informative essay: "how to live a healthy life."

HealthyHabitsSuck-part1.pdf

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PART 1

Being Healthy Is Hard

C o p y r i g h t 2 0 1 9 . N e w H a r b i n g e r P u b l i c a t i o n s .

A l l r i g h t s r e s e r v e d . M a y n o t b e r e p r o d u c e d i n a n y f o r m w i t h o u t p e r m i s s i o n f r o m t h e p u b l i s h e r , e x c e p t f a i r u s e s p e r m i t t e d u n d e r U . S . o r a p p l i c a b l e c o p y r i g h t l a w .

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CHAPTER 1

The Marathon Runner Who Hated Running

In my efforts to lose my divorce weight, I decided to join a running club. One day I found myself running with a man who was turning seventy. He was a much better runner than me, and despite our age difference I had to keep asking him to slow down! While discussing the topic of running, he said to me, “Oh, I don’t enjoy running.” This came as quite a shock, considering he had already run more than a dozen marathons. He explained, “I don’t actually enjoy the act of running. But I really enjoy being a runner.” He said he felt quite accomplished and proud when he told other people that he runs marathons. Thus, this man who had run more than a dozen mara- thons didn’t like running, and yet he kept running because he had found something important and meaningful in the act.

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Healthy Habits Suck

Why on Earth Would You Engage in Health Behaviors? Have you chosen a healthy habit to work on that you haven’t suc- cessfully stuck with? Whatever you’ve chosen, I’m willing to bet it’s something that goes against our human instincts. As I noted in the last chapter, millions of years of evolution have shaped humans to avoid pain, seek pleasure, take the path of least resistance, and live for today. Over time, these strategies became instincts that showed up automatically, and they were tremendously helpful for our early ancestors, as they still can be today. For example, if you accidentally put your hand on a hot stove, your instincts jump into action, and you take your hand away from the source of pain without conscious awareness. Your hand moves before you even register the pain. This is an ancient instinct at work.

Let’s examine some typical healthy habits to see if they violate our instincts. Eating more vegetables? Yup, sure does: seeking plea- sure. There are no receptors in your brain that respond to vegetables like they do for sugar. Going for a walk? It violates the instinct to take the path of least resistance. No matter how many times you go for a walk, it will always take more effort to walk than to lie on the couch. Training for a marathon? This completely violates the instinct to avoid pain. Avoiding junk food? Yes, indeed. This vio- lates the instinct to live for today. Almost every health behavior goes against your natural instincts, and therefore health behaviors suck. They inherently don’t feel good. So why on earth would you engage in health behaviors if they suck so much?

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Values Values are the qualities and characteristics that we would most like to express and represent in our lives; they are what matter most to us; they represent how we want to engage with the world. Values aren’t just a thing, a noun, such as “parent.” They include qualities, such as being adventurous, caring, creative, resilient, and persistent. A value is being an engaged parent, a compassionate spouse, an artis- tic worker. Values also have an emotional resonance: they just feel right. You don’t have to explain why a value matters to you, you just know.

Western culture is very focused on goals, which are different from values. Goals are things that happen or don’t happen. Once we achieve a goal, we usually stop pursuing it and move on to a new goal. For example, let’s say you have the goal of losing weight, so you go on a diet. If you reach your goal weight, then what do you do? Many people stop doing whatever it is they were doing to lose weight. This is entirely consistent with the notion that when you achieve a goal, you move on to a new goal and stop working on the goal you just achieved. Do you see the problem? If you stop engaging in the health behaviors that resulted in weight loss, you’re likely to regain the weight.

Unlike goals, values are more like a direction you head in. Imagine that heading west is an important value of yours. You might hit certain landmarks or cities along the way that will let you know you’re headed west, but these markers (goals) alone aren’t all that matters—every step heading west matters. Also, you’d never be able to “get west” in the goal sense. If heading west was a value, you’d always be trying to head in that direction.

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Here’s a less abstract example: if being a caring and loving person is a value of yours, then you have to continue to express that value all the time, such as by kissing your child or telling your husband you love him daily. You may hit markers along the way that let you know you’re living this value, such as getting married, but you could never say, “Well, in 1985 I was super kind to my sister, so I’m good.” Values don’t work that way; you have to keep expressing them.

Let’s briefly explore your values. I assume that you’re reading this book because you want to be healthier, so answer this question for yourself: Why do you want to be healthier? Most people say they want to feel better, be more confident, have more energy and be more active, live longer, or avoid some bad health outcome (for example, diabetes, heart disease, cancer). Does your answer fall along these lines? The problem is we often don’t go any deeper than this by asking, What am I going to do what that extra energy, con- fidence, health, and longevity? The way you answer this question helps reveal what really matters to you—your values (for example, traveling, exploring, dancing, playing music, and so forth).

I had such a discussion with a woman living with obesity who really wanted to stop eating her favorite snack, jelly beans, so she could lose weight. I started with the standard question: Why do you want to lose weight? And she gave the standard answer: “So I can be healthier.” I probed further: Why do you want to be healthier? “So I can be more active.” Why do you want to be more active? “So I can be healthier and lose weight.” We went around in circles like this, yet I continued to press: What will you do with better health and extra energy? “I’ll be able to walk stairs better. It hurts too much right now to do stairs.” And what matters to you about being able to

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The Marathon Runner Who Hated Running

walk up stairs better? With this question, she suddenly burst into tears and said, “I have to move out of my family home because I can’t walk up the stairs.” Through her tears she explained, “This is my dream home. I’ve lived in it for forty years. I raised all my children there. I wanted to spend the rest of my life there…but I can’t because I can’t handle the stairs anymore.”

I was in tears at this point, too. That she had to give up some- thing that meant so much to her because of her health was so poignant and painful. Just “wanting to be healthier” may not make giving up jelly beans worth the effort, but wanting to stay in her dream home just might be. (The “Clarify Your Values” exercise, available for download at this book’s website, http://www.newhar binger.com/43317, can help you sort through your values.)

Linking Values and Health Behaviors You’ve identified some of your values and the healthy habits you want to engage in. Let’s work to link one of your values with one of your health behaviors. You can download the “Linking Values and Behaviors” worksheet at this book’s website: http://www.newharbin ger.com/43317. Remember, the goal is not to make “health” or “fitness” or “being active” a value. Real sustained change happens when we’re able to link a health behavior to an existing, deeply felt value.

Ask yourself these questions:

How will engaging in the health behavior help me move toward a value?

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How does engaging in the health behavior help me express a value?

Why does this health behavior matter? And what matters to me about that?

Here are some examples of ways to link a value and a health behavior:

• Directly linked: When I go for a walk I’m expressing my value of contact with nature.

• Means to an end: If I eat more vegetables, I am at a healthier weight, and if I’m at a healthier weight then I’m funnier and more sociable (value = humor/engaged relationships).

• Think outside the box: I value honesty. I need to track my food to be honest with myself about what I’m eating.

I follow a plant-based diet. It’s similar to a vegan diet (no dairy, no meat) but focuses on what I do eat rather than what I don’t eat. It’s supposed to improve my health, but that’s really just a bonus. The main reason I started this diet has to do with climate change. Reducing my contribution to this phenomenon is important to me. It turns out that the agricultural industry related to meat production typically contributes more greenhouse gases per person than does driving a car. That’s to say that eating animal-based foods was prob- ably generating more greenhouse gases than driving my car. For me, linking the value of “doing my part to reduce greenhouse gases” to this diet motivates me to stay on it, and the diet has the side effect of being a healthy choice for me.

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The Marathon Runner Who Hated Running

Here’s an example of how a client of mine linked behaviors and values. He came to see me to learn how to better manage diabetes. He knew he should be doing healthy things, but he never seemed to get around to them. Specifically, he wanted to get on the treadmill every morning (his health behavior). Here’s the discussion we had:

Me: What about getting on the treadmill is important to you?

Client: My sugars are better. My day is generally better. I have more energy.

Me: Why is it important to you to have more energy?

Client: So I can do more things. So I can be more prepared.

Me: So when you have more energy you tend to be more pre- pared? And what is important to you about being more prepared?

Client: Things go more smoothly.

Me: What is important to you about things going more smoothly?

Client: People around me are happier. I get along better with my family. I can enjoy them more.

Me: And it matters to you to have good relationships with your family members?

Client: Yes, very much.

Me: So getting up in the morning is not just about managing your sugars. It’s also about your values regarding getting to enjoy your family more.

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Healthy Habits Suck

Through this inquisitory process he and I were able to link his stated health behavior with values, and this connection allowed him to better stick to getting on the treadmill—even when he didn’t want to.

Apple Pie Will Always Taste Better Than Apples What tastes better, apple pie or apples? Uh, apple pie. You may eat a healthy diet such that the sugar and fat in apple pie is a shock to the system, and you may feel quite tired and yucky after eating apple pie, but your brain is hardwired to get excited about sugar and fat (apple pie) and not apples. What feels better, lying on the couch or going for a run? Lying on the couch! Again, your brain is hardwired to prefer the path of least resistance. It doesn’t matter if you’re a triath- lete. You may get used to expending energy in a certain way, but it will always take more energy to go for a run than it does to lie on the couch.

All health behaviors have pros and cons. Pros include things like improved mood, more energy, or being able to stay active with grandkids. Cons include things like expending effort and being sweaty and uncomfortable. Research shows that when the pros out- weigh the cons, you’re more likely to engage in and stick with a health behavior (Hall and Rossi 2008).

There are different ways to make the pros outweigh the cons. One option is to make the pro side “heavier.” Another option is to make the con side “lighter.” People in your life (especially your health care providers) may try to make the con side lighter by trying

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The Marathon Runner Who Hated Running

to convince you that a health behavior isn’t that bad (“After a while you won’t notice the side effects of your medication” or “You’ll get a runner’s high and feel so good!”). I know many physiotherapists who recommend that their patients find an exercise they enjoy—that is, find an exercise with fewer cons to it. Well, many of us (including my marathon-runner friend) don’t enjoy exercise. I have run a half mar- athon and more than a dozen 10Ks, and I have never had a runner’s high. So I say that it’s totally okay to hate every minute of exercise. You don’t have to find an exercise you’ll enjoy. Your exercise can continue to suck. We don’t have to decrease the cons of the behav- ior in order to do it. Instead we can increase the pros.

You can dramatically increase the pros of a health behavior by linking it to your values—to what makes it worthwhile to you. In fact, research supports the benefit of this (Hall and Rossi 2008). The reasons for doing the behavior become more meaningful as a result and have a stronger pull. It’s always going to take effort to exercise, so rather than trying to convince yourself that the health behavior won’t be that bad, you should acknowledge how much the health behavior sucks and figure out what will make it worth it for you.

We Do Difficult Things All the Time I was working with a woman who was having a hard time quitting drinking. Quitting was really important for her because she had a liver condition, and alcohol was very detrimental to her health. We talked about why she wanted to be healthy. She said she wanted to have more energy (a typical response). “What will do you with that extra energy,” I asked. She said she would use it to clean up her house, to do her dishes and her laundry. I stared at her. “You mean

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Healthy Habits Suck

we’re doing all of this work just so you can do more laundry? Well no wonder you don’t want to quit drinking. I wouldn’t quit drinking either if it meant I was going to have to do more laundry.”

With further digging we identified that the reason she wanted to clean her house was so she could socialize more by having people over. Being more social and having friends over? Now that’s likely to motivate someone to give up drinking. Ask yourself, How will engag- ing in these health behaviors help me be the person I want to be? What will make it worth it to do these health behaviors? Remember, health behaviors are hard! You need a really good reason to do them. If all you’re going to do with improved health and extra energy is sit on the couch or do more laundry, then don’t bother!

Here’s another thing to remember: We do difficult things all the time in the service of our values. For example, if you got yourself out of a warm, cozy bed to go to work today, you did something difficult in the service of something that matters to you. Perhaps it’s the pay- check, or perhaps it’s the work that you do, but something motivated you to do something uncomfortable. If it matters to you to be an engaged, attentive, caring parent, then you do difficult things for your children in the service of this value all the time, whether it’s cleaning up after your sick kid or staying up all night with a crying infant. It’s totally okay if health isn’t one of your core values. It’s totally okay if engaging in a health behavior sucks. Engaging in your health behaviors can be just one more difficult thing you do in the service of your values.

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Choice Point You can download the choice point worksheet at this book’s website: http://www.newharbinger.com/43317. At the top are boxes titled “toward” and “away.” In the model, these represent whether a behav- ior moves you toward or away from the person you want to be or the life you want to have. In this chapter you clarified your values, which help you engage in behaviors that move you toward the person you want to be or the life you want to live. Go ahead and fill in the “value” line in the box under “toward.” (I’ll clarify what a SMART goal is in chapter 3, so for now just focus on your value.) “Strong” is a value that’s important to me, so I’d write that on the “value” line.

If you’re following my suggestion of reading one chapter per week, then this week try to focus on reminding yourself of your values and how the healthy habit you’re working on is related to them. Thus, if you think about your healthy habit (for example, getting more sleep), try to also remind yourself of how engaging in it helps you be the person you want to be (for example, getting more sleep will help me be more creative, be a more engaged parent, and be more productive in my career or volunteer work).

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CHAPTER 2

Weight and Other Things You Don’t Control

I want to offer you a challenge: Tomorrow I’d like you to weigh 256 pounds; the day after that, 145 pounds; and the following day, 200 pounds. Do you think you can do this? Can anyone do this?

What if I asked you to drink one liter of water tomorrow, eat one cup of green veggies the next day, and go for a ten-minute walk the day after. Would you be able to do that?

Most individuals answer no to the first challenge but yes to the second. What’s the difference between the two requests? The differ- ence is how much control we actually have.

I’m going to say something that flies in the face of everything you know or have been told about weight: We don’t control our weight. That’s right, I just said that.

This may seem hard to believe. You’ve likely heard from the media, health care providers, and others in your life that if you just work hard enough, if you try for long enough, you’ll be able to have a beautiful skinny body. Culturally we believe that we can control our weight, and that more effort results in more weight loss. There is a strongly held myth that weight is all about calories in and calories

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Healthy Habits Suck

out, which led to a ridiculously simplified public campaign of “eat less and move more” (Chaput et al. 2014), but science actually tells us the opposite. We can influence our weight, but we don’t have direct control. Here are just a few of the factors that influence weight (Hafekost et al. 2013; Schmidt et al. 2014):

• Genetics

• Maternal weight

• Paternal weight

• Maternal weight gain during pregnancy

• Whether you were breastfed

• Hormone levels, including cortisol, ghrelin, and leptin

• Sleep

• The walkability of your city

• Access to fresh fruits and vegetables

• The number of fast-food restaurants in your neighborhood

• The kind of job you have (for example, sedentary versus active)

With so many factors influencing weight, and the fact that we have very little control over most of them, it’s impossible for us to have direct control over our weight.

The American and Canadian Medical Associations recently defined obesity as a chronic disease, which has several important implications. First, it means that the medical community will start

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Weight and Other Things You Don’t Control

to see and treat obesity not as a failure of character but a chronic condition similar to diabetes or high blood pressure. The second is that weight, similar to other chronic conditions, must be managed for the long term. Doctors would never treat someone’s diabetes for only six months and then be confused why five years later the patient’s blood sugar was out of control. Yet that’s exactly how weight is approached. We expect that dieting for six months will have effects far into the future.

At the obesity clinic where I worked, participants often asked what the five-year outcomes were for our one-year program. We responded that obesity is a chronic condition that must be managed indefinitely. Our goal was to encourage participants to continue with their weight-related health behaviors for the long term.

As we’ve come to understand obesity as a chronic condition, and not as a failure of willpower, we’ve learned that we have a lot less control over our weight than we thought. In fact, not only does our culture trick us into thinking we have direct control over our weight, so does our own mind.

Our Problem-Solving Brain Remember our cave person brain? One of the most critical things early humans had to do to survive was to problem solve, such as determining if they had enough water and food, and where they could find shelter. The problem-solving aspect of our brain comes in handy when we’re trying to control aspects of the external environ- ment, because these problems can be “fixed.” If you need shelter, you can solve that problem. Food and water? Solvable! Thank you prob- lem-solving brain!

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However, this same problem-solving brain can also get us into trouble. Many of us in the developed world don’t need to invest con- siderable amounts of effort in finding food or water or shelter. Most of the ways we solve these problems are straightforward and clear: go to the grocery store, turn on the tap, turn on the air conditioner. As a result of this relative ease, our problem-solving brain looks for other “problems” to solve, because it’s hardwired to do this.

One of the other “problems” our brains will try to solve is weight, or any other chronic condition (for example, diabetes, chronic pain, heart disease). Our problem-solving brain identifies weight as a problem and works to get us to solve it or to get rid of it. Western culture fuels our problem-solving brain with messages that weight is under our control, and if you’re overweight you’re a failure or you’re lazy. Corporations capitalize on our tendency to want to fix things by pointing out what’s wrong with us and by offering solutions to make us happy, and we buy these “fixes” by the boatload: weight loss was a 64-billion-dollar industry in 2014 (Marketdata LLC 2017).

One of my clients, Claire, was a classic example of someone who experienced negative consequences as a result of the problem-solv- ing brain. Claire described to me the numerous diets, gyms, trainers, and weight-loss programs she’d used to try to lose weight. Like many people she had spent thousands of dollars, invested a huge amount of time and effort, and sacrificed things she enjoyed to “fix” her weight only to end up heavier than when she had started. Sound familiar?

A key issue with the problem-solving brain is that it tends to focus on the number on the scale as the goal and measure of weight- loss success. But using this number alone can actually lead to some unintended consequences in the long run. For example, Claire

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Weight and Other Things You Don’t Control

described adding exercise to her weight-loss efforts. “Every time I exercise I gain weight,” she told me. Because losing weight was her goal, her understandable, natural response was to stop exercising because it wasn’t helping. However, we know from research that exercise is important for long-term weight maintenance. Exercise also makes you healthier, regardless of your weight. But because exercise didn’t result in short-term weight loss, Claire came to a natural, logical conclusion: Why continue to exercise if it’s not helping me reach my goal? She therefore stopped engaging in that health behavior.

But even if you do lose weight, focusing on “fixing” your weight still has unintended consequences. Evelyn, another client of mine, successfully lost forty pounds by carefully counting calories, avoid- ing all social activities involving food, and knitting in the evenings (instead of eating chips while watching TV). When she finally got to her target weight, she was delighted (in fact, she celebrated by having her favorite food, an ice cream sundae). Being a well-socialized human in Western culture, once she reached her goal she stopped working on it and moved on to the next one. She therefore stopped doing all the behaviors that helped her lose weight. Not only did this make sense based on our understanding of goals (after all, she had accomplished her goal), but the behaviors she was engaged in to lose weight weren’t sustainable over time. How was she going to avoid social activities involving food forever just to manage her weight? Science tells us that continuing with weight-related health behaviors long term is key to managing weight. As expected, when Evelyn stopped engaging in her behaviors she started putting the weight back on.

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The inherent problem with a fix-it approach is that we focus on “getting rid” of the problem. By focusing on the number on the scale we assume that there is an “end” to the problem. When you fix it you’re done. It therefore offers short-term solutions that don’t result in long-term behavior change. Claire gave up because she never found the fix, and Evelyn gave up because she reached her goal and thought she was done. In both cases (whether you’re succeeding or failing at losing weight), focusing on the number on the scale does not promote long-term behavior change.

Why do we need long-term behavior change? If you’ve struggled with weight then you have probably thought about and worked on your weight a great deal, sometimes even more than people who have been a “normal” weight their whole life. You’ve probably lost more weight in your life than these people. In fact, results from sci- entific research and my own clinical experience working with hun- dreds of people trying to lose weight clearly demonstrate this: weight loss isn’t the hardest part of weight management—keeping the weight off, or weight maintenance, is (Chaput et al. 2014; MacLean et al. 2011). Just like any chronic disease, weight must be managed long term, not fixed with short-term solutions (Coughlin et al. 2016). The key to weight maintenance is continuing to engage in weight- related health behaviors over the long run. You therefore need a way to continue with health behaviors even when the scale doesn’t change. How on earth do you do that?

After my divorce, I personally spent a lot of time not losing weight, and I had to figure out how to keep engaging in weight- related health behaviors even when they didn’t result in weight loss. I mentioned that I follow a plant-based diet, not for weight loss but to reduce my environmental impact. I also go to boot camp three

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Weight and Other Things You Don’t Control

times per week. Again, I don’t do this to lose weight, but to feel strong. Being able to do squats and push-ups and burpees makes me feel capable of tackling problems. While I was going through my divorce, feeling strong and capable was really meaningful for me. Even if I felt like an emotional wreck, I could still do some push-ups and remind myself that I could deal with whatever issue I was facing.

But despite this focus, my mind never stopped trying to get me to focus on weight rather than behavior. After all, a well-functioning mind is hardwired to relentlessly focus on fixing a problem. I had to remind myself that my job is to do my health behaviors; what my body does with that effort is out of my control. I had to repeatedly remind myself that my health behaviors were things I did in the service of my values (climate change, being strong and capable) rather than a “fix” for my weight.

Why Weight Isn’t Fixable If you’ve been socialized in Western culture, the belief that weight is fixable is typical. So I’m going to provide some more information about why weight isn’t fixable. Over millions of years of evolutionary pressure human beings have evolved to make sure they don’t starve death. For example, research shows that our metabolism slows down when we lose weight, a phenomenon referred to as “metabolic adap- tation” (Muller and Bosy-Westphal 2013; Rosenbaum and Leibel 2010). Moreover, metabolism does not necessarily recover when weight is regained. For example, researchers followed the winners of the show The Biggest Loser for six years (Fothergill et al. 2016). After six years, contestants had regained 85 percent of their weight, but

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Healthy Habits Suck

their resting metabolism was still at the slower rate it had been at after they’d lost weight. What does this mean? Let’s take the average contestant.

At the beginning of the show, Mr. Average Contestant weighed roughly 330 pounds and could consume 2,600 calories and stay the same weight. At the end of the show he’d lost 130 pounds (he now weighed 200 pounds) and his metabolic rate had slowed. He could now only consume 2,000 calories a day and stay the same weight. After six years, he had regained 90 pounds (he now weighed 290 pounds) but his metabolic rate remained slow. He could only consume 1,900 calories a day and stay the same weight even though he had regained 85 percent of his original weight. So if you’ve lost weight and you feel like you’re gaining weight just breathing air, you might be right.

But our bodies don’t just stop at reducing our metabolism to make sure we don’t starve to death (Tremblay et al. 2013; Dulloo, Jacquet, and Girardier 1996). Research shows that food will actually smell better one year after you lose weight. Food will also taste better a year after you lose weight. Why on earth would your body torture you like this? Well, it thinks it’s just been through a famine, or a long, terrible winter with no food. Your body is desperate to put the weight back on to make sure you don’t starve to death. You know all those skinny girls in the advertisements—they’re not the ones who could survive a long, hard winter. Individuals who could put on extra pounds whenever food was available are the ones who sur- vived—they are our ancestors.

Not only does your body encourage you to eat, it motivates you to eat all the things that are so-called unhealthy. Why are we moti- vated to eat “unhealthy” food? Consider the honey seekers of New

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Weight and Other Things You Don’t Control

Guinea. Members of this tribe climb about forty feet up a tree in order to reach into a beehive while dangling precariously in the air and getting stung. Sugar is so scarce in those parts that it’s worth it. Let that sink in for a minute: this is the world our body and brain were adapted for, one in which sugar, fat, and salt are rare. Would you want to climb forty meters in the air and get stung by bees just to get a handful of sugar? Of course not! So your body developed a highly motivating system to make doing so worth it: the reward system of the brain.

This reward system releases neurotransmitters (chemicals in your brain) that make you feel awesome in order to motivate you to get sugary foods (McGonigal 2013). Interestingly, this reward system doesn’t release these chemicals when you ingest the sugar, but rather in anticipation of ingesting the sugar. Have you ever anticipated that next bite of delicious food only to take the bite and not feel satisfied? This is the reward system in action! From the standpoint of survival, it makes no sense to be rewarded once you’ve gotten the food. If that were the case, you’d stop after ingesting the food. No, your brain is much smarter than that, because it wants you to survive! When we ingest the food, we don’t feel satisfied, so we continue to want more until there’s no food left.

What this means is that bodies that gain weight are doing exactly what they evolved to do. Despite everything you’ve been told, gaining weight is a natural consequence of a highly adaptive evolutionary system. If you are overweight, your systems are working exactly as they were intended to work. You’re just not meant to live in an environment where you can ingest your total daily caloric needs in a single meal. I’m not saying that being overweight is healthy, but being overweight in our modern, Western world where

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Healthy Habits Suck

food is so readily available is a natural, adaptive process—a conse- quence of millions of years of evolution.

So perhaps you’re thinking, Why haven’t we evolved past this yet!? Great question. The most important reason is that as you read this right now, there are humans somewhere on the planet starving to death. Starvation is still a threat to human life today.

What Do You Control? At this point you might be feeling demoralized. Perhaps you’re thinking, Does this mean I’m going to be overweight forever? Does this mean there’s nothing I can do about my weight? There are things you can do. Just keep reading.

Let’s try an experiment (inspired by Harris 2009). Recall how you bought this book. Maybe you ordered it online or maybe you went to a bookstore to buy it. And now completely forget how you bought this book.

Could you do it? Not likely. Deleting a specific memory or thought is not a typical human ability. Now let’s try another experi- ment. Make your leg go completely numb. Remove any sensation or feeling from your leg, to the point that you could cut it off with a chain saw and not feel any pain.

Could you do that? Not likely. Okay, one more experiment: stand up.

Which one of these experiments was the easiest to do? Most people will say the final one. Compared to thoughts and feelings, we have far more control over our behavior. What do I mean by “behav- ior”? Behavior is something someone else can see you do, like stand- ing up. If there was a reality TV show all about you, behavior is what

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Weight and Other Things You Don’t Control

we’d see you do on the screen. Behavior is not how you feel about your action, or whether you wanted to or felt motivated to do it, it’s the action itself. The fact that we have control over behavior is great news! You can control health behavior—including going to the gym, walking, drinking water, consuming more fruits and vegetables, and integrating them into your life will make you healthier (and perhaps have the side effect of causing you to lose weight). In the next chapter we’ll go over several exercises to help clarify health behaviors.

Health Behaviors Are the Goal Changing your goal from the weight itself to health behaviors you engage in serves several purposes. First, you’ve created a goal you can actually control. If you work harder at trying to eat green veggies, you will likely eat more green veggies, whereas working harder to lose weight can sometimes have the opposite effect. Fixating on weight can lead to stress, which releases the stress hormone cortisol, and cortisol can interfere with weight loss (Jackson, Kirschbaum, and Steptoe 2017). From an evolutionary point of view, it makes sense that cortisol might prevent weight loss. Our mind interprets high levels of cortisol as being indicative of some type of danger. In cave person times, this might have been something like living through a long winter or a war. Cave people’s bodies responded by conserving energy and storing fat so they’d have the resources to make it through the stressful event. Nowadays, though, stress isn’t always linked to a need to put on weight. So the stress (and resulting cortisol) associated with the pressure one might feel to lose weight can actually prevent weight loss.

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Healthy Habits Suck

Here’s a striking example. You might think that I lost weight when I trained for a half marathon. This was my assumption too. After all, I was running close to thirty kilometers a week. But I was gaining weight, not losing it. My trainer was not surprised. He said that running for more than an hour at a time decreases your metab- olism and therefore can lead to weight gain. This makes sense from an evolutionary perspective. My body thought I must be under stress or facing a threat because I was spending a lot of energy running around! So, my body worked to conserve energy so I could keep running.

Second, focusing on behavior instead of weight creates a goal that is healthy. Focusing on health behaviors means you will end up healthier, regardless of whether you lose weight or not. This is important, because there is strong evidence that weight alone is not a good indicator of overall health. For example, consider body mass index (BMI), a method used by health care providers to qualify weight based on height and weight—in other words, it’s another way of measuring weight. Health care providers often use this method to categorize an individual as “underweight,” “normal,” “overweight,” or “obese,” but BMI doesn’t distinguish between a six- foot-two person who’s 260 pounds of fat or 260 pounds of pure muscle. These two people both have a BMI of 33.4 and fall into the “obese” category. In fact, the BMI system categorizes many elite athletes as obese even though by all other methods they are consid- ered extremely healthy. Some research suggests that if you don’t have health complications, then you shouldn’t be diagnosed as overweight or obese at all, regardless of what your BMI indicates. This research suggests that “obesity” is only a condition when excess

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Weight and Other Things You Don’t Control

adipose (that is, fat tissue) causes health complications (Sharma 2017). If you don’t have complications, then you should just be described as having excess adipose but not as obese. (Personally, I like saying “extra fleshiness.”)

Additionally, research has shown that a single session of exer- cise can result in “healthier” fat cells (Van Pelt, Guth, and Horowitz 2017). Specifically, after exercise the fat cells had a greater ability for blood flow and to reduce inflammation, both of which are related to better overall health regardless of weight. Thus, even if you don’t lose weight, you can be healthier at the weight you’re at by focusing on health behaviors.

Third, changing your goal provides a reason to engage in health behaviors over the long term, and long-term behavior change is really the key to good health. Another study of The Biggest Loser contestants showed that those who continued to exercise after their time on the program were the ones most likely to keep the weight off (Kerns et al. 2017). This is a consistent finding in the literature: continuing to engage in health behaviors is associated with weight maintenance (McGuire et al. 1999). For example, the National Weight Control Registry (http://www.nwcr.ws) is a research study currently tracking more than ten thousand people who have suc- cessfully lost weight (at least thirty pounds) and kept it off for at least one year. Studies using this database have repeatedly shown that participants who continue to engage in weight-related health behav- iors, such as exercising, following a low-calorie diet, or watching less TV, successfully maintain weight loss in the long run.

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Healthy Habits Suck

Values So if keeping up weight-related health behaviors is the key, how do we do it? By linking health behaviors with values. Managing your weight in the long run is going to suck. All weight-related health behaviors violate our basic principles of human functioning. So why on earth would you do them? Because engaging in your health behaviors may help you be the person you want to be.

Here’s an example of what I mean. While discussing health behaviors with a woman living with obesity, she said she wanted to start eating more green vegetables. I asked her what eating more green vegetables meant for her. She replied, “It means I’m on a diet and I’m being punished because I’ve messed up again and gained weight.” Well, if eating green vegetables represented “punishment” to her, no wonder she was struggling to eat more of them. Then we talked about why she wanted to lose weight in the first place. She offered the usual round of answers: to be healthier, to be more active, to live longer. But I kept digging deeper: What was she going to do with her improved health, extra energy, and extra years of life? Eventually she got around to the fact that she wanted to be healthier so she could continue to live independently. She didn’t want to have to go to a home or be cared for by others. “I’m very stubborn” she reported. “I like to do things on my own.”

“So it sounds like being stubborn and being independent are really important to you,” I suggested. She agreed. “So, eating green vegetables is actually your way of being defiant. It’s your way of telling the world to f*ck off because you’re not going to a home. It’s your way of being stubborn and independent.”

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Weight and Other Things You Don’t Control

Her eyes opened wide as she stared at me. “I never thought about it like that.” And all of a sudden she was excited to go home and eat her green vegetables so she could tell the world to f*ck off.

If you flipped to this chapter hoping that I’d give you the magic key to weight loss, go back to chapter 1 and learn about the real secret weapon in life: living a values-based life.

Choice Point In this chapter I discussed how we don’t control our weight. This also applies to a number of other health outcomes, such as blood pressure, blood sugar, and cholesterol, and many of the goals we set for ourselves, such as “sleep more” or “be healthy.” Our aim is to set a goal for ourselves that is achievable, a health behavior we can actually do, rather than something we don’t control. For the choice point worksheet this week, consider whether your healthy habit is something under your control. Is your healthy habit an outcome or a behavior? Do you need to rethink your healthy habit? (See chapter 3 for more details on making your healthy habit a behavior.) My example of “exercise more” is a behavior and not an outcome. If I had instead listed “feel more energetic” or “be less tired” or “lose five pounds” as my healthy habit, then I would want to think about how I could recast them as health behaviors, because these are examples that are much less under my control.

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