Hi, I am Dr Milind Pimprikar. And you are listening to fighting fit Fridays with Dr. Pimprikar. Today we are going to talk about human behaviour and approach towards exercise. we all know very well that, to start exercising is one of the most sought for new year resolution. Most of the people want to start exercising with the dawn of the new year’s…only to get dissolved in the mist of the 1 st Jan. morning. Similarly, 1st day of the month and 1st day week in the calendar, hung on the wall or in one’s smartphone is the biggest enemy of any exercise behaviour. More often than not these days never come.
It is now very well established that, half of all causes of morbidity and mortality in the world are linked to behavioural and social factors. Despite knowing this fact, if we observe that, in general population the number of people undertaking exercise is not satisfactory.
So, the question is, why this happens? even the literate population which is aware of the health hazards of sedentary lifestyle are not motivated enough to do physical activity. And the answer lies in what we call as “Behaviour”.
Human behaviour for ages has been a mystery and there are varied patterns in which the human mind thinks about a given issue. It is evident after industrial revolution that most of the inventions were made to make day to day life easy. Thus, reducing the efforts put in by us in doing a particular job. And we call this as comfort. For example, automobile invention stopped us from walking, mixers in the kitchen stopped us from grinding. Washing machines moved us away from hand washing and in turn physical activity. Refrigerators held us back from moving out every day for procurement of food and we started stacking our refrigerators with different food items. To top it all now, we have so many apps delivering every damn thing in the world online at a click of the button. Instead of listening to the conversation “aaj khane me kys banana hai?” we often listen to aaj kya order karana hai. And this is exactly now, has started showing consequences in the form of life-style diseases called as non-communicable diseases which has become a leading cause of morbidity and mortality in the world.
To fight this out we need to change our behaviour. When I say this, it does not mean one should get rid of all the modern amenities. But it surely means that, as with these modern amenities one can perform activities of daily living without spending more time and energy. Which means one has time to spare and this extra time one needs to put in taking up exercise.
No change is sudden. It takes a hell of an effort to put any kind of change in practice. More so ever, once changed even greater effort is required to adhere to this change and this exactly happens to exercise behavioural change…. The magic word is motivation.
We as a medical fraternity have done tremendous advances in disease based medical solutions, but it is high time that this needs to change its focus to user-centric healthcare, we must empower patients to take responsibility for their own health. The healthcare professionals applying communication skills such as motivational interviewing. Meaning taking an extra bit of effort to stress the importance of exercise. Establishing the barriers and the facilitators for the exercise behaviour in a given individual. We hear of so many lame excuses put forth as barriers for example, there is no nearby gym, I don’t get enough time, I am afraid of injuries, so on and so forth. Research has suggested certain behavioural interventions which might shift the pendulum in favour of exercise behaviour and is called as stages of change, which was originally described by Procheska in 1979.
So, there are five stages through which the human mind travels before accepting the change and they are precontemplation, contemplation, preparation, action and maintenance.
Precontemplation– is kind of a daydreaming about deciding to exercise someday. People daydream of having completed a half marathon and the typical verdict is gym join karna hai yaar lekin time nahi mil raha hai.( this stage can stay with you for years together)
Contemplation- here you have overcome the time nahi mil raha hai. And you have decided that you are joining a gym in next six months. You are all pumped and prepped with gym costumes and a nice-looking running shoe. Here the decision is made.
Preparation- here you have taken a membership, you have found out an auspicious day to start. You have prepared yourself mentally and physically. The kitchen shelf now has a protein supplement and a sports drink. In short you are all set.
Action – AT LAST the D-Day is here. You are so elated. You have done it. People in your house and workplace know that you are working out, self-worth is very high. You suddenly start feeling fit. The posture becomes erect. You are glowing with confidence…. But this takes you to the most treacherous phase and that is maintenance.
Maintenance- maintenance also called as adherence to the changed behaviour is a challenge. It is seen that vast majority of people will drop out with in first 6 months. The protein supplement has collected dust on it. Your sports shoe is lying in the corner and you are back to square one.
Those who continue the changed behaviour for more than six months are likely to continue with the good work.
