Jackson Free Press

Lose weight, exercise, quit smoking—no one wants to hear it again. Most of us, especially when we're young and healthy, just ignore the advice. We stopped listening a long time ago, and precious few of us are making any changes in our behavior, at the cost of billions of health-care dollars, not to mention the impact on millions of lives.

In a May 2005 article in Fast Company, titled "Change or Die," Dr. Raphael "Ray" Levey, founder of the Global Medical Forum, said that five behavioral issues make up 80 percent of health-care spending. It's no surprise what those five issues are: smoking, drinking, eating, stress and lack of exercise. While it's not exactly earth-shattering news, the statement is significant because these are the same issues identified at least 60 years ago.

Also cited in the article was Dr. Edward Miller, dean of the medical school and CEO of the hospital at Johns Hopkins University. The synopsis of his presentation, centered on a study of heart by-pass recipients, completely floored me: Few patients made the permanent lifestyle changes necessary to avoid their pain returning, repeating debilitating surgery and saving their own lives. "If you look at people after coronary bypass grafting two years later, 90 percent of them have not changed their lifestyle," Miller said.

Regardless of how much information we have available, even when repeated major surgery or death threatens our lives, we do not alter the way we live our lives. Why?

Back in 1982, I attended one of those self-improvement/pop psychology pseudo-philosophy seminars. I remember a conversation about how we can justify almost anything we do or say to avoid changing. As an example, the instructor used the subject of weight loss. "You already know how to do it, and it's simple," he said. "Eat less and exercise more. All of that other stuff you tell yourself is bullsh*t."

It's one of those annoyingly simple, black-and-white truths that tend to piss us off. In order to get or stay healthy, we need to stop smoking, stop drinking (or drugging) excessively, eat a balanced diet in moderate proportions, get regular exercise and learn to deal effectively with the stresses of life. Variations on this theme are endless, and each variation has its dedicated proponents. But the likelihood is that you, like me, are in the 90 percent of the population that continues to act as if it doesn't apply to us.

So if great big doses of fear—what could possibly produce more fear than imminent threat of death—don't work to stimulate change, what does?

Answers to that question are as prolific as fad diets and self-help books. Helping people change—behaviors, business trends, attitudes—is the basis for entire industries. Solid, scientifically based research is harder to find.

Dr. Dean Ornish, founder of the Preventative Medicine Research Institute, identified several actionable precursors to effective, long-term change. He also found that fear is not a motivator for change. His test program for high-risk heart patients, completed for Mutual of Omaha in 1993, found 77 percent of patients still with the program after three years. The changes to their lifestyles successfully curtailed the bypass or angioplasty surgeries that were inevitably in their futures prior to making the changes. Here are just a few of his suggestions for changing behavior:

Reframe the issue. Instead of trying to change with a fear-based motivation (which all of us eventually become numb to), change it to a joy-based motivation. "I'll feel better" (instead of "I'll avoid surgery") is a motivation you can stick with.

Radical, sweeping changes are often easier to make than small, incremental ones. We are so programmed to look for instant results that small changes, with small results over long periods, don't work for many of us. If the desired result takes too long, we give up.

Get support. Sharing the experience with others and being accountable for your results are powerful motivators. Ornish credits his weekly support groups and attention from other professionals, which expanded his patients' options, as primary success factors.

The most important element for changing personal behavior is our own desire to change. Without the desire, regardless of the underlying reason, we won't undertake the work of change. It's simply too hard.

But embracing change and cultivating the ability to learn new behaviors is vital. Dr. Michael Merzenich, a professor at the University of California at San Francisco, neuroscientist and entrepreneur, is working to reverse cognitive decline in older adults. The brain, he says, never loses the ability to learn and change. When you stop learning, stop changing, you risk calcifying your brain in the same way that obesity and smoking will harden your arteries.

Sources: Fast Company, and The Preventive Medicine Research Institute.