Yo-yo dieting, smoothies, zumba, keto, crossfit...
Have you ever thought you’ve found the thing that is finally going to help you get on top of your weight, only for that enthusiasm to burn out after a few weeks or months as you fall back into old habits?
You’re not the only one!
But why can't you make any of these changes stick?
The Stages of Change Model could be one way of looking at what’s going on when you fall off the wagon.
What is the Stages of Change Model?
If you only know one model of behaviour change, make sure it is the Stages of Change Model (SCM). This model also has a more academic name – the Transtheoretical Model – so called because it underpins nearly every theory of behaviour change before or since its inception.
The SCM describes the various psychological stages everyone goes through when making intentional change. The SCM points out that people rarely go from decision to perfect action. Life is not black and white. change is not something you either do or do not make. It is a process. It is messy, it is non-linear, and we often relapse.
Once you start to make a change, that doesn’t mean that change will stick. The bigger and more complicated than change is, the more true that seems to be.
The Stages of Change
1. Pre-contemplation
This is where we all start. This is when you’re not thinking about changing. That might mean you don’t yet see a need to change, or it could mean you are intentionally ignoring the problem, telling yourself it is not a big deal or feeling like it’s an impossible problem and not even worth trying to change.
If close friends and family have expressed concern about something but you’ve been brushing them off, you might want to take it as a sign to think again. If you are not currently thinking about making a change, despite your current state hurting or others, you probably get extremely frustrated by people giving you advice about what you should be doing. Any practical advice you get at this stage might as well be falling on deaf ears.
Before you can take it on board, you first need to shift into contemplation. The best way to do that is to deeply explore and consider the implications of your behaviour with them. What will your life be like in 5 years if nothing changes?
2. Contemplation
You’ve passed the first hurdle. Well done! Now you’re willing to entertain the idea of change.
You’re starting to think about it, and imagining different possibilities in your head. You may even be taking a little responsibility for change. It almost feels like you’re making progress already (hah!). If you’re not careful, you can spend a lot of time here. Thinking and imagining. Maybe even feeling motivated. Weighing up options and looking for the best diet and/or exercise routine for so long that you’re honestly a little paralysed.
I’m sorry to tell you this, but you won’t move past the contemplation stage unless you make some decisions. Sure, take the time to make a good decision and not run into things blindly, but beware of trying to make a perfect decision. If you spend too long agonising over how to move forward, you might find yourself slipping backwards into pre-contemplation, and putting all this messy change business in the too hard basket.
3. Preparation
Now you’re getting close to the business end. You’ve recognised a problem. You’ve taken responsibility for making a change. Decided on a course of action, even! When you’ve decided and start setting plans in motion - signing up for gym memberships, experimenting with new meal plans, etc. - then you’re firmly in the preparation stage.
This is when you’re likely the most motivated to change. You’re still excited about the possibilities and the grind of long-term change hasn't completely worn you out yet. If weight loss is new to you, it might also be the time you’re putting yourself out on a limb and asking for friends to help keep you accountable with exercise. Be careful of relying too much on others for help here.
It’s great to have good supports around you, but if you’re prone to being easily disappointed, I’d hate to see all the hard work you’ve put in getting to this stage go to waste because your friend Tim hurt his knee and can’t go running with you for a while. If you need that kind of social accountability, you might want to consider investing in a trainer as a backup.
The Preparation stage is the best time to think about all the things that can go wrong or get in the way of your planned changes. Make no mistake, things will go wrong. However, we know if you consider them in advance, accept that they will occur, and resolve to move forward anyway, then when they do crop up you will be more likely to take them in your stride and keep going.
4. Action
If you haven’t fallen over the dozens of hurdles up until this point, then well done! This stage could just as easily be called ‘the grind’! Because that’s what it is. Particularly when it comes to health behaviour change and weight loss.
If new diets or exercise programs have long-term consequences (e.g., depriving you of cake on your birthday or forcing 5 am wake-ups), then it’s in this stage that they tend to catch up to you. ‘Lifestyle’ type changes tend to have knock-on effects we rarely think of. For example, if you plan to cook healthier meals, it’s rarely as simple as swapping out ingredients.
Maybe you also have to shop more frequently because fresh ingredients spoil quicker. Maybe you need to start meal planning. Maybe your partner doesn’t want to eat what you eat and there is now more cooking and kitchen logistics. Maybe you will deprive yourself of some favourite foods, get tired of the healthier meals, slip up, and then fall back into old habits because it was too hard.
One seemingly small and sensible change can often have tens or hundreds of micro-changes that need to go with it. The Action stage can feel like trying to walk through a field of knee-high mud. It seems doable at the start but quickly gets exhausting. The important thing here is to recognise that every micro-challenge you persevere through and overcome is progress you have fought hard for.
Every challenge and point of resistance you face is a place millions of others have given up before. Keep going. Even after you slip up. Especially after you slip up, which as a human, you will. With every step, you are becoming more resilient and forging a path in the mud that will be easier for you to trudge through if you have to do it a second time.
5. Maintenance
Here you are, on the far side of the knee-high mud, or more likely still somewhere in the middle. When it comes time to maintain weight loss, or more in the spirit of this article, maintain the behavioural changes that were necessary for you to live a healthier life, it is important to recognise you have reached an entirely different stage of your journey.
Maintaining weight loss often requires you to completely switch gears. The discipline, focus, and sacrifice that got you here are not all the same ones that are going to keep you here. If you are a goal-oriented type of person, you might find yourself slipping back into old habits without a goal to make sacrifices for. If you don’t re-set your goal to something more appropriate (e.g., keep weight between X and Y kgs/lbs), then it’s very likely that life will happen, old habits will creep back in, and you will relapse (note this is just an example - relapse is way more complicated than this).
The trick for this stage is to make sure your lifestyle enables the identity you want for yourself. If you’re still sacrificing your values (e.g., sleeping in) just to move a number on your scale, then sooner or later it will stop feeling worth it.
6. Relapse
Even though we’ve listed relapse last, relapse is far from the last stage of change. There is no last stage of change. If you take anything away from this post, make sure it is that relapse is normal. If not inevitable. We all do it.
The trick is to minimise the amount of time you spend in this stage. There are hundreds of reasons it can be particularly hard to claw your way back after relapsing. Injury, tragedy, exciting new challenges that are keeping you busy. Too many reasons to cover here.
There is, however, one particular quirk of relapse I think isn’t commonly appreciated. A trap I have noticed quite a few of my patients fall into. Namely, when somebody, maybe you, has previously been in peak physical form but is now a long way from their ideal of themselves, they can be almost paralysed by how far they’ve got to go to be back to where they once were. Why? Surely they’ve got it easy because they know they can do it. After all, they’ve done it before.
Well, you see, that’s the problem. They know just how far they’ve got to go. They know it better than most. The trap they tend to fall into is comparing where they are today with where they were 5-10 years ago. Frankly, that's a high and usually depressing goal to set.
We know that goals are only motivating when they’re only ‘slightly’ higher than where we currently are. Too low and we don’t feel like we need to put in extra work. Too high and the effort we know we need to put in is too exhausting to even think about.
When I ask those formerly fit clients if they had the same ideal version of themselves in mind when they were working their way to that ideal the first time, they all say no. Most clients who had previous success with weight loss were successful because they were focused on making forward progress day after day, or enjoying the journey. They were not fixated on how fit they used to be, or the circumference of their waist or biceps.
Often the best way for them to shift out of the relapse stage is to readjust their point of comparison to the person they were yesterday, not the person they were 5-10 years ago.
While the diagram at the top of this post is a circle, we bounce around the stages all the time. It is not static. We’re not even at the same stage in the model on everything at the same time. We might be maintaining exercise, still contemplating diet, and relapsing on self-care.
The big lesson here is that relapse is a normal part of behaviour change. It is going to happen. The question is when it does, will you tell yourself that you’re back at square one, or will you think about this model, recognise that you have just slipped past your action and maintenance stages, and tell yourself you just need to go back to preparation or even contemplation for a bit to find a better way forward?