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Lifestyle diseases are caused by such things as smoking, poor diet, lack of exercise and poor stress management.
Individual and Environmental Factors that contribute to lifestyle diseases. "I don't know what to
tell her; I just don't think she has a chance," you confess to a
colleague. "She wants to lose 50 pounds. Her whole family is
obese
and, worst of all, they tease her when she goes to exercise. Ten
years ago, I thought that if you had enough willpower, you could
accomplish anything. Now I'm not so sure.
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But is it so simple? Education and counseling play an
important role in addressing the epidemic of lifestyle diseases, but
educational programs designed to facilitate individual behavior
change are not enough. Negative side-effects can accompany these
programs, especially a tendency to blame individuals for their
habits and even their diseases. This individual-focused approach can
also generate feelings of guilt and low self-esteem in clients who
fail to live up to high expectations. Perhaps most damaging is that this approach can create an inability to examine and change the larger picture. Consider the client described in the opening paragraph. If she fails to get to the fitness center five times a week, and lose 50 pounds, she will probably blame herself for her failure. But is this failure really her fault? Stress-management workshops often provide great case histories of people who simply have more to do than they could ever create time for. No amount of time management, problem solving or deep breathing can fix every difficult situation. Environmental factors No person is an island. People are a product and a part of their environments. Environments are the worlds people live in, and include physical, cultural and sociological influences. Environmental factors strongly influence a person's choices and options. Most people have several different environments, and may make choices differently depending upon which environment they are in. For example, a person may never smoke at work, where smoking is frowned upon, but he or she may smoke at home where other family members smoke, and where smoking is a social activity. Consider again the client in the opening paragraph. What environmental factors have been described? A family that teases her when she exercises. A full-time job and family obligations are also environmental influences that affect the choices she makes about whether to go to the fitness center for her workout |
Many fitness professionals underestimate the powerful influence
environmental factors have on clients, since they tend to be
dedicated to physical fitness and exercise. Many are paid to
exercise, or have easy access to fitness facilities, and are
motivated to maintain their fitness to enhance credibility as
fitness professionals. Fitness is something they make a priority and
they may think, "If I can do it, why can't everyone else?"
If you observe people who walk through fitness center doors (and
remember, these people are not even typical of the American
population in general), you will notice that some can't do it.
Sticking to an exercise program is harder than it looks, even for
people who are convinced that consistent exercise is essential for
good health. Are these members weak-willed, lazy or stupid? Not
necessarily. Sometimes life just gets in the way. Job
responsibilities, sick kids, aging parents, financial problems,
travel and even relatively minor hassles can pile up.
As we try to get America moving, we must consider some cultural
groups in our country who can't even imagine going to a fitness
center. For some people, physical activity options are very limited.
Some people can't bring themselves to perform physical activity just
for the sake of exercising. Fitness professionals must help design
culturally appropriate activities for these overlooked groups of
people who are often at the highest risk for lifestyle diseases.
Working with the total picture
Because environmental influences are powerful and difficult to
change, it is tempting to ignore them and proceed as best you can.
But there are at least three good reasons to consider environmental
influences in your work.
First, you can help clients take these influences into account as
you design their exercise programs. Work with existing environmental
constraints (just as you work within genetic constraints) to make
programs as convenient and realistic as possible. Help clients think
about their particular constraints and think of some options to
address them.
Second, there are many things you can do to help change
environmental influences in your community. You can encourage work
places to offer exercise options for employees, urge your local
schools to improve physical education programs, volunteer to coach a
sport, or organize a walking club for your extended family and
neighborhood.
Third, remember that your clients are not to blame when they fail to
live up to their noble intentions. And neither are you. Positive
emotions, like forgiveness and commitment, are more likely to get
you back on track. FM
Barbara A. Brehm, Ed.D., is professor of exercise and sport studies
at Smith College, Northampton, Mass
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When life starts to feel overwhelming, it pays to take some time to rethink your priorities.