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home : columns : ask the doctors June 16, 2019

3/1/2019 7:58:00 AM
Be practical when tackling major lifestyle changes

Dear Doctor: After the new year, I started making some serious lifestyle changes, including losing weight and quitting smoking. It's not my first time around, so I hope you have advice to stay motivated. I really don't want to be making these same resolutions next year.

Dear Reader: As we've all learned by now, there's a world of difference between knowing what's best for us and actually doing it in real life. One of the reasons making changes can be so challenging is that even a seemingly simple goal involves altering our behavior -- and our thinking -- on multiple fronts.

Before you begin, we think it's important to fully understand your goals. Let's begin with your resolution to quit smoking. Start with understanding why you're going to make this change. If the answer is for better health, go a bit deeper and make a list of all the ways that smoking makes you feel bad. Are you short of breath? Is it hard to run (or even quickly walk) a short distance? Do you get winded going up a flight of stairs? Maybe you start the day coughing? On the social side of things, perhaps you're sensitive to how your clothes or hair or car smell, how your family and friends respond to your being a smoker, or to the financial cost of your habit.

Once you've written your list -- and we urge you to be as complete, detailed and honest as possible -- you've taken a significant step toward understanding what's at stake as you go about making this change. Where before all you had was the command "quit smoking," you now have a multifaceted understanding of the different ways this habit affects your life. You have imbued your goal to quit with depth and personal meaning. That's important because when you're struggling through the inevitable rough patches that we all go through when making a lifestyle change, you now have multiple toeholds to help stop the fall.

Another element of successful change is setting reasonable interim goals. Sure, the endpoint is zero cigarettes. But two or three fewer cigarettes per day or week, depending on your habit, is definitely a success. The same goes for weight loss. Lose just 5 ounces per week and by the time the next New Year's Eve rolls around, you're down 16-plus pounds. Taking the long view in reaching your goals will make it easier (and far less painful) to integrate ongoing changes into your daily life.

A final note: In your letter you refer to "some" serious lifestyle changes, indicating you've set more than just the goals of quitting smoking and weight loss. If so, you've added a significant level of difficulty. We think it would be wise to prioritize those changes and work toward them sequentially rather than all at once. Pick the goal that's most important. When you feel solidly on the road to success with it, then tackle the next one. That way you've got a better chance of crossing at least one or two of the goals off your list of resolutions, rather than feeling overwhelmed and giving up on all of them.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.

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