The fact is that once you are successful at changing you are not out of the woods. As tragic as it might be, the majority of people who change are very likely to drift away from the health behaviour, back to the unhealthy behaviour, over time. I would suggest that we need to really roll up our sleeves and figure out how to only change that which we can keep changed.
Why does drift happen? Although complex there are several things we know that can help us reduce this problem. The strongest predictors of drift relate to what is happening inside our heads, in our social world, and in our world in general. Let's start with what is going on in our heads. People do things for a variety of reasons and motivation to change is no exception. But motivation is tricky. Let me explain. A basic rule of human behaviour is "if it's not broke, don't fix it". So when people want to change it is often because the experience a problem (feel bad) that they want to solve. Makes sense. But let's follow this through. I start by feeling bad about something, and I work hard to change. Great. Now, how do I feel? I feel good. Why was I working so hard? I was feeling bad. So if I no longer feel bad (the source of motivation) my motivation goes away, and so does my behaviour; I give up. Also, change can be hard work and the benefits of this hard work may not be felt by the individual, but the work is felt. So if I have to get up early to fit exercise into my day the effort to do so doesn't go away. But the benefit (avoiding diabetes, heart disease, etc) isn't felt. I have to continually remind myself why I am doing all this work. It's easy to forget to remind yourself. So change isn't as much about getting away from the pain of where we were (although this is the starting point for most of us) but about creating a new you. Developing self-esteem around the new behaviour. If the behaviour becomes part of how we define ourselves in a positive way it will motivate us to keep working and will help us develop the confidence to continue in the face of challenges (self-efficacy).
The second predictor of drift is social support. We need to find ourselves amongst like-minded others if we expect our new behaviour to last. The fact is that humans are highly social. Our behaviour is very strongly influenced by the behaviour of those around us. The implication of this is that we might need to readjust our social connections if we want to avoid drifting back once we've changed.
The other predictor of drift that I want to mention is stress. As stress increases self-care decreases. As with social behaviour, this is a normal aspect of human functioning. So preventing drift also requires us to be mindful of stress in our lives and how we can systematically cope with stress to prevent it from spoiling all of our successes. I will have more to say about stress in a future post.
I should also mention that achieving sustainable change might mean being satisfied with smaller changes than one would hope. Weight management is probably the area where this is most challenging. Talking to a 200 lb person about aspiring to a goal of 14 - 20 lb weight loss (no more) is very difficult. Our society breeds the attitude of "go big or go home" (consider the level of drama displayed on the TV so-called reality weight loss shows). People want their problems to go away; who wouldn't want to lose all of their excess weight? Regardless of the understandable reasons that people choose goals that, for most, are unsustainable, this problem needs a solution. If we can't help resolve this issue we create more problems and we avoid what might end up being a very optimistic outcome. The problem? Learned helpnessness. This is a psychological state akin to depression where people give up trying to control something when they learn, based on experience, that their efforts to change do not work. If I work hard, achieve my goal, and then drift away, I will see that as a personal failure. If this becomes a pattern ("no matter what I do, I can't achieve my goal") don't be surprised if I stop trying - I learn to be helpless. For this reason alone if I can achieve a goal that I can sustain I will feel so much better about myself. The optimism is connected to the fact that once I become confident that the previous change will last, that it is "the new me", I can set another goal and build on past successes.
I apologize for the length of this post. But I think you can see that its length is related to the complexity of the problem and solution to drift. I would recommend that if any of us is interested in change that we change how we view change. Rather than as a single goal (achieving the change - getting there) we view change as having two separate goals - getting there and staying there. Staying there is about looking at our motivation, self-esteem, relationships and stress management skills. Strengthening these factors might be our best odds of success in the long run. Food for thought......