Disclaimer

This blog is an accounting of my personal journey to find fitness. All the content on this blog should be read as a biographical piece of literature, not a medical resource. I am a physician, but I am in no way giving medical advice or establishing doctor patient relationships with my readers. I am simply keeping a diary. If you are starting a diet or exercise program or require medical evaluation or advice, please see your own family physician.

Wednesday, January 26, 2011

What stage are you?

I had a great day today, despite being super sore. My arms are killing me, especially my triceps. But, on the bright side, the touch of tendinitis I still have in my elbow is hardly noticeable in comparison. Today was good overall. I didn't exercise today except to practice my TKD as I do plan to test again on Friday. The kids are pysched up to see Mom break her first board.

 I ate well today. For breakfast I had egg white on toast sandwich and a pear. For lunch I had a chicken breast with green beans. For dinner I had a small bowl of beef stew Nanny made and fresh veggies on the side-carrots, celery, bell pepers, grape tomatoes.  Sometimes I just don't want an actual "salad".  My calories are 1203. I drank 96 oz of water, my coffee and a diet DP. So plenty of fluids.

 Lately I've run into a lot of patients in the office wanting to make lifestyle changes.  New Year and all that. And then there are those that just aren't ready. These people are smokers, bad eaters, overweight, drinkers, but aren't going to quit anytime soon.  Believe it or not there is a label for this. PRE-contemplation.  These people don't bother me. Some doctors get irritated when the Smoker of 20 years says he's not quitting or when the morbidly obese patient says they hate exercise and they aren't doing it. Not me. I just smile. I remind the patient that it's my job to tell them they could die if they don't, document that I said that and move on.


The next stage of change is Contemplation. These are the people that know they need to change, but aren't ready to commit.  They know smoking causes cancer and it isn't good. They know they need to lose weight and exercise, but they aren't really serious about it. These are the people that are more frustrating for me. It's like I tell them they are standing in a fire and their pants are starting to burn, but they just are so happy being warm, they don't want to move yet. I don't get that.


But people who are constantly stuck in the preparation stage are the saddest ones. These are the people that know they need to lose weight. They make plans about it. Buy a cookbook. Join a gym. Get the newest DVD.  They've tried before. Each time they join a new program or method, but they never REALLY do what they intend to. This was me for a long time.  I joined a gym in college. I joined a gym about 5years ago. I went, like twice and quit. Payed for it though. Lots. I've got cookbooks, DVDs, equipment. And it sat there for years gathering dust.  These people think they are making a change. They think they are doing something, but really they aren't. They're spinning wheels. All talk and planning and lists, no actually doing it.


The really exciting thing as a physician is to see someone make the shift from preparation to action. Sometimes patients DO listen!  When you counsel them to quit smoking, how to do it and next thing you know, they've done it. That's really one of the best parts of my job. Seeing someone succeed in making their health better.  I am so glad to be in the ACTION stage. It doesn't mean I'm perfect. It doesn't mean I don't slip up, but it DOES mean that I am REALLY doing something. I am heading toward my goal which is the final stage- maintenance.


We all think of maintenance as the time when you are in this state of bliss and goal weight heaven. But, the definition of this stage is a time when you work to prevent relapse. In maintenance, you are solidifying the habits you developed in the action stage. You are constantly looking for ways to continue the healthy habits. People in this stage remind themselves on how far they've come, but they know they could relapse into bad habits. They are able to anticipate situations where they might be tempted back to it and make adjustments to avoid their old behaviors.


Wow. Just typing that made me realize how much work maintenance is. It isn't a time when all your problems are "done", but a time that while you are happy with what you've done, you realize you have to be on guard for falling back into your old habits.  So really, it's never over. And talking to people in maintenance I know it to be true. I also know that the longer you do healthy things, the easier it gets. The easier it is to maintain. So while it is discouraging at times to think about always having to be on guard about my weight, it is exciting to know that practice makes perfect. The more I practice my healthy lifestyle, the more natural it will feel to me.


So which stage are you in? Are you in ACTION or are you spinning wheels? Have you reached maintenance?  No matter which stage you're in, what lessons have you learned lately that are helping you?

16 comments:

  1. I'm totally in action. I remember being in my doctors' office a year ago telling her that I was going to start getting healthy because I knew I needed to be heathly and I was getting to the age when things start to go wrong...and I don't want to have to take pills to regulate my body. I hate taking pills.

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  2. Dr F2F: Very useful post to remind us all of decision stages. Thaanks!

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  3. I've been stuck in the "preparation stage" for about 20 years and just stepping into the "action stage". I would say I am about ankle deep in the action stage. I am starting to make the changes that are needed to turn my health around but by my actions and how slow I am to change my ways I can tell that I haven't fully committed. I want to. I want to desperately and am trying. I just need to do. My heart is there but I am still working on the mind.

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  4. Thinking about the Stage Deli here in NYC for a pastrami sandwich...

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  5. I'm in the maintenance stage. And yes it's hard! I'm constantly worried that I'll "relapse," and I worry that my habits aren't strong enough.

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  6. Gosh, amazing how synchronous thoughts are sometimes in the world. Just last week I stumbled across this very thing! Yes - I am one of those stuck in preparation. I know what to do, yet I'm still not doing it all out.

    I do take comfort in looking back though at how I was a few years ago in eating & behaviour habits and how much I have improved in those. Giving up smoking is a Biggie and I am SO proud of that. :) That came about by finally getting totally fed up with smelling bad and worrying about passive smoking effects on my beloved pets. My ignite moment.

    And pulling myself out of depression is another. That has taken several years too, to rebuild my confidence in my sense of self. I guess, when my 'preparation' reaches critical mass, it will ignite in my head, just like I did to achieve those two things. In the meantime, I'm just going to keep in making small, small changes like I've been doing, and keeping happy.

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  7. As a yo-yo dieter, I've never managed to maintain. I have to figure out what it is that keeps me regaining. Sigh.

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  8. I'm probably, technically, blending back and forth from action to maintenance..I've lost and kept off over a 100 lbs for 1 yr +, but I still have more weight to lose and have to be diligent and in ACTIVE mode to do that...gets harder to lose once you've lost a bunch

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  9. With only 20 pounds left to lose and the ability to eat within my calorie range without really having to count the calories, I think I'm at the beginning of maintenance. I still have weight to lose but the actions are there and I am making them into lifelong habits.

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  10. There is an important stage to remember: RELAPSE. We all relapse but then we recycle, hopefully better prepared to enter back into the action stage; better educated as to what let us to stumble; what it will take to keep us in maintenance (whatever behavior change). Relapse and recycling are normal. Eventually one does get to maintenance - but it is much harder for eating behaviors than something like smoking, which you can live without. (Professional and personal opinion.)

    I am still deep in action for physical activity and eating behaviors but planning ahead for maintenance.

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  11. Some good eats on your eats today, yum. In action myself. The intensity of which I an in action varies from day to day. Makes me wonder what maintenance will be like when I do get there. How much wavering in that phase can i endure and not fall backwards I wonder?

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  12. I like how you're doing with your eating. I've had a good start, a week and a half in, but it's not any easier yet. I'll get there tho! Cheers, Rick

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  13. I wavered between contemplation and preparation for years with one successful trip into action before slipping way back. I am now fully in the action stage (just since the first of the year) and loving where I am at! I have a long way before maintenance, but I will get there.

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  14. Fantastic post. Very thoughtful. I am in maintenance mode. The food part gets easier, becomes habit but the emotional desire to feed my fears is still there. I don't know if that will ever go away completely. Hope so.

    Dr Phil says that weight is managed, not cured. I like that, it keeps me on my toes.

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  15. In ACTION, DOC! And it feels great. I am with you and was in that prep limbo for years. But not any more! Love the post. Love it! Have a great weekend! Michele

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  16. I was in ACTION for a long while there but somehow ended up in complete inaction.

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