Tuesday, January 3, 2012

The Stages of Change and Weight Loss



Continuing the thread from last week, the average person in the US dies sooner than the average person in forty-nine other nations of the world.  Our higher death rates are linked to our astounding rates of overweight and obesity.  People with severe mental illness die even earlier, 15-25 years earlier.  We have the same life span as the people of Sudan.  The same things kill us as kill everybody else, heart disease, stroke, diabetes, cancer.  They just kill us sooner, because even more of us are overweight and obese.

Side bar: I have growing difficulty using the term mental illness, because I think the term leads to an artificial bifurcation of mental and physical illness.  The weight issue is a case in point.  Most psychiatrists accept the biological model of mental illness, that our diseases are brain diseases.  Nevertheless, most consider the physical aspects as outside their purview.  As a consequence, the part of our disease that is going to kill us does not get treatment.

Weight issues are a case in point.  Psychiatrists hand us prescriptions for medications that cause ballooning weight gain and off the chart cholesterol levels along with the pro forma reminder that we won't gain weight if we don't eat more than we expend in energy.  So all we have to do is eat less and exercise more.

This kind of help doesn't help anybody, regardless of mental status.  Here, as in any other aspect of our recovery, we are on our own.

Weight Loss Programs - Hah!

The temptation is to buy the promises of the commercials that flood the airwaves each New Year.  Here is the deal.  These promises are less verifiable than the ethically-compromised promises of your medications.  But what studies that have been done indicate a relapse rate of at least 50% weight regained within a year or two.

Bottom line, diets don't work.  You have to change your life.  And to change your life, you have to change your brain.

Luckily, you can change your brain.  You just have to understand how.  You have to take the time that it takes.  But you can change your brain.

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From Thursday, June 30, 2011 and edited a bit: 

Habit and the Stages of Change



I have been writing for several weeks now [June, 2010] about this mass of electrical activity inside our brains, dendrites and nerve endings, meeting at synapses, passing their spark from one neuron to the next, creating -- what?  A wink, a whisper, a sensation, the next big brainstorm.

Most of these connections could be called, in the widest sense, habits.  By habits, I mean that pathways get used over and over, form patterns, become familiar, channel us to certain outcomes.  Most bypass the frontal cortex, requiring no thought.  Like breathing, smelling, salivating at the cinnamon.
 
Most of the remainder are still automatic.  But with effort, they can be brought to consciousness where the frontal cortex could interfere, and a decision made.  Like blinking.  Or picking up the cookie somebody brought to the meeting.

What if you don't want to pick up the cookie?  Okay, you really do want to pick up the cookie.  What if you want to not pick up the cookie anyway? 

How Do You Change A Habit?



You're gonna take more than one step.

Last week, I put some numbers out there, the Wahls diet.  Nine cups a day of vegetables and fruits.  I broke it down for you: 3 cups leafy greens, 3 cups cruciferous veggies, 3 cups intensely colored.

This food plan helped Dr. Terry Wahls reverse her secondary progressive MS and get up out of her wheelchair.  It could help you reduce your symptoms of heart disease, lung disease, asthma, hypertension, depression, obesity, bipolar disorder, diabetes, Alzheimer's or Parkinson's.

If you have, or are tending toward any of these chronic diseases, you have already heard your doctor/mother/spouse tell you that you need to improve your diet.  Dr. Wahl's book, Minding My Mitochondria tells you just how much and why. 

Nine cups a day of vegetables and fruits:

3 cups leafy greens
3 cups cruciferous veggies
3 cups intensely colored

Stages Of Change 

So there is your canyon.  Here are the steps, more than one.  Several, in fact.  The steps are known as the Stages of Change.




The Stages of Change model appears all over the place lately.  This article from the journal American Family Physician uses the Stages to help physicians help their patients, something more effective than Just do it.  A Youtube search yields results for addiction recovery counselors, life coach trainers, weight loss clinics.

Different sites number the stages differently.  Some say Precontemplation is Stage 0.  Some give Relapse its own number.  Some add Transcendence, whatever that is -- said the priest who gets cynical when quasi-religious language gets used for the purposes of self-improvement.  Whatever we are supposed to transcend, evidently it is not our desire to improve ourselves. -- But I digress.

I like this site, which is the source of the graphic above, even if the author does use that word Transcendence that made me twitchy there for a minute before I got back on track.  It works through the stages from the perspective of the person who is making the change, not the person who wants somebody else to change. 

Crossing Canyons/Building Bridges In My Brain 

Dr. Wahls calls it a diet.  I don't diet.  Who wants to DIE-t?   Each chocolate chip cookie left on the plate represents a little death.  A diet is a temporary interruption.  When it ends, you go back to your life.  But there is nothing temporary about the nutritional needs of my mitochondria, without whom there would be no life.

I'm into changing my brain.  In that mass of electrical wiring, some potentially healthy pathways are blocked by the detritus of dead dendrites.  Other destructive pathways are carved into canyons of well-worn automatic responses. 

Changing my brain will take time.  It is taking decades.  It will take at least another blogpost. 

And The Word Became Flesh 

Question: What do the Stages of Change have to do with Prozac Monologues? 

Answer: Words.  The Stages of Change use language to shape the brain.


Language is one kind of pathway from neuron to neuron.  It connects electrical impulses from the autonomic systems, the olfactory nerve, the amygdala, through the hippocampus (memory and emotion) and the anterior cingulate cortex (pattern seeking) and into the frontal cortex (conscious thought).


Language is how all this electrical activity gets turned into meaning.  It is where the brain and the mind become one. 

The Stages of Change include a process of changing our patterned thinking about food.  And thinking is how we move from one stage to the next. 

Dr. Wahls writes about synergy, how exercise and diet work together to heal her myelin and reduce the symptoms of her MS.  I'm thinking the same process works for changing habits, particularly food habits.  Each new behavior reinforces the preceding thought that moved you to the new stage.  That repeated behavior patterns the thought that will move you to the next stage. 

Meanwhile, what you are eating while you are trying to make any change matters.  Your mitochondria need the right materials to build the dendrites that form the new pathways.  Like lunch for the road crew.

So don't try to skip stages.  And don't skip broccoli.

One of these days I will write my own food autobiography, my trip through these stages.

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Back to New Year's, 2012 

Pre-Contemplation 

The good news is, you have already moved past Stage One, Pre-Contemplation.  I presume you have moved past Stage One.  Pre-Contemplation is when you don't really think you have a problem. And why would you still be reading this post if it wasn't your problem?  So you have already made progress! 

Contemplation 

But don't try to jump that canyon.  Don't go from I have a problem to New Year's Resolution: no more cookies.  It is January 3rd, and that resolution is probably already in the toilet.  We are not talking about the New Year here.  We are talking about your life.

One step at a time.  Make a list.  Make it as long as you can.  Why do you want to change?  What difference would this change make in your life?  Go deep here.  Screw those little graphics with the magically shrinking ladies that show up in your Facebook sidebar.  What is at stake for you?  This is no longer a game.

Read that list every day.  That will help the re-patterning process.

That is enough for this week.  You have homework to do.  I have my life to get back to.

Happy New Year!  Happy Long Life!


No New Year's Resolutions - Change Your Life December 29, 2011 -- Overweight is a major health issue, the largest contributing factor to early death for people who have mental illness.
My Food Autobiography and the Stages of Change March 8, 2012 -- Pre-contemplation and contemplation.
Changing Food Habits -- Contemplation and Preparation March 15, 2012 -- Reviews The End of Overeating by David Kessler and introduces the brain science of the sugar/salt/fat trifecta.
Dopamine -- Can't Live Without It March 23, 2012 -- The brain science behind habit formation and an experiment to try.
Relapse/Maintenance -- Stages of Change May 24, 2012 -- Review and finishing up the series.



photo of salmon in Ketchikan Creek by Wknight94 and used under the terms of the GNU Free Documentation License 
photo of Women Working at a Bell Telephone Switchboard from the National Archives and Records Administration and in the public domain
photos of Hatherton Canal in Staffordshire by Roger Kidd, Coal Creek Falls by Walter Siegmund, Glen Canyon by Sascha BrückJeff Kubina used under the Creative Commons Attribution-Share Alike 3.0 Unported license.
Stages of Change graphic was created by Todd Atkins, who placed it in the public domain

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