The Challenge of Change

Change can be hard. Many of us, including myself, go kicking and screaming into it. It’s just not always that easy to do. Why? Because we’re creatures of habit. We like we what we like and we want to do what we always do. But sometimes life gets in the way and we discover that our habits won’t work for us anymore. I’m speaking specifically about diet and disease, and for many, that dirty word, exercise.

I meet with and teach thousands of patients every year at the hospital where I work. For almost every single one of them, I discuss behavior change. Because when we talk about what we eat, a big part of what we’re speaking about is altering what we do. And when it comes to food and physical activity, it hits very close to home.

Unfortunately, the reality of life is that certain disease states and conditions require that we change what we eat, even sometimes limiting certain foods to help manage our health. Diabetes, hypertension, high cholesterol, kidney disease, obesity and more are affected by what we put in our mouths and how much we move our bodies.  It’s hard for so many of us to hear, but hear it we must. Our lives, and the quality of them, can depend on it.

How do you feel when you hear some unwelcome news? It typically takes us time to absorb it. We go through many emotions including denial, anger, bargaining and acceptance. It can be hard to get to acceptance and difficult to stay there. But when it comes to certain diseases and conditions, make no mistake about it, change we must.

When I teach a class, such as diabetes, whether it is a class of 15 or one numbering 150, or when I meet one-on-one with a patient for a consult, I see a variety of emotions. Sometimes the list of things that need to be done can be relatively short. Often, it’s quite long. This can be very overwhelming. Giving up or cutting back on foods that one has eaten and enjoyed for years can be depressing. Starting an exercise program, when the most physical activity you’ve had in years has been walking to and from the car that you’ve parked closest to whatever entrance you’re trying to access can be daunting. That overwhelming feeling may cause us to do….nothing. And that’s not good.

I tell my patients that it typically isn’t necessary to change everything overnight. Sometimes it is, but not always. Picking a couple of things to do from even a long list is a great start. Building on those every week is the goal. Small steps add up to big changes. And as we continue to build, we start creating new habits. We succeed in behavior change.

So, start somewhere. Set yourself specific goals like, “I will walk on the treadmill for 30 minutes on Monday, Wednesday and Friday mornings,” or “I will read the nutrition facts labels on all food items that I eat.” Make sure that you’re pretty confident that you will make that goal. If not, rework it. Because what happens when we set goals that we don’t have a chance of achieving? We set ourselves up for failure and we may give up.

It would be wonderful to go to bed one night and wake up the next morning to have lost all of our excess weight and normalized our blood pressure, cholesterol, and blood sugar levels, but it doesn’t work that way. We have to take steps to get there. Think of these steps as your road map. Would you get in the car on the eastern United States and drive to the western United States without your route planned? Most of us wouldn’t. Your short-term goals are the path you will take to end up where you want to be. But you have to start. Any change is better than no change. Pick a few things and keep on adding. You’ll get there. And you’ll likely be the much better for it.


Visit Lisa Tillinger Johansen at, on Facebook at Lisa Tillinger Johansen and on Twitter @LisaTJohansen.

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