Behaviour change is hard. Eating healthier, stopping smoking, starting to exercise, increasing your activity – living a more healthy lifestyle is really, really hard. But with Covid-19, we can change our behaviour relatively quickly. Hand washing suddenly becomes more important than it ever was. How can we adopt some of those behaviour change practices so quickly, when chronic condition behaviour change practices are so much more difficult?
I was having this discussion with Professor Grant Schofield the other day and we unearthed some interesting insights surrounding this. The first is, our perception of an infectious disease happening to us is vastly different than a chronic disease occurring sometime in the future. The time course of chronic disease is a much longer period of time. Covid-19 is on our doorstep. We could be doing the most day-to-day mundane tasks – shaking someone’s hand, going to the shops and touching a stair rail, then touching your face, and we could get infected. And it’s totally out of our control. Chronic disease, heart disease, diabetes, cancer – these are things that happen in the far distant future, far away. There’s a level of urgency that changes our framing of the disease.
With chronic disease, such as heart disease, diabetes and cancer, maybe there’s something that I can actively do, or stop doing. Possibly something that I’ve really enjoyed. I loved eating the Kentucky Fried Chicken, I loved drinking the red wine. It was fabulous. Our framing of the cost of what is required to get the disease is also vastly different.
“What is it going to take for me to be ready to invest in my health?”
When we put these two major factors together, what do we get? We get a scenario where people can, and do, change their behaviour because (1) the consequence of what’s going to happen is much, much sooner, and (2) the consequence of what’s going to happen is very relatable and perceivable. I can see people going into ICU. I don’t want to be one of those people. (3) The consequence of what’s going to happen is something that I can amend and it’s not worth the trade-off. For example, I can stay home. It’s not worth the trade-off of going out and potentially risking it. Whereas, do I want to trade-off all those delicious meals, junk food and alcohol? Maybe I don’t.
Exiting lockdown healthier
It’s fascinating to compare the psychological elements of Covid-19 versus chronic disease. I think there are a few insights that explain the difference in approach and why it’s so hard for people to improve their life in chronic disease. I’d like to share with you my personal journey through this period, related to living a healthy life and exiting lockdown healthier than I entered it.
I’m six foot two. I’m a big guy. I’m never going to be super skinny and lean. My whole life I’ve been yo-yoing up and down in weight – plus or minus 10 kilos for me is something that’s pretty easy to do.
I entered lockdown and I was actually sick with some respiratory symptoms. I thought it was unlikely to be Covid-19, but it was possible. During that period I didn’t feel very well, and it was easy to bring that junky type food into my diet. I reached a point where I weighed the most I ever have. But then I thought, “I don’t like this. I don’t like this sitting on my couch, being unwell, bending over, getting a bit short of breath, not feeling like myself”. And I knew that I needed to change something.
This is what I did:
- I clarified my strategy.
I’ve tried a variety of things – low-carb and keto diets, training for triathlons – that all worked in the short term, but I just couldn’t sustain it. So I reconsidered my strategy. Low-carb or keto overall just isn’t for me. I come from an Italian background. You know how much we love pasta? We love pasta lots. And I don’t want to give that up. Eating for me is a real cultural element. We love going to my Mum and Dad’s house and eating with the grandparents and cousins. That’s an important part of my life. But I know I’m prone to overeating. So I started tracking what I’m eating.
- I started moving.
As soon as my symptoms resolved, and I got the all-clear test result, I started going for walks. I found real joy in going for a walk in this slowed-down world. I’m embracing what is around me, enjoying the birds tweeting, enjoying the sunshine. I was able to go out and just explore with curiosity, something we teach in coaching. I’ve also hired a rowing machine that now sits in my house, and I’ll do a rowing sprint as part of my day
- I started to reflect on the source of nutrition that I’m eating.
I am a prolific restaurant eater. I love going out. I love the dining experience. But restaurants have been closed in Australia. I also love cooking, and I’ve tapped back into eating whole, nutritious and minimally processed foods.
All those things put together have given me the momentum to exit lockdown much, much healthier and better than I entered it.
I put almost four kilos on in that first period where I was a bit off the wagon. I’ve lost almost 10 kilos since.
I know the struggle and the effort involved in behaviour change because I’ve personally been there.
I have high blood pressure and high cholesterol. These are things that I’ve had for quite some time. They run in my family. And the best thing that I can do is to lose weight and be active.
Now, the question is, how are we going to maintain this healthy change? If you have started or kept up healthy behaviours in lockdown – well done! Cherish that. If you went through the lockdown period and you found it just too hard, and you’re exiting less healthy, now’s the time to ask yourself the question, “What is it going to take for me to be ready to invest in my health?”.
I’m so proud of myself in what I’ve done. I know I have a likelihood of relapsing back and I’ve implemented measures and got really clear about what I need to do to maintain it. For now, it’s feeling great.
We can change our framing of chronic disease by pursuing feeling as good as we can and living the most active life, versus fearing it or running away from it.