Overcoming Obesity Series 4 of 4: How to Create a Habit
In our previous posts in this series, we introduced the latest thinking about obesity; discussed body acceptance and the hard reality of visceral fat; and delved in Binge Eating Disorder.
In our final post in the Overcoming Obesity series, we look at how to create a habit. Habits are acquired behaviors that are followed so regularly they become almost involuntary or unconscious. Avoiding habituary actions feels wrong – like going to bed without brushing one’s teeth.
Steering away from habitual behaviors takes effort. Good or bad, habits develop over a lifetime and there is no quick fix for changing habits. Forget the wive’s tale that it takes 21 days to form a new habit. It can but it’s not that simple.
We need to stop blaming excess weight on people not showing enough willpower. When it comes to diet and exercise, many of our habits and preferences are built very early in life. Building the right habits requires a step-by-step process of change. And changing established habits involves failure, loss of motivation and the need for re-engagement.
Slowly, it is possible to transition old habits to new ones.
We all have cognitive patterns related to food. But we may not be aware of how habitual our triggers, cravings and actions may be. Our brains like to conserve energy and habits help keep thinking efficient. Our habits help us literally turn our attention off.
“There are two ways you can disrupt a habit: change the physical environment or change your social environment,” says BJ Fogg. To navigate the newly changed environment, we need switch out of autopilot.
For example, if your old habit is a bowl of cereal every night during the commercial break of your favourite show, disrupt the ritual with some mental effort! Lock the cereal in a drawer with a combination lock or even a hard-to-reach shelf. You may find that you can wean yourself from this habit with time. Disrupting the habit repeatedly weakens its hold on you.
In BJ Fogg’s Tiny Habits approach, he recommends identifying a tiny new action that you want to habituate and chaining it to an established habit.
Let’s say I’m a person with Type 2 Diabetes who wants to introduce some strength training. Fogg recommends that I join up my new behavior (stretching a resistance band just one time) with an established habit like brushing my teeth. I commit to 1 band stretch after brushing my teeth. and brushing my teeth serves as a trigger for introducing this to my new routine. The key is to put the new behavior after the existing habit. The old habit becomes a trigger for the new habit. The habits become chained together. Over time, I will find that I am doing more stretches and will scale up from 1 to 10 in no time, but they key is to make the new habit as tiny as possible.
Framing the new habit with BJ Fogg’s structure, requires little motivation, because you are chaining new actions to the old:
After I [do the specific old habit], I will [do the new tiny habit].
After I brush my teeth, I will stretch the resistance band.
Ditch Willpower, Get Rid of Choice
Willpower is tiring. And so is choice. Being repeatedly confronted with choice makes it difficult to establish a habit. Think of changing your home environment to make it more boring, with only healthy choices. Don’t have the cereal in the house, let alone a selection of it and your 9pm snack will default to a healthy one.
Take an hour on Sunday to prepack a bundles of snack-sized health packs of veggies and a protein that you can pull out when snacking on the go, or in a moment of hunger or weakness. Do all your thinking once—when you make the snack packs. Be sure to include a few seeds and nuts, some lean chicken or fish, a hard-boiled egg or cube of cheese in each pack.
Track Emotional Triggers and Emotional Eating Patterns
Emotional eating can be triggered in unexpected ways. Learning to predict triggers and plan for them can be an empowering experience. For many people simple food tracking activities help them see that their planned meals are healthy, but they are off going off track, or worse, going into hiding (not tracking their food) as they binge. And those binges may begin to appear in predictable patterns that rest on triggers, times of day, hormonal and emotional states.
Lose Weight with a Curriculum of Habit Change
In a recent pilot of Picture It! Weight Loss, patients with Class III Obesity preparing for bariatric surgery worked through a curriculum of weight loss. Active users made up 60% of pilot participants. These patients used the application several times a day, in conjunction with treatment as usual, for twelve weeks. At the end of the twelve weeks, those who embraced the curriculum of habit change (the active users) showed that they lost 17.3 lbs vs. 7 lbs for patients in the control group.
The learnings from this pilot were rolled into a new Empower product, for Obesity.
The key design elements for a curriculum of habit change used in Ayogo’s Empower for Obesity include:
- Daily engagement for a period of 30–90 days
- Tiny actionable steps make up the curriculum of habit change
- Emphasis on forming new habits through chaining vs. stopping old habits using willpower
- Persuasive Design and Gamification elements to sustain patient engagement over time