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Lifestyle Management Therapy                                      

When a loved one needs to change, nagging just won't work

Growing up in New York, Michelle and Todd Brooks were reared on heavy foods she, Italian, on pasta; he, from Buffalo, on doughnuts, pizza and chicken wings.

But when the couple moved to Atlanta shortly after college, Michelle, feeling heavier than many of her new peers, had a culinary change of heart. She overhauled her diet and dedicated her free time to exercise, losing some 25 pounds. She urged her husband to do the same.

That didn't go over so well.

"He thought I didn't like the way he looked," said Michelle, 38, a property director for an apartment community.

Insulted and annoyed, Todd would shoot back that he hadn't changed she had.

"And I continued to do what I wanted to do," said Todd, 38, who works at the Home Depot.

Getting yourself into shape is hard enough. Getting a spouse to kick bad habits is a far more daunting battle, a minefield of touchy territory that leaves few people unscathed.

But if you wish to spend retirement traveling the world rather than to doctors' appointments, you must intervene. The trick is to understand what inspires people to change their behavior. And it's not you telling them what to do.

"I can only make myself change," said University of Virginia nursing professor Jeanette Lancaster, who teaches a class on health promotion.

What you can do is create an environment that steers people toward healthful choices, Lancaster said. That might start with a conversation decidedly free of "you shoulds."

When you make it a team effort why don't we eat healthier? a spouse is less likely to get defensive, Lancaster said. And express your concern in the first person: "I want to do everything I can to help you live the longest life you can."

If there's resistance, promise you'll be ready to help at any point, and back off, Lancaster said. When you nag, criticize or push changes a person is not ready for, the stress might prompt more eating, drinking, smoking or whatever vice provides immediate comfort.

"Any time you push too hard, you elicit psychological reactives," said Jeffrey Fisher, director of the Center for Health, Intervention and Prevention at the University of Connecticut. "Rather than help your cause, you're going to hurt the cause."

A well-tested model advocates three essential components to spur health behavior change, Fisher said: information, motivation and behavioral skills.

Information is easy: Chat about studies on the long-term health effects of boozing, print out articles on smoking cessation or gather the family around for a viewing of the film "Fast Food Nation."

Often facts alone can spark motivation, which requires both a favorable attitude toward the healthful behavior and a feeling that you have social support, Fisher said. If not, you can take a page from advertisers and highlight an opinion leader, such as a sports star who likes his veggies.

Skills can be trickier. For example, drinkers may not know how to refrain when everyone around them has a beer in hand, Fisher said.

You can help by interspersing glasses of water between each drink, Lancaster said, though take care not to be overly nurturing, which can put people off. Stocking your kitchen with healthy foods, splitting meals at restaurants and offering to pack your spouse's office lunch are other ways to cultivate skills, she said.

Once started on a healthful path, people thrive on praise and encouragement.

"I think people can become as addicted to the success as they were to the (vices)," Lancaster said.

For Todd Brooks, change came in several steps.

In agreement with his wife that their two sons should eat healthfully, he watched the soda and snack cakes disappear from their kitchen, replaced by whole-grain bread and fresh vegetables. His own diet, by necessity, followed suit.

Michelle, realizing her concern was being misinterpreted as vanity, had a serious conversation about his high blood pressure, explaining that she didn't want to raise their kids alone. When Todd's doctor put him on blood pressure medication and told him bluntly that he needed to lose weight, it was the catalyst that spurred him to exercise.

He has lost 15 pounds in eight months, and, enjoying the compliments, hopes to lose 30 more.

"I don't want to be a foo-foo nuts and twigs person," said Todd, who still brings home the occasional box of doughnuts. But he likes some of the new foods his wife has introduced; when he asked Michelle to buy him the all-natural jelly, "I was so excited," she said.

"I think it has helped our marriage," she added. "Because over the years, you don't have many commonalities. This is now something we work on together."


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