Triaging lifestyle changes is there such a thing?


When clients come in for a consult they usually have a list of things they want help with – usually the list is something like this:

  • more energy
  • lose weight
  • help with hair loss, skin issues like acne or eczema
  • help with bloating and other digestive upsets and food intolerances
  • help with erratic menstrual cycles and PMS and natural fertility/ preconception care
  • help with headaches
  • help with sleep quality
  • help with reducing anxiety

There are more, but these are the most common things I see clients asking for help with. Usually in my clinic because I’ve got a “plant-based approach” and follow a mostly plant-based diet (I’ll talk about this more soon if you’re curious) I tend to see these issues in vegetarians and vegans or people transitioning to vegetarian and vegan diets as well as those with mainstream diets.

At the end of the 90 minute initial consult I tend to have a list of things that I can see we need to tackle too like:

  • getting more sleep – going to bed earlier
  • getting more exercise/ some exercise
  • drinking more water
  • getting some sunshine and fresh air
  • balancing some nutrients based on blood tests – eg. iron or vitamin D or herbs
  • reducing stress
  • dietary changes like – adding in more fibre, more fruit, more veggies, more whole grains, nuts, seeds or legumes etc. depending on their diet style and what kind of issues are going on.

So as you can see between the two lists – the clients’ lists (the outcomes they want to achieve) and my practitioner list (the list of things which will help to achieve it) a bit of “triaging” needs to happen. It’s called a “practice” for a reason – because once you come out of the idealistic world of college and text books and start to work with real life people you soon realise a few things – what people want to do and what they can do aren’t always the same thing. Yet if they don’t see the results they want to see straight up they may not come back to give you a second chance. Perhaps for this reason, naturopathy seems to have taken a direction toward more supplementing and generally more “complexity”?

Anyway, the real problem is believing these issues even have a quick fix.

After a 90 minute consult we tend to find that each of these things on our “to change” list has its own special issues so it might look a bit like this:

  • getting to bed earlier – difficult because they work 2 jobs, or they have young children waking through the night. They get home from work late, eat late and consequently go to bed late.
  • reducing stress – stress from bosses at work – stress from friendships or relationships – eg their ex may be causing them stress, or they’re making good lifestyle changes but their friends try to guide them off track. They could be spending time helping family members just move from one drama to another.
  • making dietary changes – their kids don’t like it, their hubby doesn’t like it. They work long hours or 2 jobs and can’t get to the shops. Money is tight adding another dimension.

So “simply reducing stress” isn’t as simple as just prescribing a yoga lesson. That alone is a band-aid; the real problem is the boss causing excessive stress with unrealistic expectations at work or humiliating workers in public etc. A yoga lesson or even a term of yoga in this situation is not the “needle mover” that is going to make a huge difference to this person’s life in terms of removing the ongoing cause of stress and damage to health. In this example the needle mover would be changing the situation at work which is the problem.

So what do you need to change first in general to get the biggest “bang for your buck” so to speak when it comes to getting your health back on track? I’ve been thinking about this for a while and doing quite a bit of observation of it both in clinic, in my own life and chatting with other praccies: what I’ve concluded is that it isn’t changing diet, exercise or sleep first, because I’ve tried each of these approaches many times and I don’t see the long lasting changes I’m looking for.

Eating well certainly helps, but as soon as things start getting stressful, self care via diet tends to go out the window especially as people “run out of time” (you recall from this post).

Getting to bed early helps – but as soon as things get busy and multiple deadlines loom or cluster then people tend to catch up by having less sleep – they go to bed later to meet the deadline or get up earlier – or do both. Their exercise routine suffers (if they have one) and they cut down the meal prep time and opt for pre-made, packaged, take away or restaurant options.

Taking supplements can also help with energy but when the budget begins to feel a squeeze these are the first things to go – along with health consults. Health spending (such as for a pilates lesson or a consult) is ditched rather than discretionary purchases on jewellery, clothing, makeup or hair appointments. You might think I’m joking or generalising here, but there are many times I’ve had people tell me that money is tight, but then talk about their new DSLR, Dior sunglasses or new hairstyle.

With this in mind I have been writing a series of blog posts on this life changing stuff. It’s these seemingly simple, not-so-academic things on people’s lists (which in my experience have the biggest impact) which can be hardest to change.

By the way, I still know that diet is very important – and for those of you who used to love my nutrition posts – they’ll come back again but I think this lifestyle stuff is very important too as I’ve found it to be the reason other priorities come unstuck – it’s why I keep getting burnt out, running out of time to cook healthy meals and exercise and I see the same happen with friends, clients and colleagues.

So in my new lifestyle triage list – I think the #1 thing people need more help with is time management and understanding then setting their priorities.

Time management is a bit like managing a budget. Too many people have “champagne tastes” on a “beer budget” when it comes to their time. Their exhausted, stressed-out bodies are proof of just how far they are living beyond their means. Using the money analogy, so many people nowadays are exhausting themselves because they’re spending their time as though it is going on a credit card with no limit (and there is no tomorrow when they need to pay it off). They keep borrowing from time they really don’t have until the bank (their bodies) effectively shut down and say “Funds Unavailable”!

From what I’ve seen – poor time management exemplified by people taking on more than they really have time to do – leads to less sleep, exercise and home cooking or eating good meals in general – which depletes already-reduced stress coping as well as leading to nutritional deficiencies which tend to exacerbate that health cycle. It tends to add financial pressure because people don’t have the time to do it themselves so they need to pay for solutions, like eating out or getting takeaway, or getting a house cleaner, or gardener, dog walker, or buying more holidays, or they do more comfort shopping. All of this then tends to add more financial pressure so they have to work more and are more bound to their jobs which are often the cause of their stress to begin with.

That’s just one way poor time management can mess up your health.

So how do you help people manage their time better?

I’m still working on this, and it is why I began this blog series. Time management (and setting priorities) is as much a conceptual skill as a practical one. It seems to work better once people “get” it. A bit like losing weight. People can tell you you’re over weight, you can look in the mirror and berate your appearance for years. But one day, something “clicks” and you “get it” and things start to change.

These time management concepts are what I will discuss from a “user perspective” next.

Until then, I’d like to know if any of this resonates with you? Have you tried to change all of the other things first and found that it was hard to maintain when things got busy?

By looking at time management and priorities I think you can establish some skills to help you not over commit your precious time in the first place. While you can’t control everything and from time to time chaos will creep in, I think it is a matter of dealing with the chaos you can change rather than the chaos you have no control over.

So one of the most useful time management things I’ve found is to ponder on the statement: “Just because you think you can do something extra doesn’t necessarily mean that you should“.