The long game is hard

One reason it is difficult to maintain good, healthy habits over the long term is that there are no immediate consequences for straying from your desired path. Skipping a workout or eating the extra dessert might feel good right now, and it may be years or even decades before the "pain" of this decision becomes real.

An interesting model:
In the book The Innovator's Prescription, the authors divide chronic health conditions into 4 quadrants depending on the answer to these questions:

1. How much behavior change is required for treatment?
2. Are there immediate consequences for failing to follow the recommended therapy?

Please see the diagram below, which comes from the book. For a condition like myopia (poor eyesight) the treatment is simple - wear your glasses - and if you don't you won't be able to see. You are inherently encouraged to stick with the treatment. This condition lives in the top left.

In contrast, conditions like type 2 diabetes and obesity live in the bottom right, the "Chronic Care Quadrant," where extensive behavior change is recommended and consequences are delayed. These are hard conditions for people to manage and providers to treat effectively as motivation is challenging to maintain.

Why This Matters:
Working to improve nutrition, exercise regularly, or prioritize sleep can feel like and endless slog. Even if you make progress, sooner or later the thought creeps in, "Am I really going to do this forever?"

What You Can Do:
One potential strategy to help move past the "forever barrier" is to look for milestones to celebrate along the way. Milestones help you to break a long journey into multiple shorter ones by providing some finish lines and marks of tangible progress.

For instance, if you're trying to build the habit of regular walking, you could celebrate any of the following:

• Walked 5 days in a row
• Walked with another person
• Walked in the rain
• Walked 10 hours (100 hours) total
• Walked 29 miles total (the distance from Boulder to Denver)
• Walked 4 days in a week for 4 consecutive weeks
• Wore out a pair of shoes
• Insert your own, you get the idea...

Pick some milestones, write them down, then cross them off as you hit them. Celebrate them with friends or family. When you've run out, pick some new ones. (For more on milestones, see the Power of Moments book below.)

Going Deeper:

• The Innovator's Prescription by Clayton Christensen, et al.
• The Power of Moments, by Chip and Dan Heath

Have a wonderful week,

Dr. Topher Fox

P.S. If you missed any previous emails, the content is posted weekly here

P.P.S. Below are the pictures from my exam room wall which we are exploring for this email series.