from fat to fit: one step at a time


A doctor’s journey from fat to fit: Taking one stage at a time

I've made many positive changes on my journey to better health; however, these changes haven't come without some serious growing pains. Almost no one is capable of long lasting behavior change without a few step backs, including me!  

Lately, I've been thinking about an experiment I took part in during medical school. We were asked to change one behavior for one month and write about our progress. The point was to highlight how difficult it is to break bad habits and institute new behaviors. The experiment was designed to help us med students understand what we will be asking of our patients when we talk about lifestyle changes, like quitting smoking, taking a medication or losing weight. My behavior change was to floss daily, and I think I made it through a week before skipping a night when I felt too tired to care about flossing.   

There is a model of behavior change theorizing that all people are in one of the five stages of change at any given time. These five stages are:

  1. precontemplation (not ready)
  2. contemplation (getting ready)
  3. preparation (ready)
  4. action
  5. maintenance

I'm currently working my way through these five phases. In precontemplation, the change is often something you've dealt with before and you actively avoid thinking about it. Up until now, I had been actively avoiding my weight, nutrition and stress level for years. Contemplation begins when something piques your interest and gets you thinking about the change you might want to make. For me, my unhappiness with my weight and fitness level piqued when I went down-hill skiing in Montana and had trouble keeping up with my family and friends.   

My preparation phase had me setting aside time to exercise, buying a pair of new sneakers, getting a body composition analysis, researching meal planning ideas and meeting with a nutritionist. The action phase is the most difficult phase and where I currently am: going to the gym, using my sneakers and preparing healthy meals. Once an action or change has been implemented for six months, you move in the maintenance phase. This is where I will cross my fingers and toes and do my best not to fall right back into my old habits.  

I've already hit a few bumps. I sprained my left foot and I have had knee and low back pain that I can easily attribute to working out with an extra 40 pounds on my frame. I also got sick and went right back to my bad food choices of processed sugars and chips as a way to cope with not feeling well. I felt pretty demoralized after consuming that junk, but I reminded myself that I am human and I make mistakes. I'm doing my best to change my negative self-talk into something positive and effective rather than being so hard on myself.

Toward the end of my medical school experiment on behavior changes, we discussed how almost everyone relapses back into bad habits. For example, research has shown that smokers attempting to quit went through the action and maintenance stages at least three times before successfully quitting. I'm continuously reminding myself of this lately—that sometimes the best I can do is to aim for the positive and learn from my mistakes.


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