House Call: Revive your resolutions and make healthy changes stick

It is six weeks into 2022. Are your resolutions holding up? When people make resolutions, or commitment to a lifestyle change, we tend to set vague goals: I will exercise more, eat better, lose weight, drink less.

All admirable intentions, but what does that mean, and what steps will make it a reality? If you want to make a change, set specific, realistic goals; look at what might be barriers to your success; and make a plan that works within your lifestyle.

I was talking with a senior patient of mine about exercise. He reported that he walked 5 miles each day, and I said, “Holy smokes! How do you maintain that?” He said, “I have a secret.” He has a close friend in another state who is also an avid walker. So, he uses his hearing aids for a Bluetooth connection to his cellphone.

The two start a long-distance phone call together, then start their virtual walk together and chat the whole time! It keeps him motivated. Technology can be a wonderful tool to help maintain accountability and motivation.

Lifestyle changes, even small ones, can have an enormous impact on your body, mental health and well-being. We might dream of becoming a gourmet vegetarian cook or competing in a triathlon, and sometimes big goals are motivating.

But small changes can also have big rewards. As I’ve said in previous columns, a 25- to 30-minute daily walk can lower a senior’s risk of hip fracture by 28% by helping to strengthen bones and improving balance.

Making changes in incremental steps can help make aspirations into a longer-term lifestyle change that lasts. Whether your end goal is running a 5k or running a marathon, having a clear, specific plan is essential. Over the years, I’ve seen what works for many of my patients in following through with their resolutions.

Make a realistic and flexible plan

Create and commit to a plan that works for your life. Do a “barrier analysis” of what might get in your way. Biking might be an exercise you enjoy, but it’s not realistic in winter for most people. When it’s raining, what will you do? What’s your alternative? You could join a gym or get an indoor training bike for home, which might be easier to access and more time efficient.

Once you’ve decided on a gym membership, is the gym near your work or home? How will you get there? What times or days of the week are too packed for a workout? What else might get in your way?

If you’re trying to quit smoking or cut back on sugar, think about times of day when it’s more difficult for you and perform a “trigger analysis.” Have an action plan for when you are triggered because you know it’s going to happen. Maybe chew sugarless gum or grab an apple instead. It only takes about 10 minutes to get over that hump or craving, and often the urge will subside.

When you have “what” and “how” settled, set specific and realistic goals. Your gym plan might be to bike 45 minutes four days a week. Plan that out farther so you know you are biking or at the gym at 8 a.m. Monday, Wednesday and Friday and 10 a.m. Sundays to let yourself relax a bit on weekends. Specific actionable goals are much more likely to be sustained.

Make it tolerable and rewarding

Some people can live by “no pain, no gain,” but for most people, if going to the gym is a chore, they’re less likely to stick with it. Find a workout you will enjoy or enjoy well enough. If you’re eating better, make a list of restaurants where you can get a healthy dish you crave, and stock up on healthy foods you love at home. Plan a reward for each month you don’t smoke.

Backup plans are a good idea

Life happens: Have a plan for when your plan doesn’t work. There will be curveballs. Expect them, and don’t let them derail you. You might have a meeting you can’t miss at your workout time or need to take your dog to the vet instead of prepping a healthy dinner. Be flexible, but respect your goals with an alternative plan in mind for another workout time or healthy takeout.

If you have a backup plan, you can move through life with your goals intact. I recently had to plow my driveway in the morning when I normally work out. Fortunately, I have a plan in place for missing my workout: I do it on the same day in the evening. It’s not ideal since it means two showers and a changed schedule, but it keeps me on track.

If you miss your goals a time or two, don’t throw in the towel. Empower yourself to succeed the next time. So, you skipped a bike ride or gave in to that cheesecake. That’s life, and you can get past it and get back on track again. Be forgiving of yourself for being human, but don’t lose sight of your goals.

Speaking of cake, what is your plan for that birthday party next week? If you’re cutting back on drinking alcohol, that might work out fine when you’re staying in for the night but might be different at a party. Go into situations you know might be challenging with a plan to have only one small slice of cake or find a delicious non-alcoholic cocktail to drink.

When your motivation wanes

Having a cheerleader helps. Find someone who supports you or can be an accountability partner to check in with to keep you on track. Don’t be afraid to ask for help from friends and family, a trainer or coach and, if you need it, a mental health professional or health care provider.

Recognize your accomplishments. You might be slowing down on motivation, but you’ve come this far. Be kind to yourself. You’ve made it part way to your goal.

Learning to use simple technology with a smart phone can be a helpful ally to maintain motivation and provide rewarding feedback. Many apps will track your walk, run or biking route mileage and times, which can be fun when you look back on a week or month’s accomplishments.

I see people lose motivation if they only lose three or four pounds in a month when the goal was 10. Don’t get discouraged. Weight in reality tends to go on slow and come off slow. Three or four pounds per month doesn’t seem like much but translates to 36 to 48 pounds per year if sustained.

If you’re exercising more, you might not drop 30 pounds, but you may feel better, sleep better, have a healthier heart and lower your cholesterol. Making meaningful lifestyle changes is about mental preparation as much as physical.

Take the time to write down your specific goals, harness your allies for accountability, make a detailed action plan and set realistic, achievable goals for yourself. Most of all, try to make it fun. Remember: It’s the tortoise that wins the race. Good luck in 2022 and beyond!

Dr. Jeff Markin is a family medicine physician practicing at Kaiser Permanente’s Veradale Medical Center.