Supporting Behaviour Change – the Engine Room of Lifestyle Medicine

“Knowledge is Power” goes the saying, often attributed to the 17th century Philosopher and Scientist Sir Francis Bacon (who some people hold is also the author of Shakespeare’s works – another story…). To that I would add the words of the American Professor Emeritus of Political Science, Francis A Beer (you read that right – bacon and beer) “Power without Purpose is Pointless”.

So by logical extension “Knowledge without purpose is pointless”.

This is the dilemma we often find ourselves in as health practitioners - armed to the back teeth with knowledge of the ingredients of great mind and body health – nutrition, exercise, sleep, social support, stress management, tobacco avoidance, alcohol moderation. We’re ready to share that knowledge gladly, yet sometimes feel like our patients just don’t get it. Let’s be clear here – if knowledge were all that was necessary, our rooms wouldn’t be filled with people unhappy about their health and feeling unable to change the course of it.

Evidence based lifestyle medicine has come a long way in a short time – we know that thoughtfully applied, evidence based lifestyle modification prescriptions have the power to manage and reverse a number of lifestyle diseases and significantly cut risks for the development of others. If you want to review some of the evidence yourself, take a look at this page, on the website of the American College of Lifestyle Medicine.

So how can it be that with all this information, all this knowledge, all this evidence, we’re still seeing so many people affected by illness and disease that need not be present? The answer, in part, I think lies in what I consider to be the Engine Room of Lifestyle Medicine – supporting health behaviour change.  Having the knowledge that something can be different is vital – that creates the capacity to imagine a different life. But the desire to make that change – the purpose behind making a change is what brings that imagined life into being.

In my experience, a fruitful approach is to begin exploring the person’s motivation to change. Find out from your patient an answer to the question: “WIIFM?” (What’s in it for me?). These responses begin to reach into purpose and drive and are always the bedrock of behavioural change. Without them, any behavioural change is at best “going through the motions” and likely transient, or at worst, never gets off the ground.

Making the time to explore this in detail can pose a challenge in practice, particularly if you’re also attending to other matters for your patient, so referral to a Health Coach or Psychologist would be useful. But the truth is that even small interventions can plant the seed of change and have a significant effect over time. Useful interventions can be as simple as asking:

“What’s the thing that would change most in your life if you stopped smoking/reduced alcohol/lost weight/etc?” or

 “Outside of you, who would be most positively impacted by you stopping smoking/etc?” (this builds on the relational and participatory aspects of behavior change) or

“What’s your vision for your own health and wellness a year from now?”

Any of these inquiries can energise the process of a person identifying “WIIFM” and connecting with their own dreams, drives, motivators and purpose.

Knowledge without Purpose is Pointless, but

Knowledge with Purpose is Phenomenal.