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01/03/2007Ready to clean up your act?Understanding bad habits may helpWe're fat. We smoke. Drink too much. Don't exercise enough. And our stress levels are off the charts. We're killing ourselves, and we know it. And yet we carry on — overeating, lighting up, slumping in front of the television and throwing back another beer — inspiring some of the greatest thinkers in the worlds of genomics, neuroscience, biochemistry and evolutionary psychology to ponder the Big Mac of medical questions: Why is it so hard for people to change? Is it possible that we're missing a self-discipline gene? Unlikely, though recent research synthesized by the National Academy of Sciences suggests there may be combinations of genes and environmental factors that make it hard for some people to maintain control over their habits. And every year, as if we had learned nothing from our past, we renew our vows to change. Then we crack open our wallets. In recent years: $63 billion on low-carb, low-fat, low-sugar, low-calorie foods; more than $1 billion on smoking cessation products and programs; $46 billion on diet and fitness programs, drugs and surgeries. At the same time, the nation's health-care industry spends hundreds of billions to treat preventable illnesses in a process that H.L. Mencken recognized decades ago: "The true aim of medicine," he said, "is not to make men virtuous; it is to safeguard and rescue them from the consequences of their vices." In the end, what doctors and studies and experts have pointed out is that the thing that really helps to change behavior is something hard to measure but ultimately powerful. Change comes from the heart, not the head. The Roots of the Problem Except, in many cases, when the emotion concerned is fear. As a motivator for personal change, fear is a poor performer. Consider: Doctors at Washington University School of Medicine in St. Louis found that among a group of smokers who had had surgery to remove early-stage lung cancer, nearly half picked up a cigarette again within 12 months. Most started smoking within two months. In another study by researchers at Johns Hopkins University, nine out of 10 patients who'd recently had coronary bypass surgery failed to take steps to improve their nutrition, exercise more and reduce stress.
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