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The psychology of weight loss.

Today Is Not The Day To Change My Life

Why we put off big but necessary life changes

Now is not a good time for me. Work is busy. The kids are on break. The house is a mess. The holidays are coming. The semester just started. I have exams. Grandma isn’t well. Things will clear up soon. That does it, I will wait until later.  

I counsel people for weight loss and it never fails that a few weeks into the program that a patient will start talking about why now turns out to not be a good time for him/her to lose the weight after all.  It is as if they didn’t realize how busy they were going to be.  It is as if they think they will be less busy later.  The belief that “today is not the day” is one of the biggest barriers to any life change, be it a weight loss, career change, or breakup.  While today may or may not be the right time to make a change, the trouble is that this belief can persist for years. Waiting for the right moment to do what needs to be done may mean putting off your health and happiness… indefinitely. 

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Why do we do this?  This pattern isn’t garden variety procrastination, it is what psychologists call avoidance. Avoidance is actually one of the most powerful motivators of our behavior.  Wait, how can avoidance motivate behavior? Another term for avoidance is “negative reinforcement” and this is defined as an increase in any behavior that results in the removal of something aversive (e.g., anxiety, fear, pain, anger, sadness, etc).  We avoid a lot of things:  conversations, the boss, the scale, the doctor, the mirror, the neighbor, the phone, the truth, and of course, the dreaded engine light.

We avoid big things too, like our health.

Take Susan.  She is feeling frustrated and distressed about her slow weight loss.  She comes to her 5th visit with me and says that she can no longer make it to our regular 5:30pm counseling appointments because she now has a standing 5:30p meeting at work.  She says that work got too busy which is why she just can’t focus on her weight now.  Work is her avoidance behavior.  She can ramp it up and down at will to skillfully steer around other areas of her life that generate feelings of frustration.  I tell Susan that busy people exercise, busy people lose weight, we can figure out how to fit this into her schedule. I suggest we meet at a different time.  She then lists her work responsibilities, I assume in an effort to make the case that she is busier than the busy people I mentioned.  And so we are stuck.   

The tricky thing about avoidance behavior is that we pick socially acceptable ones so that we feel better about what is being compromised (and so that people leave us alone about it---or maybe even cheer us on).  Susan’s husband doesn’t question her commitment to her work, in fact he reinforces the pattern by saying things like, “You work so hard, just relax when you get home.  Don’t put more stress on yourself by worrying about rushing off to the gym or cooking up some elaborate healthy recipe.”  Avoidance rewarded.  We are so stuck.

The danger of avoidance is not only that it is often very prolonged, but also that the gravity of the avoided task becomes heavier over time. Most problems get worse when unattended.  The longer Susan avoids addressing her weight and health problems, the more weight she will gain--especially because her avoidance behavior (i.e., working more) is one that generates stress.  What is a modest task today becomes an enormous task later.  Another danger is that by avoiding the task and its associated bad feelings, our perception of how bad we will feel when we finally confront the task snowballs.  The longer you avoid a task, the more fearful you will become about confronting it.  Avoidance is the process by which fears become irrational.

How to break through avoidance?

1. Identify what your avoidance behavior is.  You may know what you are avoiding, but it may not be clear to you what exactly you are doing to avoid it.  Susan doesn’t realize that she’s using work as avoidance behavior because work is a good thing in her life.  It doesn’t immediately occur to her that it is a conscious choice she is making to work instead of persist with her weight loss plan.

2. Write a list of ways the problem could very well worsen with time.  One thing that makes avoidance easy is not thinking about the cost of avoidance.  What do you risk by waiting, say, one year to tackle this problem?

3.  Write a list of ways that the problem is likely to improve with time.  Some problems actually do improve simply with the passage of time (i.e., by doing nothing).  For example, a grad student might be experiencing stress and second thoughts about school when in the midst of a tough class.  Giving the problem some time might be better than making a career change right away because the class might get better or the student might find enjoyment in other courses such that one bad class might not matter.  It is very important to know whether your problem is likely to get worse or improve over time. 

4.  Compare the two lists.  If you could imagine several scenarios in which your problem could worsen, but few in which it could improve, then now definitely is the best time to make a change. 

5. Scaffolding –If you are embarking on a tough change, you will need scaffolding in the same way a building does when it is being built or repaired.  Scaffolding comes in the form of helpful others who will prop you up, nudge you forward, and reinforce your progress.  Find a friend, friends, or entire social network to be the scaffolding while you remodel you.  Let them know your goals, your timeline, and progress updates.  Very few big problems ever got solved by a person working alone---don’t try it.

6. Set smaller daily or weekly goals that make progress on the problem.  Susan was overwhelmed  because she only lost 3 lbs so far and her goal was to lose 50 lbs.  The discrepancy between where she is now and her overall goal was generating frustration. Instead of giving up though, she should focus on smaller, shorter term goals like 1 pound per week or 3-4 pounds per month.  With a big looming problem, focusing on the bigger picture can actually be bad for motivation. Instead, focus on the mile markers along the way.

7. Let go of the fallacy that you will be less busy later.  Life rarely gets less busy, at least not for long.  Even if it did, things will pick up again. Most of us like to stay busy--even when we retire. Susan would gain a tremendous amount of confidence if she had the skills to manage her weight during busy periods in her life.  If she waited until work was slow (which may never even happen) to put the effort into her weight, she would put herself at risk for regain as soon as work got busy again. Accomplishing a tough thing at a tough time makes it less likely that anything going forward will knock you down.

Today is never the best day to make a change in your life. Because tomorrow isn’t either, today will just have to do.  The good news is that nothing feels better than finally being on the other side of a big change. 

Good things are waiting for you. Ready?

Sherry Pagoto, Ph.D., is an Associate Professor of Medicine, Division of Preventive and Behavioral Medicine, Department of Medicine at the University of Massachusetts Medical School.

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