Why is changing a lifestyle difficult? Or more explicitly, why making healthy lifestyle changes is difficult? Because when it comes to changes, most of us will agree it refers to positive changes, changes that make our life better. We have seen or heard of numerous cases that something happened and has therefore changed a person’s life completely, such as a fatal accident, a severe disease, losing someone he or she loved…The most recent incident that has made such an impact on many people perhaps is the coronavirus pandemic, which is still on going. Despite how devastating it is, positive changes have been happening - we care more about our love ones, talk to them more often. We wash our hands more thoroughly and frequently and pay more attention to personal hygiene. We realize how healthier and much more we can save through home cooking. Some of us quit or decrease alcohol consumption based on health concerns. So why changing a lifestyle is difficult? Maybe it is because it requires a huge cost for someone to change. Or maybe that is just one of the many reasons that contribute to the change?
Changing a Lifestyle under Normal Settings
Huge impacts like Covid-19 is definitely a once in a lifetime matter and it takes enormous life and economic tolls to take changes to our life. In most cases, the desire or requirement to change happens under normal settings, where life goes on as usual and the surrounding environment is the same. For example, the continually increasing cases of people with obesity and a sedentary lifestyle, as well as having type 2 diabetes and cardiovascular diseases. Governments, health institutions and individuals all know the situation needs to change because it affects people’s quality of life and it can even be fatal. Therefore, some start to spread the message about healthy living. Patients with similar diseases were told to change their habits and what they should do to be healthy, like quit smoking, limit alcohol intake, be physically active, eat more vegetables and fruits, have a low carb low fat diet, etc.
How are these methods and suggestions working? Research shows that they are not working particularly well. For example, when it comes to weight control, success rate of long-term weight loss maintenance is around 20%, according to a 2005 study[1], where a successful long-term weight loss was defined as “losing at least 10% of initial body weight and maintaining the loss for at least 1y”. Also, medical trigger for weight loss seems to have a positive impact on the long-term success. A success rate of 20% for one year or more is not very high, and it is likely that a two-year rate will be even lower.
A low long-term success rate implies that under normal settings, changing a lifestyle is difficult. You may have heard that it takes 21 days to form a new habit. However, the reality is it may take 21 days to form a single small habit, but forming a new lifestyle is way more complicated and it can consist of a lot of small habits. Furthermore, forming a new habit in 21 days seems to emphasize more on self-discipline, which ignores how big the social environmental impact can have on us.
What Do the Experts Say?
To explain why changing behavior is difficult, health experts have proposed quite a few models.
One is the transtheoretical model, also called stages of change. In this model, change is broken down into five stages – precontemplation, contemplation, preparation, action and maintenance. Each stage takes time to go through, and “skipping stages is likely to result in setbacks”[2]. In the process of change, relapse is common. What you need to do is to be resilient, reflect on the old strategy and figure out a new strategy and carry forward.
The theory faces criticisms. Some say that such theory relies too much on people’s rationality, as is assumed by many other utility related theories, but ignores the fact that some behaviors are irrational. Also, most of the time a behavior is not self-controlled but influenced by the social environment, including the government, health institutions, advertising agencies other people, and more. Since the reason for a certain behavior can be complicated, we should apply concepts like automatic response and reflective response in behavioral science, as well as social practice in sociology to understand such behavior, and solve the problem like a detective (viewing backward), instead of a researcher (looking forward).
However, the use of behavioral science, the nudge concept specifically, also faces some criticisms. The recent one was the UK’s method towards combating Covid-19. Another argument was that the use of behavioral science is manipulative. Despite the differences, both theories do emphasize on the importance of breaking the behavior chain down into small parts or stages in order to solve the problem.
So, What to Do?
Based on facts and the theories mentioned above, we have to admit that making a lifestyle change is indeed difficult, and there is no way around it. As an individual, what one can do is perhaps try to make it less strenuous to sustain as much as possible, for example, adding details in your daily life that make yourself act towards the outcome you desire, because PERSISTENCE is very critical. Don’t forget to ask for help when necessary. On the other hand, since it involves many social environmental factors, obvious downward trends of obesity, type 2 diabetes, cardiovascular diseases and other similar diseases probably won’t happen until every sector in the society cooperates, just like what they do for smoking and the coronavirus pandemic.
Making a lifestyle change is difficult but don’t stop trying. Remember to be consistent and patient, don’t go extreme, and success will be waiting for you at the end of the tunnel.
[1] Rena R Wing, Suzanne Phelan, “Long-term weight loss maintenance”. The American Journal of Clinical Nutrition, Volume 82, Issue 1, July 2005, Pages 222S–225S.
[2] Harvard Health Publishing, “Why it's hard to change unhealthy behavior - and why you should keep trying”. updated: August 2, 2019, published: January, 2007.
[3] Anne-Lise SIBONY. “The UK COVID-19 Response: A Behavioural Irony?”. Eur J Risk Regul. 2020 Apr 2 : 1–8. doi: 10.1017/err.2020.22.