Mary-Jo Murphy, MS, RN, CDE, certified diabetes educator
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You're just going through a stage

7/25/2012

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When considering behavioral change, I am reminded of the title of a book by Bill Hogan: How Do You Eat An Elephant? One bite at a time! 

Maybe you can relate.

You have every intention of being healthier. You join a gym. You even buy expensive running shoes. They sit unused, because you hate to run. Most nights, you get home too late from work to use your membership. Besides, your kids need help with their homework. Your wife cooks your favorite dessert. How can you resist?           

Fast food restaurants call out to you. And, let’s face it; you’re hungry all the time.

You tell yourself, I’ll start first thing tomorrow. But your alarm doesn’t go off. You grab a cup of coffee, and someone at work has brought in doughnuts.           

Another week, month, year goes by, and eventually your calendar reminds you of the return appointment to your doctor. You rush out to buy vegetables and fruit. Your stuff yourself on plain yogurt and celery sticks and hope your doctor won’t notice the ten-pound weight gain.

“I'll do it, Doc. This is a wake up call.”  But what you really want to say is, “Do you have any idea how hard it is to lose weight? Do you know how much I hate exercise? I have a life, you know. This is a very bad time to ask me to do these things, to cut out the sweets, the rich foods. It's my birthday or vacation time or holiday time or summertime, springtime...”

You just want to get out of there. As he’s writing the prescription, you sneak a look. Under that lab coat you see a little flab around his middle. Secretly, you feel vindicated.

I have a friend who when faced with a delicious, chocolate chip cookie would tell me, “We’re all going to die anyway, so why not enjoy ourselves?”

The same friend would remind me with nostalgia of lovely figure she “used to have.” Aware of current styles, she anticipated the next season, by which time she would have “lost 10 or 20 pounds.”

I felt compelled to offered fact-based, boring, medical information as to why taking charge of her weight would be a good idea: family history of diabetes, risk of high blood pressure, increased energy and a family who needed her to be a healthy role model. When she’d glaze over, I’d remind her how cute she’d look in those new jeans we’d seen at the mall.

She continued to eat cookies, but I felt hopeful. I knew something she didn’t. She was on the brink of change. She had already progressed into the second stage of Behavioral Change, the Contemplative Stage.            

If you are reading this, you are likely way ahead of those Pre-Contemplative types, who haven’t given Preventative Health a thought. If you are thinking of or talking about losing weight, giving up smoking, taking up exercising, going for regular mammograms, anything healthful, be hopeful. Sometime in the future you will replace intention with action?

My friend was partially right. If we allowed our human condition to overwhelm our consciousness, we might just stay in bed, eat bon-bons, and wait for the end to come. But miraculously we choose to get up every morning. We affirm life and our desire to make things better. We get on with it. We offer our talents and efforts at work or school or home. We look forward to having fun. We love and are loved back. We balance that sense of futility with hope.

So how did contemplation move my friend into the next stage, A Plan?

One day a couple of her friends showed up at her door for an evening walk. She took a tiny bite of the elephant. Her friends showed up another night, and she went for another walk. They showed up another night, and she went for another walk. Another night, she went for another walk…

Before she knew it, she was walking regularly. Those lovely endorphines secreted during exercise, hormones that make us feel happy and content, kicked in. Her contemplation took the form of a plan. Her plan became a habit. Initially, she was huffing and puffing. Now she keeps up. When she looks in the mirror, she notices she is more fit. She discovered what was in it for her to change.

Her positive self- image re-emerged. She saw that as a healthier person, she might have more years with her children and grandchildren. Her energy came back. In the process her blood pressure improved. Then, she discovered dancing, and found she was good at. People started to tell her how fantastic she looked. Caught in the loop of life-affirming experiences, her new habits became part of her life.

She still eats cookies, but she finds enjoyment in other things too. She has moved into the next stage of Behavioral Change, Maintenance.

This week, take a nibble. Contemplate.  And while you do, walk around the block or up a flight of stairs. Ask yourself: If I had a plan, what, if anything, would I be willing to do today?


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