Doctors prescribe lifestyle changes for all sorts of health issues: a low-everything diet and thrice-weekly cardio to bring down cholesterol; lots of sardines and circuit training to temper multiple sclerosis symptoms; consistent sleep and 45 minutes of daily movement to help stave off depressive lows. Of course, actually making medically recommended changes is often easier said than done, and research suggests that, across the board, people only hit about half of their intended health goals. But while forming a new health habit takes discipline and focus, success isn’t only about willpower. The right perspective goes a long way when it comes to self-regulation, meaning the ability to commit to a new behavior.
It’s normal to hit rough patches in pursuit of health goals or have trouble finding the motivation to upend your day-to-day rhythms. Fortunately, health psychology research offers some practical strategies to help you follow through on your doctor’s orders.
Get involved in your care
Getting a diagnosis or any less-than-ideal medical news can disrupt your sense of control over your own well-being. When you feel like your health is spiraling, it can help to focus on things you do have a say in, such as your treatment plan. Research shows that patient autonomy, the ability to choose health pursuits that align with your personal values, can increase engagement with healthy behaviors and resilience against temptations. If you feel a sense of ownership over the goal you’re trying to hit, you’ll be more motivated to get there. Researchers say self-knowledge, or an awareness of your goals and personal values, is the first step in asserting autonomy.
Let’s say that your doctor recommends a diet overhaul on account of your rising cholesterol and family history of heart disease. Then the doctor hands you a list of eating rules and bland, heart-healthy recipes that don’t appeal to you. You shouldn’t just say thanks and take off. Instead, talk to the doctor about the nutritional principles behind the diet and come up with a way to make it work for you. Is scouting out a farmer’s market for seasonal veggies your idea of a fun Saturday morning? Would a meal-planning service work best with your schedule?
But autonomy is a two-way street. Self-knowledge won’t do you much good unless your doctor is open to your involvement. Seek out a provider who not only listens to your questions and concerns but also wants to hear your perspective. To ensure a sense of autonomy with your practitioner, don’t be afraid to ask questions.
“For choice to be truly autonomous, patients must adequately understand the choice options and their potential consequences,” says Danielle Cosme, a psychology doctoral student at the University of Oregon. “Patients can increase their autonomy by stating explicitly to medical practitioners when they don’t fully understand care options, and by requesting additional information necessary to make decisions in line with their treatment goals.”
Be kind to yourself
Even the most regimented health fanatics face setbacks. If you view a missed workout or a diet slip-up as a failure, you’ll be more likely to drop the routine altogether. Rather than beat yourself up for a perceived defeat, cut yourself some slack and move on. Adopting a gentler approach toward self-discipline, one study found, can save you from becoming overwhelmed and make it easier to regulate your emotions and behavior — which gives you more time and energy for healthy choices later on. Unsurprisingly, the study found a compassionate approach toward goal adherence to be especially beneficial for those with perfectionist tendencies.
“Instead of ruminating on perceived failures, isolating oneself and beating oneself up, individuals will identify the setback with compassion and move forward with the exercise or nutrition plan,” says study coauthor Duke Biber, an assistant professor of sport management, wellness and physical education at the University of West Georgia.
In practice, what does it mean to show yourself compassion? Treat yourself how you’d treat a friend in your situation. Chances are you wouldn’t punish your loved ones for getting derailed. You’d simply remind them of their progress and encourage them to keep at it.
To incorporate self-compassion into a health routine, start by monitoring your self-talk. Biber says awareness of how you speak to yourself during challenging moments can help you sub out negative thoughts for more positive, motivating messages. He also recommends writing a compassionate letter to yourself that lists the goals you want to achieve in the future. “This practice,” he says, “will help you create a ‘healthy identity,’ as well as learn to overcome setbacks with compassion.”
Make it fun
Let’s face it: Taking on a healthy habit (or swearing off an unhealthy one) typically isn’t a rollicking good time. But allowing the process to be a bit more enjoyable can boost your odds of making a good-for-you habit stick.
In a 2014 study, Katherine Milkman, a behavioral scientist at the University of Pennsylvania, ran an experiment to test the impact of instant gratification on exercise motivation. When study participants were allowed to listen to a page-turning audiobook (think The Hunger Games or The Da Vinci Code) during gym sessions, they were far more likely to hit the gym frequently.
Milkman calls this concept “temptation bundling,” and she says it can promote adherence to healthy habits. The key is to only let yourself give in to the temptation while you’re practicing the new habit, she says: “That way, you’ll do it more often.”
While her study focused on gym attendance, Milkman says pairing other healthy behaviors with small treats could be just as effective. “You could schedule a weekly date with a friend to get salads for lunch, and don’t let yourself hang out with that friend for a meal unless you’re eating there,” she says. “If you want to eat more healthy, home-cooked meals and less gluttonous takeout, you could only let yourself enjoy your favorite podcast while cooking fresh and healthy foods.”
Lose control once in a while
Discipline is obviously beneficial to habit formation, but overly black-and-white thinking might not be. That’s why all-or-nothing crash diets tend to fail. To develop habits that stay with you for the long haul, go ahead and let yourself cheat every now and then.
A psychological theory called ego depletion says that self-control is a limited resource. Your ability to self-regulate behavior weakens with overuse, just like a muscle. If you resist the same urge repeatedly, your craving will grow as your willpower muscle tires out. And you’ll end up giving in later on, in a much bigger way than you would have 10 self-denials ago. While ego depletion has received some pushback in recent years, it’s the foundation of a lot of research on willpower.
For instance, if you’re trying to rein in your erratic sleep schedule, that doesn’t mean you need to decline every invitation for a night out. Instead, allow yourself to break your self-imposed curfew once a week. By giving yourself room to indulge, you’re saving your self-control for when the urge is strongest and hardest to resist — and setting yourself up for a longer-term commitment to healthy sleep.
Focus on the right rewards
When you’re working hard to achieve a health goal, it’s easy to think about superficial benefits, like how great you’ll look after a few months of daily runs. But focusing on inward improvement will get you further.
When it comes to promoting healthy behaviors, there are two kinds of rewards: hedonia (H-rewards) and eudaimonia (E-rewards). H-rewards are more concrete and surface-level, like losing weight to improve your appearance. E-rewards provide a sense of meaning by contributing to your overall sense of well-being. Dr. Srini Pillay, a psychiatrist and professor at Harvard Medical School, says these deeper, longer-lasting rewards make for more motivating, sustainable goals.
For example, if your physician suggests upping your cardio, focus on the long-term benefits of improved cardiovascular health rather than dropping a pants size. This can be hard to do, but internal goals are the strongest agents of positive change.