People often know what they should eat to fuel their workouts, support good health, and manage conditions such as type 2 diabetes and high blood pressure, but they don’t always make the best decisions about food. Here’s why it’s so difficult for people to make healthier choices and how you can help them develop lasting, beneficial behaviors.

It’s Not That Easy to “Just Do It”

Every day, your clients, friends and family make an average of 200 decisions about what and how much to eat in a variety of settings: at home, at work, and in grocery stores and restaurants (Wansink & Sobal 2007). The type and amount of sweetener they stir into coffee, whether they pack their lunch or buy it, and how many vegetables they eat at dinner may seem insignificant choices when considered alone, but those decisions and others affect body weight and well-being in the long run.

Food decisions are complicated by our “obesogenic” environment—which encourages poor choices, discourages physical activity, and contributes to high rates of overweight and obesity in adults and children. Timesavers like drive-through windows accelerate our ability to buy high-calorie meals and snacks. Chain restaurants serve large portions of calorie-laden foods and beverages, making it difficult to judge proper portion sizes and avoid overeating. Proximity matters, too.

One recent study found that when office workers kept candy in plain sight, they ate more of it than when they kept it in a desk drawer (Painter, Wansink & Hieggelki 2002). Easy access to nutrient-poor foods in stores and in the workplace lures consumers into making impulsive, often unhealthy, choices, especially when they’re hungry.

On a more personal level, the home environment also affects how much people eat and drink. Brian Wansink, PhD, author of Mindless Eating: Why We Eat More Than We Think (Bantam 2010), points to a long list of factors resulting in excessive food intake. Among them:

  • large plates
  • big drinking glasses
  • sizes and shapes of food packages
  • family, friends and coworkers

Many of our choices—good and bad—may stem from the company we keep. When Harvard researchers analyzed 32 years’ worth of data from social networks of about 12,000 adults, they found that the chances of becoming obese increased by 37% if a spouse had become obese, 40% if a sibling had, and 57% if a friend had gained a lot of weight (Christakis & Fowler 2007). But the issue cuts both ways: Though friends and family may undermine healthy food decisions, they can also encourage better choices.

It may be that no matter how motivated or seemingly unmotivated we are to eat well, we mimic the diets of those around us, changing our perception of what’s normal or right for us, for worse or for better. Couples may gain weight after marriage, but one partner’s healthy habits can also be contagious. Researchers found that when only one marital partner participated in a weight loss program, the spouse lost weight, too, without being on a structured diet (Gorin et al. 2008).

Decisions about food and physical activity are ultimately personal choices, but it’s difficult to ignore that the deck is stacked against us in our quest for good health and weight control. When it comes to changing for the better, it’s been said that motivation is what gets you started and habit is what keeps you going. Forming healthier habits helps to counteract a host of environmental influences that cue us to eat more than we should.

Exploiting the Power of Habit

We are creatures of habit—recurrent behavior that’s become nearly or completely involuntary and is hard to give up. It’s estimated that more than 40% of our daily actions are habits, not decisions (Neal, Wood & Quinn 2006). The distinction between habits and decisions is noteworthy because it affects how we help people establish positive behaviors.

Habit making and decision making happen in different parts of the brain: habits in the basal ganglia and decisions in the prefrontal cortex. Habits are “default” behaviors that require little or no contemplation. As such, habits are timesavers; they free up the brain to think about other tasks. It would be impossible to mull over every action you take during the day, like brushing your teeth, tying your shoes and driving to work. You’d never get anything done.

Understanding Habit Loops

With regard to health and well-being, there are good habits, like having whole-grain cereal, low-fat milk and fruit every morning; and negative ones, like starting each day with a cigarette and a can of soda. Behavior experts say habits are loops that happen in three steps:

  • The cue, an urge alerting your brain to go on automatic pilot. Cues can include time of day (noon equals lunchtime, for example), location and emotions (such as stress).
  • The routine, the action you take to satisfy the urge.
  • The reward, which may be the delight of biting into a juicy cheeseburger, the relaxing effects of a cocktail, or the stress reduction you get from taking a run. Rewards train the brain to remember and repeat the behavior loop over and over,
    making it deeply ingrained and difficult to budge.

Awareness is the first step to habit change, and it’s helpful for clients to understand the structure of unhealthy habits in order to recognize their behavior patterns and see ways to
improve them. However, bad habits appear to die harder than good ones, and experts say it’s better to focus on establishing healthier behaviors rather than banishing the bad. Good habits tend to crowd out bad ones with time.

It’s unclear from the scant scientific literature on the topic how long it takes to form a new habit. However, it’s safe to say it varies widely. Researchers found it took 18–254 days for people to “automate” doing a certain healthy behavior in the same context every day, such as performing 50 sit-ups before breakfast (Lally et al. 2010).

Making Willpower Stronger

We constantly struggle to balance our innate need for instant gratification—by gobbling up candy with little regard for its calories, for example—with our rational long-term goals, such as eating better to lose weight, lower blood pressure or improve blood glucose levels. And as if poor eating isn’t encouraged enough by environmental prompts, including relentless marketing of high-calorie foods, research shows that taste trumps healthfulness when we choose foods (IFIC 2013). That makes sense, since our brains are wired to seek pleasure and avoid pain, which people may interpret as dietary deprivation. Our preference for pleasure over good health only adds to the challenge of dodging temptation.

When clients choose candy instead of an orange to satisfy their sweet tooth, they may berate themselves for a lack of willpower. They may decide they don’t have enough self-control to make even the smallest of benefificial dietary changes, but that’s not usually the case. Every day, your clients practice their willpower. For example, they will themselves to be diplomatic at work and at home when they may want to say something snide or negative; to go to bed at a decent hour instead of watching television; and to help their kids with homework or other school projects.

Self-control is vital for making healthy food choices and forming new, default behaviors that can offset environmental cues to eat the wrong foods. Willpower varies from person to person and possibly from day to day. The struggle to do better is harder for some than others, which is why many people don’t make the lifestyle changes we recommend, at least not right away. In addition, willpower is a limited resource. Striving to form new habits in an environment that offers constant temptation saps inner energy reserves. And that’s not the only drag on willpower. After performing so many tasks throughout the day that we don’t necessarily want to do, there may not always be enough self-control left to get to the gym or to resist that big bag of chips, especially when we’re tired, stressed or overwhelmed.

While willpower may waver, however, it can also grow. Self-control is a lot like a muscle—the more you use it, the stronger it gets. It’s possible to bolster better choices with practice, according to researcher Roy Baumeister, coauthor of Willpower: Rediscovering the Greatest Human Strength (Penguin 2012). Baumeister’s research shows that strengthening willpower in one area of our life increases self-control in others which may include making better eating choices and getting regular physical activity. Strengthening willpower may be as simple as eating satisfying meals and snacks throughout the day (so that we resist poor food choices while we’re out or at home) and keeping tempting foods out of the house.

Strategies to Help Consumers Make Better Eating Choices

It’s difficult for most people to devote a lot of thought to food decisions, and it would be easier for everyone if the environment were more conducive to good health. Habits are hard to change, but when our surroundings change for the better, habits can, too. Until that day arrives, it’s beneficial to develop strong default behaviors to counteract the effects of our foodfilled environment. Here are some hints for helping your clients to make better choices and lasting changes:

  • Plan to succeed. It’s much easier to make poor food decisions when you’re famished, whether you’re at home or out. Encourage clients to plan their meals and snacks for the week and to shop regularly for healthful ingredients. Meals and snacks should include adequate protein and fiber to promote fullness, so when that candy bar calls out to clients, they are more able to resist. Besides, protein-rich foods, such as milk, and fiber-rich foods, such as vegetables, contain an array of nutrients missing from most people’s eating plans.
  • Affirm any progress. Losing 20 pounds may seem like an insurmountable goal to some; so may working out for at least 30 minutes on most days of the week. Encourage clients to pat themselves on the back for any change that works toward a greater goal; for example, losing a pound a week or walking for 10 minutes a day is progress. Taking baby steps can increase confidence and willpower. Successfully making one better choice encourages another good choice and helps to establish healthier habits.
  • Focus on pleasurable, healthy foods. Though pleasure is often blamed for dietary setbacks, it can be used to help the brain lock into a healthy habit, such as eating more fruits, vegetables and whole grains. That’s why healthy foods should be as enticing as possible. For example, eating plain, steamed broccoli may be unappealing, but roasting it with olive oil and a smattering of salt may change that. Including raw
    spinach, sweet potato, pumpkin or kale in a fruit smoothie is another way to slip more vegetables into the diet without really tasting them. Baby carrots may be more attractive as a snack when dipped in hummus or peanut butter.
  • Don’t stray too far from typical eating patterns. It’s possible to use nutrition facts to scare clients away from large portions of fast-food favorites and full-fat ice cream. However, most people feel uncomfortable and deprived when asked to make radical eating changes, such as substituting salads for burgers and fries. Choosing a single burger and a small order of fries is more reasonable than going “cold turkey,” and this first step may lead to other more healthful behaviors, such as adding a side salad to the meal, in the long run.
  • Acknowledge the limits of self-control. Don’t tax willpower by encouraging too many dietary changes all at once. Propose one habit at a time, such as establishing a goal of five servings of fruits and vegetables every day. Remember, it’s easier to establish new habits than to break bad ones. Asking people to choose five servings of fruits and vegetables daily is an inclusive behavior that may naturally crowd out less healthy foods, like snack chips and cookies.
  • Take it slowly. People often expect quick results. Remind clients that it can take a long time for an action to become habitual, and encourage short-term thinking to establish long-term behavior change. Advise clients to forgo concentrating on how much weight they want to shed or how much more they need to exercise, and to think instead about how they’ll behave at the next meal, in the next exercise session or even during the next 30 minutes. This may help them to feel less burdened by lifestyle changes that seem insurmountable. Small accomplishments can strengthen the will to do better.
  • Keep your eyes on the prize. In trying to establish healthy habits, professionals and their clients may appeal to a sense of reason. However, habits and decisions are made in separate parts of the brain. Deciding to lose weight or choose healthier food is one thing; forming the habits required to accomplish those goals is quite another. Saying you should work out on most days of the week because it’s good for you is often not enough to make a behavior stick. Motivation to establish healthier behaviors often requires more of an emotional appeal. Helping clients to think about making healthy choices as a means to a highly desirable end, such as getting strong enough to travel with ease, or staying energetic for their children or grandchildren, can motivate healthier habits.
  • Take the lead in your social network. Clients can’t pick their families and often have little control over whom they work with, but they can control their eating and exercise choices by setting the tone. Encourage them to navigate challenging social situations by bringing healthier dishes to family gatherings and by ordering their lower-calorie, healthier entrée first—rather than following someone else’s lead—when eating in restaurants. Organizing walking or running groups at work or in their neighborhoods also garners social support for their efforts.
Legislating Good Nutrition: Can Laws Promote Healthier Decisions?

Many health experts believe that limiting portion sizes, providing nutrition information and taxing highly desirable ingredients such as sugar may prove effective for reducing calorie and sugar consumption. However, it remains to be seen if it’s possible to mandate good nutrition.

Former New York City Mayor Michael Bloomberg planned to prohibit the sale of sugary drinks larger than 16 ounces. The ban, which was to go into effect in March 2013, was blocked in court, and there are no immediate plans for its implementation. The matter is under review by the New York State Court of Appeals.

Taxing sugary drinks is another potential calorie-saving tactic that hasn’t yet met with much success in reducing body weight (Fletcher, Frisvold & Tefft 2014). It may take a relatively high tax on sugar as an ingredient to produce a broader effect on calorie and sugar consumption. It’s estimated that levying a 20% tax on sugar would reduce calories by 18% and lower sugar intake by 16% (Harding & Lovenheim 2014). Taxing sugar as an ingredient would drive up the cost, not only of sugary drinks, but also of products like cookies, candy and ice cream; as a result, consumers would presumably eat less of these relatively caloric items, which may also be high in fat and sodium.

As for restaurants, more than 20 states and localities have adopted menu-labeling regulations for chain restaurants, usually in the form of calorie information at the point of purchase. While information in cafeterias and restaurants increases awareness about nutrition, it appears to influence ordering habits only among certain groups, such as women who are already closely monitoring their diets (Krieger & Saelens 2013).

It’s unclear if predetermined portions, food taxes and point-of-sale nutrition information will make a difference in food intake. Factors other than nutritional and health concerns—including taste, price and convenience—may shape choices to a greater extent than nutrition (Krieger & Saelens 2013).

Portion Distortion

If your clients think that half a box of pasta is a serving or that a typical bagel is the caloric equivalent of a piece of bread, they’re probably struggling to balance their diets. As portion sizes have grown in restaurants, in supermarkets and at home, it’s become harder to avoid overeating. Here’s how serving sizes have changed during the last 20 years.

20 years ago: 3-inch diameter, 140 calories
Today: 6-inch diameter, 350 calories
Increase: 210 calories

Turkey Sandwich
20 years ago: 320 calories
Today: 820 calories
Increase: 500 calories

Spaghetti and Meatballs
20 years ago: 1 cup spaghetti with sauce and 3 small meatballs, 500 calories
Today: 2 cups of pasta with sauce and 3 large meatballs, 1,025 calories
Increase: 525 calories

French Fries
20 years ago: 2.4 ounces, 210 calories
Today: 6.9 ounces, 610 calories
Increase: 400 calories

20 years ago: 6.5 ounces, 85 calories
Today: 20 ounces, 250 calories
Increase: 165 calories

Source: NIH 2013.

Overweight and Undernourished

Sixty-nine percent of adults living in the United States are overweight or obese (CDC 2013). We overeat, but we’re also undernourished. The 2010 Dietary Guidelines for Americans identified calcium, vitamin D, potassium and fiber as the four main nutrients that we consistently miss out on. Women of childbearing age are also at risk for iron and folic acid deficiencies (USDA & USDHHS 2010).

Consuming the suggested number of servings of dairy, whole grains, fruits and vegetables every day helps to fill nutrient gaps and brings more balance to eating plans.

Weight Control: No Magic Bullet, Just Healthy Habits

The National Weight Control Registry is the largest prospective investigation of long-term successful weight loss maintenance. The program tracks more than 10,000 people who have lost an average of 66 pounds and kept it off for 5.5 years.

There is variety in how NWCR members keep the weight off, but it appears that established healthy behaviors are making weight maintenance possible:

  • 78% eat breakfast every day.
  • 75% weigh themselves at least once a week.
  • 62% watch less than 10 hours of television per week.
  • 90% exercise, on average, about 1 hour per day.

Source: NWCR 2014.


Baumeister, R.F., & Tierney, J. 2012. Willpower: Rediscovering the Greatest Human Strength. New York: Penguin.

CDC (Centers for Disease Control and Prevention). 2013. Obesity and overweight.; accessed Mar. 21, 2014.

Christakis, N.A., & Fowler, J.H. 2007. The spread of obesity in a large social network over 32 years. The New England Journal of Medicine, 357, 370-79.

Gorin, A.A., et al. 2008. Weight loss treatment influences untreated spouses and the home environment: Evidence of a ripple effect. International Journal of Obesity, 32 (11), 1678-84.

Fletcher, J.M., Frisvold, D.E., & Tefft, N. 2014. Non-linear effects of soda taxes on consumption and weight outcomes. Health Economics. doi: 10.1002/hec.3045.

Harding, M., & Lovenheim, M. 2014. The effect of prices on nutrition: Comparing the impact of product and nutrient-specific taxes. National Bureau of Economic Research Working Paper No. 19781.

IFIC (International Food Information Council). 2013. 2013 Food & Health Survey: Consumer Attitudes Toward Food Safety. Nutrition & Health.; accessed Mar. 18, 2014.

Krieger, J., & Saelens, B.E. 2013. Impact of menu labeling on consumer behavior: A 2008-2012 update. Robert Wood Johnson Foundation.

Lally, P., et al. 2010. How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology, 40 (6), 998-1009.

Neal, D.T., Wood, W., & Quinn, J.M. 2006. Habits—a repeat performance. Current Directions in Psychological Science, 15 (4), 198-202.

NIH (National Institutes of Health). 2013. Stay young at heart, portion distortion. National Heart, Lung, and Blood Institute & National High Blood Pressure Education Program.

NWCR (National Weight Control Registry). 2014. NWCR Facts.; accessed Mar. 15, 2014.

Painter, J., Wansink, B., & Hieggelki, J. 2002. How visibility and convenience influence candy consumption. Appetite, 38 (3), 237-38.

USDA (U.S. Department of Agriculture) and USDHHS (U.S. Department of Health and Human Services). Dietary Guidelines for Americans 2010, 40-42.; accessed Mar. 22, 2014.

Wansink, B. 2010. Mindless Eating: Why We Eat More Than We Think. New York: Bantam. Wansink, B., & Sobal, J. 2007. Mindless eating: The 200 daily food decisions we overlook. Environment & Behavior, 39 (1), 106-23.

Elizabeth M. Ward, MS, RD

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