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Positive behavior change is more complicated than “getting your act together.” We live in what is called an “obesogenic environment“. What does this mean? Coined by Australian academic Boyd Swinburn, the term essentially means that your environment is acting against you daily in very sophisticated ways in order to make you fail at your new year’s resolution to lose 10 pounds.

For example, to maintain a calorie-burning level of fitness a person should walk about four miles each day, which means about 90 minutes of walking, but to accomplish requires: (1) 90 minutes of free time each day, and (2) a safe neighborhood in which to walk. Right away, you’ve lost a third of the population.

Faced with all these challenges, how do you achieve success? The real answer is that this is a public health issue that everyone should get behind, but even before the battle is won at city hall, there are lots of evidence-based ways to tackle these challenges now.

  1. Detox your home. Throw out all the junk food from your home. If necessary, buy healthy versions. This may require that you have a discussion with your family. I had one patient who sat down with her husband and children and said “I need to make a change in my life. We cannot have junk food in the house.” The solution was to put all of the junk food in the house in a separate fridge in the garage. Now personally, I would have preferred that she lay down the law and said no junk food at all, but this was a big step and it made a big difference in her health.
  2. Create your own Environment. If you tend to stop at the vending machine to pick up a candy bar on the way to the boss’s office while dropping off your TPS report, try to a) take the stairs to your bosses’ office and b) go through an alternate hallway.
  3. Get a Fit Bit: Or another type of fitness tracker! Competition is a wonderful way of creating accountability. The evidence is still evolving on this one, but it seems like regardless of whether they work, they help motivate people to move.
  4. Get Support. Having a community of people who are also working on the same goal or who can function as a cheer-leader creates big dividends in your weight loss journey. Weight is more tied to whether you friends are thin, even more so than if you spouse is thin. Check out this Harvard study by a physician and sociologist. Healthy people infect other people with healthI am a big fan of using a health coach, but there are other ways to attack this too. For example
    • Ask a friend to be your buddy.
    • Join a group weight loss program.
    • Join a weight loss network such as sparkpeople.com or any of these 
    • If you own a fitness tracker or use a fitness app, take advantage of the social networking tools
    • Participate in walking programs or similar initiative

Do you have other suggestions for creating accountability? We would love you to share with us!



  1. http://calorielab.com/news/2008/03/16/obesogenic-the-word-the-environment-the-controversy/
  2. http://www.unce.unr.edu/publications/files/hn/2010/fs1011.pdf