Take a 20 Year Wellness Challenge

It is currently something of a trend for wellness programs to offer a "20 day challenge" for people to change their lives in healthy ways. This is a great idea, as far as it goes. Twenty days is usually a manageable commitment if you (or your patients, if you're a medical provider) are trying to make a healthy lifestyle change. It gives you a chance to get used to a new routine of healthy eating and exercise, and your success can lead you to start believing that healthy lifestyle changes are actually possible.

Completing a 20 day challenge may also give you a chance to start seeing the benefits of your new wellness program - perhaps the loss of a few pounds, some additional energy, better sleep, better stamina, and fewer aches and pains. You may also like what you're starting to see in the mirror!

But what happens after the 20 days is over? Sure, you're likely to continue with the wellness program, at least for a time, and you'll receive encouragement to do so from the wellness program's staff and the other participants in the program who've stayed with it. Unfortunately, as you've probably experienced, the changes don't always stick.

I worked with patients in two major cardiac rehab programs for 14 years. Those programs were staffed with highly trained professionals: exercise physiologists, dietitians, diabetes experts, and others. The programs also had what we thought were strongly motivated participants, cardiac patients who'd been told that their very lives were at risk if they didn't change their lifestyle.

I wish I could say we had better long-term results than we did. Despite the expertise of the staff and the initial effectiveness of our lifestyle interventions, the percentage of heart patients who continued to maintain their new lifestyle changes after the rehab program ended was abysmal. If you look at the nationwide numbers, just one year following rehab, only 25-40% of former cardiac patients continue with even a single healthy lifestyle change they made during rehab, let alone the multiple lifestyle changes that are usually recommended to maintain optimal cardiac health.

Which eventually lead me to think that we needed to do something very different to help people make healthy lifestyle changes that mattered. But what? How can you engage in (or help your patients engage in) healthy lifestyle changes that really make a difference to your long-term health?

We can find clues to at least part of the answer in other areas of our lives. When we value something enough, we're often willing to make a long-term commitment to it and make profound changes in how we live. When we care about something (or someone) that truly matters to us, we're willing to go back to school, embark on a new career, change jobs, sign a 30-year mortgage, get married, or have children.

We won't make such changes when we're motivated by things we care about only in the short-term. We won't make a long-term change just because we've explored something that's new and superficially interesting for a few weeks, or because other people around us are excited about it and want us to do it, or even because we're afraid of what might happen if we don't do it. The evidence from cardiac rehab patients - who were motivated by all those things - is all too clear.

So as a place to start a wellness program, for yourself or for others you work with professionally, I'd suggest that you try to understand why you or your patients would genuinely want to make a lifestyle change, and not get caught up so much in the superficial attractiveness of what you can change that's new, different, or profitable for some wellness company.

Focus on what genuinely matters to you. Why would you want to live longer and be more healthy? This is not an easy question to answer - or at least, it shouldn't be. The answer needs to be important enough to motivate you to make substantial changes in some of your most personal and difficult to change habits (what you eat, how active you are, how you handle stress, and so on). You wouldn't get married to someone unless you were truly ready to get married and you knew your potential partner well, and you shouldn't figure on making a major healthy lifestyle change unless you have deep personal reasons to change, are ready to do so, and know what you're getting into.
Let your behavior line up with what matters. Motivational Interviewing experts suggest that we "develop discrepancy" between what we truly value and our problematic behavior. If we see clearly that what we do isn't in line with what we care most about, we're more likely to change what we're doing. And because what we care about is usually a value that we will continue to hold for the long term, we're more likely to sustain behaviors that are in line with that value.
Change in ways you can live with. There are hundreds of ways to eat a healthy diet, and dozens of ways to exercise and manage stress. If you truly want to live longer or healthier, do it in a way you can live with and enjoy. That may mean trying different options to find healthy foods and activities you genuinely like, or developing new skills such as learning to cook. It might even mean taking a "20 day challenge" to find out whether you like a particular way of being healthier!

To make the most of a 20 day challenge, think of it as a tool in service to a genuine long-term commitment to wellness that you've already made. Otherwise, as interesting as that 20 day challenge might be, after it's over you'll likely end up struggling (and failing) to do something you were never really committed to do in the first place.

The bottom line is that maintaining a healthy lifestyle is more like a "20 year challenge" that first involves determining whether you have a strong personal reason to care about your health. Not everyone does - and that's maybe hard to hear for those of us who would like to help everyone become more healthy. But if you do have a reason to be healthy that truly matters to you, you have a solid foundation for sustaining a long-term healthy lifestyle.

Take it easy,
Albert Bellg

Albert Bellg

I've been a writer most of my life - a poet, corporate speechwriter, academic writer, and author - and I'm glad to share with you some of the things I've written.

Introduction to Living the Deepest Truth You Know
May, 2020

Simply Mindful: A Daily Practice to Reclaim Your Life
April 2019

Listening to Life Stories: A New Approach to Stress Intervention in Health Care
June, 2014

Take a 20 Year Wellness Challenge
November, 2013