A Family Lifestyle 'Redesign' Trumps Motivation, Willpower

Health Writer

Whenever lifestyle change pops up in a discussion, it is likely to be accompanied by the word “motivation.” After all, changing habits seems to intuitively require a hefty dose of motivation. In fact, experts like me believe that dieters or people who commit to exercise often abandon their efforts because the motivating reason (the New Year, a school reunion, a wedding) disappears and with it goes willpower.

But a new program at Case Western Reserve University called “SystemChange” suggests that manipulating the environment can help families alter unhealthy behaviors, even when willpower wilts.

The most popular strategies used to help people change lifestyle habits rely on significant cognitive behavior changes and a personal motivation to invoke habit change and improve health. SystemChange evolved from a series of pilot tests that utilized sustained changes in the home and in the family unit’s own behaviors, to create a sustainable lifestyle change program.

One pilot study involved getting the family to consume more fruits and vegetables. Cognitive therapy would typically involve educating the family on the health benefits of consuming more fruits and vegetables (helps with weight loss, improved health, helps to prevent diseases). In the SystemChange pilot study, the researchers stocked the fridge with fruits and vegetables, putting the produce on the easiest to reach shelves, pre-washing the produce before it was stored. They also pre-packed the children’s lunch bags in the fridge with fruit already in the bags. The family was then asked to see if quantitatively they ate more produce overall during a two week period. If they did, they would keep the habit in place and if they did not, another pilot study was created, again with the goal of “changing the environment to make it easier to see and grab fruits and vegetables.”

The researchers said this type of environment change encouraged by SystemChange also helps a family to see the actual goals being met without feeling the disappointment often experienced when the goal is simply to see weight loss on a scale. Though weight measurement is important, it can be very defeating if it takes a while to shed pounds. On the other hand, it can be very empowering, especially for kids, to see that they are actively meeting health goals without a whole lot of suffering. And because the program is introduced as “a series of experiments,” if the family does not meet certain goals, the team of their health professionals helps them to create new environmental designs to try out in a new round of efforts with the major goal of adopting healthier lifestyle habits.

Forgoing a reliance on just motivation, families adopt healthy behaviors—eating better and exercising more—by following a new approach that focuses on the redesign of family daily routines. This approach also help to take the singular “I” out of the equation and it substitutes “the we,” team approach since the family collectively sees if the redesign is helping all members of the group to meet the lifestyle habit(s) goal. You can create a pilot test for example, to see if moving the TV’s out of the kitchen and bedrooms results in less TV watching and more physical activity time as a family, or see if cutting up vegetables and leaving them in a bowl on the middle shelf of the fridge encourages family members to eat more servings of vegetables daily.

The researchers also tested this by-design change approach in HIV-positive and cardiac rehabilitation patients and it is a key component of an NIH funded study to curb obesity in children who live in certain urban areas. A huge plus is the fact that you don’t need a great deal of literacy and it’s also an easy model to reproduce. A model like this program could also be used in families who have cultural differences, with the test pilots being geared to address these cultural differences as a family tries to embrace healthier habits. And healthcare providers could help their patients to design these test models as a means to change their health habits with the goal of helping the family to work together to embrace healthier living habits.

I’ve been using a similar model for decades since I’ve always felt that “good habits begin in the home,” and even if only one family member is in dire need of a lifestyle change for health reasons, the whole family needs to work as a team to support the individual and can also benefit from healthier habits. I still think motivation and willpower have a role in weight loss and improved exercise habits, but I believe that it’s infinitely more helpful for long term success to set up your home and if possible work environment to encourage a more seamless and sustainable lifestyle change (and limit temptation). Here are three “pilots” you can try:

Goal: To not skip breakfast

Pilot test: Look at the weekly calendar so you know everyone’s morning schedule. Set the table every night for breakfast the next day and if someone needs to leave early, leave a packed breakfast in the fridge for them to grab

Goal: To snack healthy

Pilot test: Once a week purchase bulk amounts of healthy snack ingredients like nuts, roasted edamame beans and high fiber cereals, mix them in a large bowl and pre-portion snack-size amounts in mini cups, containers or plastic bags so they are ready to grab daily from the pantry.

Goal: To get more physical fitness (30 minute goal) daily

Pilot: Set smartphone alarms to go off during TV watching time so that family members get up to move around for every commercial. Chart the number of “movement intervals” met during a two week period to see if everyone is accumulating significantly more physical activity minutes and starting to move without the alarms going off at every ad break.

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Amy Hendel, also known as The HealthGal, is a Physician Assistant, nutritionist and fitness expert. As a health media personality, she's been reporting and blogging on lifestyle issues and health news for over 20 years. Author of The 4 Habits of Healthy Families, her website offers daily health reports, links to her blogs, and a library of lifestyle video segments.