A few years ago, the computer guy showed up at my office for the first time in a long while. Let’s call him Gene. Right away, I knew something had changed. I said, “Gene, how are you? You’re looking very well!” He responded with an uncharacteristic grin, and answered with a statement that all of us know, but few believe. He said, “Diets don’t work.” I sat up quick.

Gene motioned to a small machine on his belt that I had assumed was a cell phone, or perhaps even an insulin pump. It was a pedometer. He said he had started slowly, satisfied at first with even 8,000 steps per day. That was then. Now he was walking close to 20,000 steps a day and sometimes even more. His pants were getting loose, and he was proud to say that he had taken in his belt a notch.

Change begets change, and health begets health. Before long, Gene had decided to stop eating the fast food lunches he had bought for years. He decided to try eating a piece of fruit and a bag of nuts instead and discovered, to his amazement, that they satisfied his hunger. He took in his belt two more notches.

Tip O’Neill, former Speaker of the House, once said, “All politics is local,” meaning that the issues we consider most important are the ones that affect us most personally. In a parallel statement, I would say that good health is personal. One size never fits all, and I should know: I’m barely 5 feet tall, so “one size fits all” never fits me! 

Some people enjoy the taste of cilantro whereas others despise it. Some people carry their water in gallon jugs, whereas others carry small bottles. Some folks thrive on a vegan diet, and others are unable to manage their weight unless they cut their intake of grains to just about nil. 

The same goes for exercise. Good health is not just about food. If you live near a track, or in a safe neighborhood with sidewalks in good repair, and you enjoy walking, then maybe you’re ready to buy a pedometer. But if your knees give you the blues, and you have always loved the water, maybe you’ll check the schedule at the community pool. Or maybe you’ll download a youtube video of a yoga or tai chi class. Do what appeals. Work with, not against, your inclinations.

What is the secret to Gene’s success? First, he understands that diets don’t work. You can’t build a system on deprivation. Secondly, Gene figured out which lifestyle choices were most easily achievable, and he started working on just those. One step at a time. Literally. And then one meal at a time. Small changes.

Thirdly, Gene increased his activity in a way that was pleasurable. When he was ready, he substituted a high-quality nutrition source for the low-quality fast food he had eaten for so long. And lastly, he stopped drinking soda. That was really all it took. He didn’t stop eating every last speck of processed food, and he didn’t say that he will never again drink a soda. He just decided that he will no longer drink it every day. What keeps him going? The fact that he feels so much better.  And his son.

Many patients have told me that the changes they start to make on behalf of their own health often become reflected in the health of their entire families. Gene drinks only water or milk now, and that’s what he offers his 6-year-old son, too. He says, “If you’re thirsty, you’ll drink water. If you want something sweet, eat a banana.” I’ve heard plenty of people complain that they don’t like water, but this is a learned response, and that means it can also be an unlearned one. You can make small changes by diluting drinks by 1/2 for a while, then 1/4, then 1/8, and so on, down to zero. Small changes, always. Gene is right: if you’re really thirsty, water should do the trick.

Change is reflected first in our thinking, and later in our actions. As our conversation came to a close, Gene surprised me by saying, “I still have a long way to go.” He must be referring to the distance he intends to walk, because mentally, as far as I’m concerned, he’s already there.

Practice makes progress. Perfection is the enemy of progress.