352. When the pain goes away, we go out to play.

352. When the pain goes away, we go out to play.

I am fascinated by the challenges of human change and a series of research papers I recently read confirmed what, for a long time, I did not want to accept; when we set out to implement major and long term change in our lives, the odds are heavily stacked against us.

The data indicate the chances of successfully sustaining any change for five years is extremely low, which means there is only a 3% likelihood we will maintain change for 60 months or beyond.

This helps explain why commercials for weight loss programs such as Jenny Craig, Weight Watchers, Herbal Magic and Dr. Bernstein proudly trot out their recent success stories – this is Brian, he lost 83 pounds and this is Bernice, she lost 102.

What they don’t show are the Brians and Bernices of five and ten years ago.

Obviously, with the sheer volume of people who go through these programs, they do have some long-term success stories but, as evidenced by this week’s story about contestants in the TV show Greatest Loser who all lost vast amounts of weight – in some cases more than 200 pounds, only to have gained most, if not all of it back in the intervening years, the vast majority of their clients will gain back all of the weight lost within five years.

Much of the research I read cited terrifying statistics from the world of medicine.

Patients undergoing cardiac bypass surgery are subjected to massively invasive procedures not only in their chests which are opened up, and their ribs spread apart, to gain access to the heart but also in their arms and the legs from which veins or arteries are removed and sutured into place in order to reroute blood around the blocked artery or arteries.

Once patients are ready to be discharged from the hospital they are usually given “the lecture” in which they are told the seriousness of their condition and strong recommendations are made to undertake gigantic lifestyle changes which include everything from quitting smoking to a whole new approach to nutrition to regular workouts.

And most patients will diligently follow this advice if, for no other reason, they have recently gone through a hellish experience and are terrified of having to repeat them or of having even worse things happen.

The amount of time they remain committed to the new lifestyle varies from person to person but what the data strongly assert is that at some point during the first five years following surgery, as these patients begin to feel really strong and vibrant and are enjoying a pain-free and seemingly healthy life again, they begin to lose their fear of a recurrence of their disease and gradually revert to the very lifestyle that brought them to surgery in the first place.

A recent overview of thousands of these cardiac patients revealed startling results: nine out of ten cardiac bypass patients will experience full occlusion within 5 years of surgery.

This means the transplanted arteries and veins will be as blocked as were the coronary arteries prior to surgery, often requiring the surgery to be repeated.


Among the many theories being floated as to why permanent change is so elusive is the “human nature” cause.

It has been long known that there are only two drivers of human motivation: we do what we do in order to gain pleasure or to avoid pain.

Human nature being what it is, these cardiac bypass patients have all experienced pain and fear prior to undergoing surgery. They also frequently experience much pain during the early stages of recovery.

Coupled with their pain is the “lecture” regarding massive lifestyle change which increases their fear by emphasising the consequences of not making these changes.

The pain and fear are powerful motivators for change and these folks often begin their transformation with a zeal and determination they have not felt in many years.

Their efforts pay off and gradually, over time, they begin to enjoy a pain-free and energy filled life.

And as the fear and pain that played such a huge role in their early motivation disappears many folks slowly go back to the lifestyle they enjoyed before surgery leading to the statistic of 9/10 of the people achieving full occlusion within five years.

Perhaps the key to this puzzle lies in how we as a society attempt to motivate others. The threat of negative consequence is the most common method: “If you do that again, you will have to go to your room, “If you don’t do this you will be fired,” or, “If you don’t change your lifestyle, you will die.”

These are powerful motivators and remain so until the fear of the consequence disappears taking with it the incentive to sustain the behaviour required to avoid the consequence, hence the return to the old lifestyle and the blocked arteries.

There must be a better way of providing long term motivation that will keep us inspired and driven.

I think I know what that may be but Gimalle, my wife just told me that if I’m don’t hurry up and get ready to go out, she won’t buy me lunch so I gotta go.

Perhaps we can revisit this next week?

Till we read again.

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