As you’ve probably experienced or at least witnessed, it’s hard to change bad health habits. Yes, some people manage to keep their health-related New Year’s resolutions or one day simply decide that from now on they will, for instance, drink less alcohol (or stop altogether), cease being a couch potato, or eat vegetables instead of junk food—and they just do it, never backsliding. Every year millions do manage to quit smoking, for example, or lose lots of weight and keep most of it off.
But such success stories are in the minority. Most attempts at behavior change fail sooner or later, and many people struggle for years to change, with or without professional help.
Why do some succeed and others fail? Are there ways to improve your chances? How do people transition from being “not ready” to “getting ready” to finally “ready to change”? Many behavioral psychologists and other experts have tried to answer such questions.
One well-known researcher in this field is James Prochaska, PhD, professor of psychology at the University of Rhode Island, who more than 30 years ago first explained the process of change as five stages, described below. Some studies have found, for instance, that people coached in this “stages of change” approach improved their odds of quitting smoking, eating more healthfully, or complying with medication or other treatment for various chronic diseases.
The five stages of change
Simply put, Prochaska’s main point is that changing behavior is not an event but a process. His stages make the process sound orderly, but it’s often messy. Some people progress steadily from stage to stage, but many others stall at one stage or slide back to earlier stages several times before they finally succeed.
1. Precontemplation. Unfortunately, many people never get further than this stage. For example, you may vaguely know that it’s unhealthy to be obese but you don’t think about actually cutting calories. You may feel fatalistic or hopeless or simply deny that you have a problem. If you do attempt to take action, it may be because your family or friends push you to do it, but your heart isn’t in it.
2. Contemplation. You accept the fact that you have a problem and need to change. You may have some ideas or indefinite plans to take action in the next few months and perhaps even do some research, but you aren’t really committed to taking action. Still, you have turned the first corner. You are more aware of how your bad habit is harming your health and interfering with your life. You may be inspired by a friend who has successfully changed. You make a mental list of the benefits that would accrue if you made changes, too. You also start believing that you can make the change, even visualizing the new you.
3. Preparation. You start planning a specific course of action and may set a date (not too far off) to start. Your belief in your ability to make the change becomes stronger; you may tell your family and friends about it. If your goal is to exercise more, you may buy a gym membership and new athletic shoes or talk with friends about joining them for daily exercise.
4. Action. You walk the walk. You start eating at least five fruit and vegetable servings a day. You read food labels, shop for groceries more strategically, learn to cook healthier meals, keep only healthy snacks around. You go only to restaurants that offer healthy foods; you quit the clean plate club and start taking extra food home. You stop buying or bumming cigarettes, perhaps using nicotine patches or gum. You may well slip back into your bad habit, but you remind yourself that most people who have successfully changed also suffered relapses. This isn’t failure, provided you get back on track again.
5. Maintenance. This is often the most difficult stage. It may take months or even years, but your new healthy habit has become firmly embedded. Your old cravings occur less and less frequently, and you’re better able to resist them. Junk food may actually not taste good any more. You’ve learned to like exercise. You have strategies to avoid and deal with temptations and relapses, but if you do slip up, you have the recovery skills gained from the previous stages. For many people, this is the final stage, where they remain for the rest of their lives. But Prochaska has added a sixth stage, called Termination, for the few who are no longer tempted by their old habits and don’t need to fear relapsing.
7 Ways to Set Good Health Habits
Whether it's quitting smoking, eating better, exercising more, or another healthy goal, behavior change is hard and can take awhile to achieve. These tips will help you stay on course.
Published October 3, 2015