Ditch Habits if You Want Your Patients to Create Lasting Changes in Exercise and Healthy Eating in 2023

By Michelle Segar, PhD, MPH, MS
Sustainable-behavior-change scientist, University of Michigan
Author, The Joy Choice: How to Finally Achieve Lasting Changes in Eating and Exercise

Behavior change apps, health coaching or counseling protocols, or other approaches aiming to improve patient health and well-being have little value if few patients can actually meet the assumptions they are based on.    

So I’ll get right to the point: If we want to cultivate sustainable change in our patients’ healthy eating, exercise, and self-care choices (and why wouldn’t we?), we need to move beyond conventional thinking, pop culture, and fads and take a clear-eyed look at our assumptions. 

Yes, I’m talking about habit formation. 

It’s time to jump off the habit bandwagon and think more critically about the actual value of habits for helping patients create sustainable changes in complex behaviors like exercise and healthy eating.

The topic of habits couldn’t be more popular right now. The Google Trends Interest Over Time graph shows an upward trend since 2009, and online searches for “habit” this past fall reached an all-time high. 

Thanks to popular bestsellers like Atomic Habits and The Power of Habit, forming automatic habits has become our cure-all for changing diet, exercise, and any behavior in between. Honestly, I’m not surprised. Popular approaches to habits are touted as simple, easy, and a quick corrective for anything we want to change.

But what if it isn’t true?

Pulling back the curtain on habits

Successful habit formation is built upon some familiar assumptions:

1. Everyone can form habits.
2. The internal conflicts about eating and exercise that many commonly have do not affect their ability to form automatic habits for healthy eating and exercise.
3. It’s possible to form an automatic habit for any lifestyle behavior.
4. The automatic, rote nature of habit is the ideal for creating lasting changes in healthy eating and exercise.

But when we pull back the curtain and examine these assumptions, we very quickly discover that when it comes to producing sustainable changes in complex behaviors like exercise and healthy eating, the power of habit isn’t what it’s cracked up to be. 

In fact, when you consider habit formation in light of these assumptions, you’ll see why habit formation for complex lifestyle behaviors is not the golden path to creating sustainable change for most patients – especially those living complex, multi-layered lives filled with responsibilities and necessitating quick pivots achieved through conscious flexible thinking.

The truth is, more people could become successful with complex health-promoting behaviors if they simply ditch habits. 

If the ultimate goal is to facilitate changes in health promoting behaviors that can survive in the real world, the behavior-change strategies and programs we prescribe and suggest for our patients must work within the true realities of their days. Instead of “going rote,” we can better help patients learn to create healthy lifestyles they can sustain by prescribing a strategy that is the exact opposite of habit formation: Learning how to consciously, flexibly, and tactically navigate the common, unexpected conflicts that healthy eating and exercise plans inevitable face. This strategy — to unhabit — will bring success for more patients over the long term because it works with rather than against the dynamic ebbs and flows of life.