Yes, it’s that time of year again when your phone/email/computer is busy with patients wanting appointments and making commitments to make their New Year’s Resolutions.
Often at this time of the year, my patients come in wanting to change just about everything about what they eat, when they eat, how much they eat, and the same for being physically active. So many of these patients have told me they have tried and tried and tried and failed in the past, but now it’s the New Year and it’s going to be different.
I have learned, and research tells us, making too many sweeping changes at one time doesn’t usually last.
Woman, 32 years of age, type 2 diabetes, class II obesity, hyperlipidemia, hypertension, came in early March 2016. She reported having started the year making New Year’s resolutions to start eating breakfast every day (she didn’t normally eat breakfast), to eat salads for lunch instead of her usual McDonald’s cheeseburger and fries, an apple for a snack rather than 2 chocolate bars, and a salad for dinner. As for activity, she said she planned to join a gym and go 7 days a week, one hour/day. She also planned to start taking her medications, which she was not taking, and to monitor her blood glucose.
When she visited, she was depressed, saying it was because she couldn’t keep her “resolutions.” She just gave up and went back to her old ways. She felt defeated. Her A1C was 10.3%.
I explained to her it’s best to make small goals, 2 to 3 at most each visit. Master those, make those a way of life, then add new ones. She was reluctant at first, but agreed.
We decided every visit to work on one aspect of her food, one aspect of her activity, and one medication. If she did more than that, that was on her.
For example, for the first visit, she worked on having a different lunch than the McDonalds’s lunch. She chose to go to the gym 2 times/week, and to take one of her 4 medications she was not taking. When she returned one month later, she had lost 3 pounds, was doing even more than we “bargained for” and added another.
In December, her A1C was 7.6% — not exactly to goal but a lot better than 10.3% — she had lost 22 pounds, and was feeling much better, not just physically but mentally about herself. She told me she is not making New Year’s Resolutions for 2017 like she did for 2016.
I’ve learned this works best with people and I’ve learned to ask them, “What will you do?” not, “What should you do?”
- When patients come in with a list of New Year’s Resolutions, ask them if they have ever done this before and how it worked out.
- Teach the importance of how mastering small steps can make big changes.
- Ask patients to be real. Ask them, “What will you do?” not “What should you do?” And, let them tell you, the practitioner, what they will do. They know better than we do what they can and will actually do.
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