5 ways to make healthy changes in your life
Thursday, May 3, 2018. Author Dr. Haran Sivapalan
Thursday, May 3, 2018. Author Dr. Haran Sivapalan
While it may sound like another one of those trite motivational quotes littering social media, it's based on a widely researched psychological concept – self-efficacy. Coined in 1977 by the eminent psychologist Albert Bandura, the term describes "people's judgments of their capabilities to organize and execute courses of action required to attain designated types of performances." Simply put, self-efficacy is the belief that you can change your behavior to reach certain goals.
Under this view, it is simply not enough to possess the know-how, skills, and resources needed to make healthy life changes. Let's face it, we all pretty much know that to become healthy, we ought to eat more fruit and vegetables, consume less junk food and exercise more often. However, without confidence in our ability to make these changes, the knowledge remains impotent and underutilized. This, according to Social Cognitive Theory, is where our beliefs and self-efficacy come into play.
Ample evidence suggests that self-efficacy is a good predictor of both starting and sticking with diet and exercise programs. For example, in a study of older adults with osteoarthritis of the knee, those with higher levels of self-efficacy in the morning went on to log more steps and moderate-intensity physical activity throughout the day.
If you don't yet have much faith in your ability to begin and sustain exercise, there's no need to fret. The link between physical activity and self-efficacy isn't purely a one-way affair. Rather it follows a reciprocal relationship: doing physical activity leads you to believe you CAN do it, which in turn makes you more likely to exercise regularly, creating a virtuous circle.
If you're new to exercise then, the key is to begin slowly and gradually ramp up the intensity.
Very few of us are truly alone. Most of us are involved in complex social networks, directly or indirectly connected to one another like nodes in a spider's web. Unsurprisingly, these social networks can have a massive influence on our behavior. For example, analysis of about 12,000 interconnected people in the Framingham Heart Study revealed that the decision to quit smoking spreads from person to person, almost like a benign virus.
If your spouse quit smoking, you are 67% more likely to quit too. If Dave from your small office packed in his habit, you have a 34% more likely to follow suit. As well as following a sort of person-to-person domino effect, people also appeared to quit smoking simultaneously, (in clusters) demonstrating that when part of a peer group adopts a healthy behavior, the group norms change. Routinely seeing other people eat salads, go for a run at lunch, or abstain from drinking alcohol normalizes such behaviors and makes them seem attainable, acceptable, and within our capabilities too. In other words, it boosts self-efficacy.
Several studies support the notion that vicarious experience i.e. observing someone else successfully perform a behavior, raises our belief that we can perform that behavior too, increasing the likelihood of adopting that behavior ourselves – seeing is believing is doing. On this note, exercise programs that are led by peers (e.g. a fellow member of an older people's group) are particularly effective at promoting long-term increases in physical activity.
So, if you're looking to sustain exercise well into the future, why not join a sports group, gym class, community initiative, or simply work out with a friend?
When you successfully cross something off your to-do list, you most likely feel a sense of accomplishment and are motivated to complete further tasks. It turns out that what works for office duties, household chores and life admin also works for making healthy lifestyle changes.
Unsurprisingly, belief in our ability to do something (self-efficacy) feeds off our past successful experiences. "I managed to get into shape for my wedding last year, so I can do it again," someone may think. This person's previous achievement, termed an ‘enactive mastery experience', motivates their future behavior.
By accruing a string of such mastery experiences, your motivation grows. Try setting a series of goals. As you hit each target and increase your number of past accomplishments, your self-efficacy and desire for behavioral change should increase. Like items on a to-do list, evidence suggests goals that are Specific, Measurable, Attainable, Researched and Time-Bound (SMART) are more likely to lead to sustained behavioral change and favorable health outcomes such as weight loss.
We're all inherently lazy. If the last few decades of research in behavioral economics has taught as anything, it's that, when making decisions, humans are not the deeply analytical, rational agents we'd like to think we are. Instead, we regularly employ mental shortcuts or ‘heuristics', looking to take the easy option and are easily manipulated by outside influences. A lot of this is beneath our conscious awareness.
For example, my choice to get a packet of potato chips (and not an apple) this lunchtime wasn't the result of a conscious calculation of price, calories or nutritional benefits. Rather it was strongly influenced by the simple fact that chips (and not apples) were in my line of sight when waiting in the supermarket checkout queue.
However, if the supermarket layout was restructured so that apples were positioned for impulse buying at checkout, I might have made the healthier choice of lunchtime snack. This is the essence of Nudge Theory, a concept which earned its creator, Richard Thaler, the 2017 Nobel Prize for Economics.
Thaler contends that by making small changes to our environment or ‘choice architecture' (e.g. supermarkets changing where they display apples), we can be ‘nudged' towards making healthier decisions. The elegance of this theory is that the tiniest of nudges can profoundly influence our choices and lead to large downstream effects on health.
Studies show that something as simple as moving unhealthy food to the second page of a menu or making it harder to reach at a self-service buffet, can unconsciously persuade us towards making healthier dietary choices.
Of course, we can all easily be ‘choice architects' ourselves, manipulating our immediate environment to promote healthy decisions. An obvious example is placing fruit on your work desk, well within your field of vision, while hiding junk snacks away in a drawer.
I'm a keen runner, but there are countless people who absolutely hate running. Nevertheless, they persist with running, reluctantly lacing their running shoes every morning, despite much preferring other aerobic activities such as swimming, cycling or rowing. This flies in the face of behavioral science.
According to Self Determination Theory, our life choices are governed by both extrinsic and intrinsic motivations. Extrinsic motivations for exercising may include things such as hitting weight loss targets, financial rewards or cutting disease risk. By contrast, intrinsic motivation involves exercising for its own sake, because it's enjoyable and satisfying to do so: the reasons I choose to run. While both classes of motivations are undoubtedly important, research suggests that doing what you naturally find enjoyable, and being intrinsically motivated, leads to better long-term adherence to exercise.
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