Maintaining Change Is a Struggle

This is the fifth column in a series of seven dedicated to the Stages of Change, highlighting weight loss.

In 1983, Prochaska and DiClemente developed the Stages of Change model, which describes the stages a person goes through as they attempt to make significant changes. The model includes six well-defined stages that people move through as they work to change a target behavior.

Before entering the maintenance stage, you have moved past denial (pre-contemplation), recognized a need for change (contemplation), gathered information and resources (preparation), developed a plan of action (action), and are well underway (maintenance). To be in the maintenance stage, we would like to first see six months in the action stage.

Maintaining change is difficult. Roughly 80 percent of people who lose a lot of weight eventually regain just about all of it. Life happens. We get triggered. We got off track. We give in to the cravings.

Treatment of obesity requires ongoing attention to support sustainable change. It’s not enough to identify a goal. You need to create a habit. The habits you repeat every day largely determine your health, wealth, and happiness. They are based on repetition and frequency. James Clear, author of Atomic Habits, says, “Ultimately, it is your commitment to the process that will determine your progress.” Not your goal.

Benjamin Hardy, Ph.D. (Inc. Magazine, May 18, 2016) says, “If you want to make any permanent change in your life, willpower won’t get you there. No matter how much internal resolve you have, you will fail to change your life if you don’t change your environment. The willpower approach doesn’t focus on changing the environment, but instead on increasing personal efforts to overcome the current environment. What ends up happening? Eventually, you succumb to your environment despite your greatest efforts to resist.”

I believe that most people can be successful in losing weight with strong willpower, but keeping off weight requires more than willpower; it requires an environment that supports your objective.

Success also requires new skills. New skills might include stress management and emotion regulation. They might also include challenging your automatic negative thoughts and replacing them with more reasonable thoughts. Good sleep habits also contribute to weight management.

Another skill is to learn to identify triggers, manage cravings, and ultimately reduce their frequency and intensity. Anything can serve as a trigger to get you off track. It may be emotions, people, places, things, thoughts, or situations. Identify your personal triggers and develop strategies for avoiding or reducing exposure to each trigger.

Identify the conditions of your ideal environment. Name the people who are supportive and the people who would pose an obstacle. Name the places that support your new behavior and the places that challenge your progress. Name the things that are helpful to your journey and the things that block your progress.

If you can survive six months of new behavior, you have earned the right to feel confident in your determination, motivation, and skills. Enjoy the benefits of your new behavior in this stage, but don’t become overconfident. Be mindful of the sixth and final stage of change—relapse.