Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. It’s 2023, a New Year, and if you’re anything like me, you are probably thinking about resolutions, making decisions about what needs to change in your life. This requires looking at our habits and behaviors.  

Successful people have habits and routines. This also applies to health. Habits are repeated behaviors that are learned, and how do you learn to get (and stay) healthy? Behavior changes.

As a family doctor, I see a lot of patients who struggle with anxiety and depression, which often causes other health problems. These patients are wanting to be successful healthwise, but unless the mental aspect is dealt with, the physical conditions will continue. That is why I’m talking today about habits and behaviors. It’s that important. I just finished rereading Atomic Habits by James Clear, which I’ll be referencing throughout this Note. This is a great book that I highly recommend to anyone wanting to change their behavior. 

Note: Over half of our behaviors are habits, so to me they mean the same thing. 


The Importance Of Delayed Gratification 


There’s an immediate impact to bad habits or behaviors. Think about that. Bad habits, like smoking a cigarette, have an immediate impact. For example, when people smoke, it immediately makes them feel good. Good habits/behaviors often have a delayed impact. You’re not going to go to the gym one or two times and see an immediate improvement. It’s going to take a while! It’s a process. 

We’re wired for immediate impact, but delayed gratification can have huge benefits. This is why making progress towards something is such a big deal. People go to school for long periods of time to become a doctor, dentist, lawyer, engineer, etc. People start businesses that (often) don’t turn a profit until years down the road. Both are examples of delayed gratification.  

Note: There is reward in the journey, so enjoy it. Progress feels good. Results will come if your “system” works. A system is a way of doing things. Think about this in regards to your health. Is your system working? 

Goals are a one time thing. When you reach your goal, it feels good! But it’s also over. Systems are long lasting. They are life long habits, which is the ultimate reward. This is especially true with your health. Systems get you on the path to where you want to go. Working out regularly is a great example of this. 

Enjoy the systems and the journey. Make your habits small at first, and then build on top of them. Collectively, this will get you powerful results. Small habits can lead to huge results over a long period of time. It’s the little steps that create movement towards optimal health. One squat at a time. One bite at a time. 


Do You See Yourself As A Healthy Person?


Habits have the power to change your belief about yourself. A great example of this is me and the guitar. I love music and playing guitar. I would love to be a great musician. The first step is to start seeing myself as a musician and doing things that musicians do. If I don’t see myself as a guitar player, I won’t be a guitar player. Being informs doing. 

The same thing with weight loss. If you think of yourself as a healthy person, then you’re going to act like a healthy person. If you act like a healthy person, then you’re not going to drink sodas all the time, or eat junk food. If you have the mindset that you’re a healthy person, you won’t do things that unhealthy people do. 

You truly have to believe this. The best way to change your identity (the way you see yourself) is through small actions over and over again. Success, more often than not, happens when repetitive behavior becomes ingrained in you. Rarely is it an epiphany. There are some situations that can speed up behavior change. For example, if you’re a smoker and you have a baby that you don’t want to expose to second hand smoke. The love of your child can give you the motivation you need to stop cold turkey. Making a drastic change ( i.e., moving away from your home/changing your environment) can lead to rapid behavior change. But for the most part, this is a slow process. 

Take pride in your new identity as a healthy person. Your new identity is being a lean and fit person. This is in contrast to thinking of yourself as fat and out of shape. There is also a social aspect to this. We’re social creatures. Behaviors that stick have a social component. Example: You mow your yard or take your trash out because you don’t want your neighbors to think you’re a slob. The social component can be extremely powerful! So, join groups that already have your desired behaviors. Hang around people you want to be like. If you want to be fit, hang around people who are fit and go to the gym. Socialize with people you want to be like. 

Same scenario goes for bad habits. If you go to the bar and drink every night, you’re around people who go to the bar and drink every night. Look at what you’re doing and who you are associating with. You’re going to end up more like the people you hang around. People want to fit in. The desire to belong overpowers the desire to be lonely. This is why limiting time around negative people is so important. 


Dopamine And Habits 


You need motivation to change. You need a reward to change. This is where the neurotransmitter dopamine comes in. Some people hack the release of dopamine using drugs or food (think addictions). When I read Atomic Habits, I learned that all habits have four things in common: Cues -> Cravings -> Response -> Reward. 

Habits all have cues. If you’re a smoker and you have a cigarette laying in front of you, that’s a cue. Then comes a craving. Then comes a response. Are you going to smoke that cigarette? Take that drink? Or, are you going to leave it alone? There is a reward either way. 


The Laws Of Behavior Change 


All habits have four things in common. With that in mind, let’s look at the four laws of behavior change that Mr. Clear talks about in his book (remember, habits are behaviors). 

  1. Make it obvious. Make it obvious what you want to change. For me, it’s putting guitars around in different rooms where I hang out. There’s always a guitar around. 
  2. Make it attractive. I want a nice guitar or a nice amplifier. Getting good at the guitar is fun! 
  3. Make it easy. Make it convenient. If healthy food is laying around, it’s convenient for you to eat it.
  4. Make it satisfying. Try to emulate good music. Keep some pictures around of lean fit people you want to be like. 

If you want to break a bad habit, you want to do the opposite. Don’t make it obvious. Make it invisible. Don’t have junk food around the house. Don’t have beer in the fridge. Note: Out of sight, out of mind. 

Make it unattractive. Make it difficult. Make it unsatisfying. If it’s unsatisfying, you can break a bad habit. That’s why some people will use medicines to get them off a drug. When they take the drug on top of the medicine, it makes them sick. We do this a lot in medicine.


Closing Thoughts


Focus on your good habits. If you spend a lot of time focusing on the good habits, you’re not going to have time for the bad habits. If you backslide, that’s OK! Remember that everybody backslides a little bit. Learn to forgive yourself. If you eat too much one day, or drink too much, pick yourself back up, laugh about it, and get back on track. We’re humans, and we’re going to fail at times. Use these tools! If we are creatures of habit, create good habits. 

As we head into 2023, think of behavior changes. Listen to people you trust. Sometimes they can see bad behaviors in us that we don’t see. Let other people help guide you towards good health. Be open to change and try new things. I’m constantly researching new things that will lead to better habits and behaviors. New discoveries. To be a good doctor you have to be a good observer and research constantly. That’s the purpose of all of these Doctor’s Notes and my podcasts. 

Here’s to an amazing 2023!

Till next week.