Have you been trying to lose weight or start exercising and can't get started or you're failing?
A typical breakfast meeting spread. Photo courtesy of Riva Greenberg
We like to think that our accomplishments are based on our merits, how strong and capable we are. And that what most influences our success is having enough smarts, money, motivation and/or willpower.
Yet we're often unaware of a powerful influence on our success or failure -- the "systems" we live within. This is the infrastructure that supports your behaviors -- both wanted and unwanted.
For example, and I'll take a wild guess but here goes, part of the reason you're able to brush your teeth one or more times a day with ease is because of the system you created. Like keeping your toothbrush in the same place. Probably near a water source and within easy reach. It may also be in plain sight which acts as a visual cue. And you probably keep the toothpaste nearby.
When we try to make a change like losing weight or exercising, going back to school or advancing at work, to a large degree it's the systems around us that either help ease us forward or hold us back -- both our own personal systems and societal systems that we must navigate.
Ann Albright, director of the division of diabetes translation at the Centers for Disease Control and Prevention, confirmed the impact of our societal systems on diabetes management saying, "While we have to think about what the individual does and individual responsibility, the individual does not live in isolation. We all are influenced, and supported or undermined, by those other circles (societal systems)."
So when you come out of the doctor's office and he's just told you to lose 20 pounds and start exercising, you need an infrastructure that supports your behavior -- both at home and outside your home -- to achieve these goals. Otherwise, it's easy to find yourself with your coat on racing to the car when a mouth-watering ad for hot, cheesy pizza comes on TV.
Luckily we can design personal systems that help support our desired actions wherever we are. With just a few simple steps you can greatly improve your health.
Broken Societal Systems
Unfortunately, many of our societal systems are not designed to support health. We have poor access to affordable healthy food, fertile soil to grow nutrient-rich food, fresh air and water, recreational space and family and community support.
Fast food restaurants are more plentiful than healthier ones, especially in small towns and cities across America. Agricultural policies and food subsidies support the overproduction of corn so metabolically unhealthy high fructose corn syrup now sweetens everything from crackers to ketchup.
Factory farming breeds profits and too often e coli. Saturday morning TV advertising to children is abundant and unlegislated. Schools needing to supplement their budgets have made Pizza Hut, Taco Bell and Burger King their primary lunch suppliers.
While people cried, "nanny state!" when Mayor Michael Bloomberg tried limiting the size of sugary sodas and drinks in NYC, we're already living in a nanny country.
Regarding our health care system, doctors are incentivized and rewarded to perform costly tests and surgeries, not preventive care. Insurance companies limit blood sugar test strips, limiting people with diabetes' ability to stay healthy. Many insurers don't cover insulin pens, which among people with Type 2 diabetes particularly, foster more responsible insulin behaviors.
Of course some would say these systems aren't broken; that they support the country's chosen economic engines of capitalism and shareholder value.
That said, I hope we won't have to wait until we are a nation of sick people to realize that healthy individuals are also an essential engine for economic growth and prosperity.
Certainly we can work on changing societal systems through political action and advocacy. More immediately we can design personal systems that support our own healthy behaviors.
Designing Systems
Over the years I've designed several systems that support my diabetes management. For instance, I keep glucose tablets under my pillow and in every coat and jacket pocket, purse and pouch, and I check my supply frequently and replenish it. I'm always prepared for low blood sugar.
I keep my meter always in the same place in my home so it's easy and convenient to check my blood sugar. This helps me check frequently without the, "Where's my meter?!" drama.
I've arranged my workday so that I can walk in the morning from 9:30 to 10:30 a.m. and I keep my walking gear in sight and accessible so it's easy to grab and go.
I bring my own food to the airport because I never trust that I'll find something healthy to eat there.
A few years ago I asked people what healthy habits they had created that helped their diabetes management. What they really told me was their systems. Like having three meters and keeping one at home, one at work and one at their parent's house. Keeping cans of soda at work in a desk drawer for a low and informing one or two people at work about their diabetes and what to do in case of emergency. Simple steps that underlie success.
To design systems for diabetes health (or substitute "general health") ask yourself:
1. What specific task in my diabetes management can I make handier, simpler, easier, less time consuming? How?
2. Where am I really falling down in my diabetes management? For instance, remembering to take my pills, checking my blood sugar, refilling my medications before I run out, preparing healthy meals? What steps can I put in place to make me more successful?
3. How can I manage the challenges to my diabetes management outside my home? For instance checking my blood sugar when I'm in a meeting, eating healthy at the airport, exercising when I'm away from home? What simple steps can help me overcome my challenge?
4. What can stop me while creating this healthier behavior and how can I prepare for that?
When my dear friend got a brain injury some years ago, her therapist focused on helping her create compensatory strategies -- new ways (systems) to live a functional life on her own again. She did, and she's succeeded beyond expectation. Designing systems for health is really no different.
While intention, motivation and desire may fuel our actions, it's often our systems that determine whether or not they'll be successful.
Riva's latest book, Diabetes Dos & How-Tos, is available in print and Kindle, along with her other books, 50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It and The ABCs Of Loving Yourself With Diabetes. Riva speaks to patients and health care providers about flourishing with diabetes. Visit her websites DiabetesStories.com and DiabetesbyDesign.com.