How to create lifestyle change that lasts – and scale it
Personalised support is vital in tackling the obesity crisis, writes Changing Health Chief Scientific Officer Professor Mike Trenell – seen above on Sky News
The causes of weight gain are varied and complex. It can be attributed to a whole range of factors, many of which are outside our control: genetics, demographics, social and environmental variables can all play a role.
If you live in a deprived area, for example, you’re five times more likely to live near a fast food outlet. It’s also more likely your town centre is home to one of Britain’s most “unhealthy high streets” (defined by the Royal Society for Public Health as having more fast food establishments, tanning salons, bookmakers and loan shops, and fewer “healthy” establishments where people exercise and/or socialise).
Pressures to eat unhealthy food can be compounded by our own personal circumstances; at Changing Health, we’ve spoken to countless users who work long hours, perhaps travelling significant distances as part of the job, and didn’t feel they had the time or the energy to cook wholesome meals at home or fit in some exercise around the typical working day.
To effect lifestyle change at scale, therefore, we need to do more than simply tell people they’d benefit from shedding a few pounds. They know that already. What people need is structured, ongoing support, both in a practical sense – showing people how they can fit manageable, sustainable changes into their daily habits – and in a psychological sense, boosting a person’s motivation to stick to a new, healthy routine.
So what should that support look like?
The future is digital. It can improve access and convenience.
Digital devices are changing almost everything we do in our day-to-day lives, from how we work to how we spend our money and what we spend it on. Support for lifestyle change is no different. Providing support through mobile devices ensures it’s on hand any time, anywhere, and as we’ve seen with Changing Health’s app, increases uptake too. As one user who reversed Type 2 diabetes on the programme put it: “It’s like having a little buddy you can carry around in your pocket, a constant reminder – ‘what have I eaten this week?’
User-centricity is fundamental.
Everybody faces different challenges in making lifestyle changes, whether that’s the hours they work, the social influences around them, their cultural norms, level of health literacy, socioeconomic status – and so on. That’s why the most effective lifestyle interventions are tailor-made for each user, taking their own unique personal circumstances, habits and traits into account to address the specific challenges they’re facing.
Understanding the psychology is key.
There’s a key distinction between intentional behaviours and habits: Intentional behaviours tend to be underpinned by our attitudes, which are consciously determined by the value we attach to a particular behaviour (“I know I shouldn’t drink so much, but it’ll be fun”). Habits, on the other hand, are automatic behaviours, frequently undertaken at low levels of awareness and repeated over time – for example, picking the same options for lunch each day.
Why is this distinction so important? Because some behaviours are planned or deliberated on, while others are given no consideration at all. Before we can empower people to change their behaviour, we need to understand which type of behaviour we’re trying to influence.
An evidence base is essential.
At least 325,000 mobile health apps are currently available for download – but only a minute proportion of those apps are based on real, robust science. As a result, outcomes are typically, at best, varied.
The bottom line
In a society in which more than half of us report being “too busy” to be healthy, in which we encounter adverts for junk food everywhere we go, and in which 40% of all the food we buy is done so at a discount, it’s easy to see why the population is becoming increasingly obese.
Yet by designing lifestyle interventions that show people how to fit more positive habits into their own daily lives, and providing the motivation to stick to them – we can empower them to change in ways they never thought possible.