The question:
 
Every week I start fresh and aim to eat well, exercise, get rest, all the good stuff. By Thursdays, my plan is right off the rails. How do I commit to bettering myself and staying on track?
 
The answer:
 
There are only a handful of things in life that are certain: death and taxes. Oh, wait – and failed diet and exercise plans.
 
You don’t need a PhD in health sciences to know that diet, exercise and sleep are three of the most crucial things that can dramatically impact and – when properly addressed – improve both physical and emotional/psychological health. But, the diet, fitness, and pharmaceutical industries are lucrative, multibillion-dollar industries for a reason: Most people struggle with sustaining long-term change in these areas. So, welcome to the club! (I myself tend to find I start slipping come about Wednesday…).
 
Nice job on identifying the fact that you want to change. This may sound obvious, but it’s not. The adage of “fail to plan, plan to fail” applies: If you haven’t even planned or visualized what you want to do differently, it won’t happen. So kudos for beginning this journey.
 
There are some important steps that you can take to enhance the likelihood your change is sustainable. If you stick to these, you dramatically increase the chance you can stick to your goals.
 
1. Pick a specific behaviour to change. Start with no more than one to two behaviours to change at a time. Precisely define what you want to change.
 
Ensure that your goal is measurable. If you need to revise your goals later on, you will have to know where you are headed, and how to determine if you are getting or have gotten there.
 
Ensure that your goal is realistic. You may want to lose 30 pounds, but a realistic goal may be to lose 15 pounds this year and 15 pounds the following year.
 
Ensure that your goal is time-limited. Set a specific period of time in which you will accomplish it.
 
2. Identify your readiness to change. Before you begin, ask yourself questions such as: “How ready am I really?” “Is this the right time for me to make a change?” “What are the pros and cons of changing?”
 
Consider the benefits of the change. How can you begin to change in a realistic fashion? What would life be like if you didn’t do it? Is it worth it – how or why? Consider how the change fits with other important life values you hold.
 
Prepare to change. Gather the information and tools that you need. Anticipate setbacks. Remember that small change is better than no change. Get supports as you begin the changing process.
 
Consider how you’ll build on your changing behaviour over time. What other behaviours can you add in? Once the changes have been made, consider how you’ll transition to a long-term maintenance plan.
 
3. Identify barriers. Anticipate setbacks. If you had tried to make a change in the past, what got in the way of success? Be brutally honest with yourself about why you failed.
 
Then solve the barriers that you encountered in the past. Identify the pros of not changing your behaviour – this can often help you appreciate why the change hasn’t happened yet. Identify the cons of changing – the reasons the change may be difficult to do. Establish a specific contingency plan for each of the barriers you identify.
 
4. Implement change. Approach behavioural change gradually. Make small, specific changes.
 
Make a schedule with yourself to build change activities into day-to-day life. Follow the “double-time” rule: Schedule double the time you think it would take to achieve the change.
 
5. Revisit and revise. Do not get discouraged by setbacks. If you are not on track with the changes you identified, work to identify the barriers again. Were your expectations too high? Was the specific goal you set too ambitious?
 
Revise your goal as necessary. Expect and visualize success.
 
6. Reward yourself. Set milestones that help you track your progress and ensure that you schedule in regular rewards for each one that you achieve. (I sheepishly admit that shoes and purses motivate me quite well!)
 
Good luck!

​

By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth ​

The question:

I’m medically obese – but totally happy with my body (I swear). Family and friends tell me there has to be something psychologically wrong with me, if I can be truly happy with my body being this large. What’s your perspective?

The answer:

​First, there is nothing “psychologically wrong” with you for truly accepting your body as it is. You sound like a confident person whose self-esteem is not impacted by your physical appearance. The reality is there are a range of physical attributes (e.g., weight, height, facial features, acne, scarring), health conditions (e.g., cancer, HIV) and physical disabilities (e.g., paraplegia, amputations) which could impact self-esteem and confidence.
 
Unfortunately, the stigma in our society surrounding weight issues is undeniable: I think most people view weight as something that is very much within one’s control. The reality is that there is a significant margin of control we can have over our weight through healthy diet and exercise, but some people have a stronger genetic component to their weight, and these individuals can have tremendous difficulty losing weight.
 
You say you are “medically obese”: a body mass index (or BMI) is the measurement that is used to define individuals’ weight classification, and involves a ratio between height and weight. Individuals are classified as being “obese” when the BMI exceed 30 kg/m2. By definition, obesity is a medical condition where body fat has accumulated to the point that there may be an adverse impact on health.
 
I wonder if the concern coming from your family and friends is related to your physical health, not your psychological well-being.
 
There is ample evidence that obesity increases the likelihood of developing a range of serious health conditions, including: heart disease, diabetes, sleep apnea, osteoarthritis, and certain types of cancer. Overall life expectancy is also reduced.
 
When your family or friends express their concerns to you, you may want to ask them what specifically they are concerned about, as I suspect it has much more to do with these health risks. I also wonder if it may be scary for you to acknowledge the possible negative health effects your weight is having.
 
Stating your happiness and acceptance of your body/weight to others may possibly be a way for you to avoid facing some of the other negative impacts that exist, as those may be daunting to both face and start to take some action toward.
 
I would suggest a conversation with either a loved one that you trust, or ideally a health professional: a physician, nutritionist, or dietitian can provide you with useful information on making some changes to your lifestyle – if that is something you feel you want to do.
 
Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail.