including those that have been led astray by food marketing, or have already made obvious changes and are running out of ideas, or have a question if a proposed change is actually a healthy decision. However, the majority of average people, like you and me, probably have some pretty obvious things that we can think of to change for the better.

So my advice from today's post: don't rely on someone else to tell you what to do, because only you
Do, or do not. There is no try. - Yoda
know what you can and can't do. These are your habits and it's for your health, so take control and own it. Pick a healthy habit you're going to do for two weeks. Not "try" to do, but actually do. When I have a patient say they'll "try" to do something, I work with them to think of smaller goals until they stop saying, "I'll try" and start saying, "I will". I've named this very official medical technique, the Yoda maneuver. Then, once you've achieved one goal, pick something else you're going to do for a few weeks. Just keep focusing on what you're going to do. Don't worry about what you "should" be doing, because what's the point of knowing what you "should" do if you're not going to do it? In the end, you can only do what you're going to do.

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