Why Knowing Isn’t Enough: The Real Keys to Sustainable Health Change

When the nervous system is overwhelmed, stressed, or operating in a state of survival, our capacity for change decreases. When you're feeling exhausted, anxious, or depleted, the brain naturally looks for efficiency and immediate relief. That's why we often reach for familiar patterns, even though they don't serve us. That's why one reason I often say stabilize before you optimize. The nervous system sets the stage for nearly everything else. Today I want to address a question I hear all the time. If we already know what to do, why is it so hard to actually do it? Most people don't struggle because they lack information. In fact, many people know exactly what they should be doing. The real challenge is creating sustainable change in the context of real life. Today, we're going to explore why healthy habits often don't stick and what gets in the way, and how we can create change that feels supportive rather than exhausting.

Dr. Julie, so nice to see you again, and I'm so happy we're speaking about this because you know we live in the era of information. It seems as though we can find out what we need in just a click, but we still struggle to feel in good health, to feel well. So why do you think so many people know what supports their health but still struggle to do it consistently?

Well, I think one of the biggest myths in health is that information automatically leads to transformation. In fact, most people I work with are incredibly informed. They know they should get more sleep, move their bodies, eat nourishing foods, spend less time on their phones, manage stress more effectively. So the issue isn't a lack of knowledge. The issue is that they're trying to implement all those behaviors while navigating demanding jobs, caregiving responsibilities, family obligations, chronic stress, hormonal shifts, in a culture that often rewards overextension. So we have to keep in mind that behavior doesn't happen in a vacuum. What we do each day is shaped by our energy, our environment, our nervous system, our routines, and of course the demands that are placed upon us. So when people struggle to follow through, I don't see that as a failure of character. I see it as a signal that we need to look at the conditions surrounding the behavior, not just the behavior itself.

And so, Dr. Julie, I've heard in the past that motivation alone isn't enough. Like we won't always feel motivated to do the things that are good for us. Or just in general, you know, we're not always motivated to work on the projects that we want to uh grow. So what's the difference between motivation and sustainable behavior change?

Well, when you have motivation, that's wonderful. When I think about motivation, it's more like a feeling. And it's not something we can rely on. In fact, most of us have felt highly motivated at certain points, for instance, at the beginning of a new year, or after a doctor's appointment, or after hearing an inspiring podcast. But the problem is motivation comes and goes. And sustainable change comes from something deeper. It comes from being connected to your why. In other words, why does this matter to you? What is the one thing you're really trying to create? Is it more energy? Is it better health? Or being present with your family? Or feeling like yourself again. When a behavior is connected to something meaningful, it becomes easier to return to even when motivation fades. So the goal isn't necessarily to stay motivated, the goal is to stay connected to what matters to you.

So important that you mention that because I think that, like you said, we start with a lot of motivation to do to make changes, to stick to what those habits that are good for us, but then we kind of forget why we're doing it in the first place. So when those days where we're tired, when we're lazy, when or not even that, but when we're busy and and we don't put that as a priority, you know, that when those days come, we we fail to put our health as a priority. And I think that's because we forget why we're doing it in the first place, right? So um, how does the nervous system influence our ability to create and my and maintain those new habits?

So this is something we don't talk about enough. Um and I know in this show we love talking about the nervous system. And it's because when the nervous system is overwhelmed, stressed, or operating in a state of survival, our capacity for change decreases. So, you know, when you're feeling exhausted or anxious or depleted, the brain naturally looks for efficiency and immediate relief. So that's why we often reach for familial, uh familiar patterns, even though they don't serve us. And again, it's not because we're weak, it's just our biology. It's like our our brain is just adapting to these demands. And this is one reason I talk so much about nervous system regulation. It's because a regulated nervous system has more capacity for planning, flexibility, reflection, and that follow-through. And when we're constantly depleted, even healthy habits can feel overwhelming. That's why one one reason I often say stabilize before you optimize. The nervous system sets the stage for nearly everything else.

And I guess what comes through for me is that motivation can't really exist in a state of depletion. It's like oppos opposite forces or something. Like if you're depleted, there's no room to be motivated. Like you said, you want to do the bare minimum, the things that allow you to just survive. Having said this, has there been a time in your own life when you realize that knowing something and living it were two very different things?

Absolutely. As a physician, um, I've spent decades studying health and well-being. I knew the importance of sleep, recovery, movement, and stress management. I would even add boundaries to that as part of um, you know, healthy habits. And even though I knew all these things, it was a long time before I consistently practiced them. For instance, there are seasons of my life where I was caring for patients, raising young children, managing a lot of responsibilities and giving to those around me and not taking time or making space to take care of myself. And so I certainly knew what supported health, but even I, as a doctor, you know, couldn't follow through consistently with some of these healthy habits. And I would say, you know, that was years ago, but even today, um, you know, there are times where I am not so consistent. You know, I would say my biggest weakness is um prioritizing sleep, at least in this season right now. And um there are stretches where, you know, I I may be sleep-deprived. But I think the difference now is that I don't let that happen for too long and that I bring you know awareness, like, oh, I need to really prioritize sleep this week and get back to my healthy habit of um prioritizing sleep. And um, I would say that's the difference today versus several years ago. Um, and you know, it it is okay sometimes to not be consistent, but don't let that be a long stretch of time to come back to the habits that support us in feeling good. And so I think one of the most important lessons I've learned is that knowledge does not automatically become behavior. And behavioral change, well, let's say that behavior changes are easier when we begin to align our lives with what matters most. And often that requires slowing down long enough to reflect on how we're actually living.

Yes, how would we actually be so sure about the changes that we need when we're not really conscious of how we're going through life? Because we're if you're an automatic just going through life, through the motions, then you're not it doesn't fully sink in with what it is that you really need. So, like you said, taking that time to or slow down enough so that you can see where those gaps are. And what are some of the most common reasons healthy habits uh fail to stick?

Yeah, there are many reasons. I would say the first is just trying to do too much too quickly, like making lots of changes all at once. The second is relying on willpower instead of creating a system for yourself. The third is expecting perfection. I think that, you know, often paralyzes people to even start any habits if they can't do it all at once, right? They don't even start, or if they're not doing it perfectly, then they just give up. And the fourth is choosing habits that don't fit the realities of our lives. You know, sometimes people create a plan that would work beautifully in an ideal week, but has no chance of surviving a real life week. So I often encourage people to ask, you know, can I still do this on a stressful Tuesday? Can I still do this when work is busy? Or can I still do this when my schedule changes? And if the answer is no, the habit may be too fragile. And the healthiest habits are often the ones that can withstand ordinary life, and those are the ones that are going to stick.

Right. Sometimes we create habits thinking that's all that or we think of creating certain habits thinking that that's all that we're gonna do, but life is still moving and happening, and that brings me back to what you said um a little while back about uh about you know, sometimes you'll have times where you can't sleep your eight hours or whatever hours you need, but you can't be on schedule with your sleep or with your nutrition, and that's fine. We're I guess we're equipped for that, right? Our nervous system is equipped to go through phases of of certain amount of stress because that's life. There is change in stress, but like you said, you know, make that a season or a phase, don't just stay there. You know, we're equipped to to face those times, but also we need to come back to our the rhythm that is more constructive for us, right? And you also said that many people try to change everything at once. Why why is that approach unsustainable?

Well, because every change requires energy. And people often, you know, decide they're gonna wake up early and exercise daily and stop eating sugar and meditate and cook every meal at home and um completely reorganize their lives all at the same time. And you know, of course it's with good intention and it sounds inspiring, but it's also exhausting, right? And the brain and the nervous system tend to resist abrupt large-scale change. And keep in mind many of us are already operating near our full capacity. So one of the questions I often encourage people to ask is, well, what season of life am I in right now? And that answer really matters. So, you know, a woman who's navigating perimenopause, caring for aging parents, raising children, and working full-time may not have the same capacity that she had ten years ago. And that's not a failure, that's just reality. And when we ignore capacity, we create a plan that looks really good on paper, but it doesn't fit our lives. And that mismatch, you know, just sort of sets us up for failure. I don't like using that word. Let me rephrase and say, you know, just it doesn't set us up for success. And I'd rather see someone make one small change consistently than attempt ten changes that feel impossible to maintain. And small changes are not small. When they're practiced consistently, they can create remarkable change over time.

Yeah, um I I was thinking when you mentioned, you know, the mismatch that, you know, having some plan that is really good on paper, but it doesn't really adapt to the phase of life that we're in. Like that that's why m a lot of us get really frustrated when we aren't able to accomplish something, right? Because we want to create these changes, but we don't have the capacity to do so. And I and I see a lot of my friends, for example, when they're just had babies and you know, they want to lose weight or they want to get fit, and and maybe they were able to do it faster in a different phase of their lives, but right now they just gave birth, they have this new baby, their life has changed tremendously. So, how are how can that old plan translate into this new phase of life? And I think that leads me to my next question that is about self-uh criticism, is how how how self-criticism interferes with long-term health behavior change? I think this mismatch, sometimes mismatch in our plans leads us to self-criticize because we aren't able to accomplish what we said on paper. So how does that interfere?

Well, I think you know, people think of self-criticism and being harsh as a form of discipline, and that's gonna motivate them. In reality, it often does the opposite. When we constantly tell ourselves, you know, we're failing, we're lazy, undisciplined, or not doing enough, we create shame. And shame rarely supports sustainable growth. And most lasting change occurs in an environment of encouragement, curiosity, and certainly self-compassion. So instead of asking, you know, what's wrong with me? You know, why can't I do this? I encourage people to ask, well, what made this difficult? And that question shifts us from judgment to understanding. And understanding creates opportunities for change.

Right. Um, I was thinking shame doesn't serve us in anything really, but I thought, okay, maybe shame has a few purposes. If you do something really bad, like if you commit a crime or something that maybe shame is useful, you know, you feel shame and that will propel you to change. But I think that we allow shame too much in our lives for when it's really not necessary. Like there's other avenues to like to create no sustainable especially when it's when it's our health. Like it's such a personal thing for us. Why should we feel shame for trying something and feeling like that doesn't work for us?

Yeah, in this context of health, shame does not serve us. And I always like to say, you know, to my patients, um the word should, like, you know, we should do this and we should do that, um that doesn't serve us because there is that shame aspect. And what is more motivating is, as we talked about earlier, aligning with our why, right? Why, why do I want to make this change? Why does it matter? And often, you know, initially these habits are hard to do. But what when you keep doing them, you actually feel better. Like, I know I will feel better if I go to bed earlier. I'll have more energy, my mood will be better. And it's just the first couple nights that it's hard to make that shift. And and once you do, it's like, ah, it feels so good to get adequate sleep. And so I'm I'm gonna go to bed earlier tonight, you know, and so it's not from a place of should, but because, oh, I'm gonna feel better. And you could probably apply that to any healthy habit, exercise, um, nourishment, um balancing, regulating our nervous system, you know, whatever um activity that helps to do that. Um, and so that is a better place to work from. Instead of should, it's really, ah, I I'm gonna feel better when I do this.

Yeah, I g I guess, you know, you mentioned something key here that changing patterns can be hard because you're accustomed to doing things in a certain way. So reprogramming your brain or your behavior to doing things in a different way can be hard, but that doesn't mean that you have to suffer through the process. And when you add that should or that shame, then you make the process sometimes unbearable. And it's like, why? Yeah.

Suffer less. Yes. Don't add, you know, to the suffering by by shaming yourself for sure. Um And yeah, yeah, no doubt. You know, initially making any change is hard. It takes energy. It takes um a new way of doing things. And it may, you know, even retraining our brain. Like this hurts right now, but it it's it's gonna be good for us. It feels gonna feel good in a few days, you know, once you get over that um initial like activation.

Yeah, I I've heard I've heard before, like, I I don't know where I saw this, but it was probably a meme. Like nobody comes back from the gym feeling like, oh, I wish I didn't do that. You might you it might hurt a little bit while you're at it or might be difficult, but once you're done, you're you feel good. And I and I think that it applies the same to sleep, for example. Nobody, I don't think I've never heard anybody regret that they had such a good night's sleep. Yeah.

Yeah, for sure. Um, that's definitely the case for for the gym. Um, it's hard in the moment. It hurts physically. Um, you know, whatever it is that you're doing. If it hurts too much, maybe that's actually another signal, like, oh, you know, you might want to look into that. Um but yeah, it's a little bit of there's a little bit of a push and pull that has to happen initially. And I think even people who let's say they exercise regularly, yeah, there's a little bit of that pleasure pain, you know. Um it's hard to lift heavy weights, but it feels good because they're getting stronger, and you know, perhaps they're building muscle and it, you know, the it looks good, it feels good, it's empowering, you know, like mentally, and it's empowering physically, right? They're getting stronger. And so there is that reward as well. And even like, you know, the soreness, like I I started adding more strength training again after a little break. And initially it's like you're sore, you can't walk, you know, because you're sore, but it's it's like um, I it it's a pleasure pain because um I know that I'm working my body and it, you know, feels good. Um so yeah, you just have to get over that initial hump.

And I and I think there's something nice about it as well. It's because you worked your body and you're more aware of it because you now feel muscles, you feel your quads, you feel your glutes. And on a regular day, when you didn't work out, you don't even think about the you don't even acknowledge that they're there.

So it's like a form of embodiment, right? Like you're really in your body when you're feeling that soreness of a workout, it's like, ah, you're connected to your body, I think is what you're saying, versus oftentimes, you know, if you if you're not moving your body and you're not feeling, you know, the effects of exercise movement, then you're you're kind of disconnected from your body.

Yeah, like a co like a cold plunge. I think one of the m most important thing lessons from that kind of activity is that you become grateful for having hot water in your shower. Something that you might take for granted, but you know. Um and Dr. Julie, how does the well-being ecosystem perspective help people move away from willpower and toward supportive systems?

Well, uh, I would say the well-being ecosystem starts from a very different premise. It assumes that health is shaped by many interconnected factors. And in fact, the well-being ecosystem invites us to stop looking at health as a collection of isolated habits. And you know, when we know everything is connected, interconnected, it really informs our choices. So, for instance, our sleep affects our food choices. You know, we we know that it influences the release of certain hormones. Um when we're uh uh underslept, um, ghrelin is released and it increases hunger. It's like the hunger hormone. Um, when we're well slept, leptin is released, and that's the satiety hormone. So literally, our sleep impacts these hormones and our food choices. But I think people know, you know, when you're tired, you just you have more sugar cravings to kind of give you more energy. What else? Um, we know stress affects our sleep, right? Um, what else? Relationships affect stress in our nervous system. Our daily rhythms affect our energy. Um, you know, daily by daily rhythms I mean um our work and rest balance, our sleep, um all the parts of our daily rhythms affect our energy. Um, we talked about motivation earlier, meaning and purpose affects our motivation. So instead of asking, um, you know, why don't I have more willpower? How do I get more willpower? We ask, what in my ecosystem is supporting me now? Or what in my ecosystem is making this harder? That's a much more compassionate and productive conversation than you know, what's wrong with me? Why don't I have enough willpower?

Right. This is a great lesson for me. I'm I'm trying to be, you know, more compassionate with the changes that I want to make in my life. And, you know, to remove that aspect of I should like I under s I'm trying to understand that I'm doing this for me, for to be better, to live better. So there's no sure. There's no I don't owe this to anybody. This is something that I want to do for myself, for my life. So that's my why. It brings me back to yeah, when when I don't really when I lose my purpose, then I go back to that. And I and it removes the shame and it removes the self punishment or self-infliction. I don't know.

Um I mean that may work for some people, you know. Um I find it it doesn't work for me and many of the women that I work with. Um and uh yeah, it can be damaging to our well-being, right? That harshness and that um criticism for sure, and certainly shame.

So I guess because everything is interconnected, um you might be uh adjusting certain areas of your life, but you're feeding stress, and then that stress then I I don't know if it I'm explaining it well, but then that stress affects all the areas of our life that we're trying so hard to adjust.

So it it you kind of yeah, and I would say as we as we talked about earlier, it's so important to um, well, uh balance our nervous system, right? So that it's more regulated in order to support us in all of these healthy habits that we're trying to incorporate. And being harsh on ourselves definitely is dysregulating, at least for my nervous system. Um, and so it doesn't really serve us. Um, and then not to mention, yeah, stress just impacts our biology and and um our sleep and all the other things that our nervous system is intimately connected with in our body, in our mind. Um so yeah, I would say um that's the one stress you can control is to not be so harsh and critical of ourselves. There's many stressors we cannot control or remove from our lives. Um, and so it's this interplay of controlling what we can control that triggers our nervous system, and certainly activities, exercises that help to regulate and balance our nervous system.

And Dr. Julie, so we we've talked a little bit about how different aspects of our well-be of our ecosystem affect how they're interconnected. So what role do environment routines, relationships, and daily rhythms play in making healthy behav behaviors easier?

Yeah, they play a tremendous role. I would say human behavior is remarkably influenced by context. Our environment can either support healthy choices or constantly create friction. Um our relationships certainly influence our habits more than we often realize. So, for instance, if our partners have healthy habits, we're more likely to also have healthy habits. So I love working with couples and families, you know, to create a healthy home. Um, what else? Our routines that we create and that structure that we create reduce decision fatigue. And that's really helpful for sustaining healthy habits. And certainly our daily rhythms affect everything from energy and mood to appetite and focus. And when all these pieces are working together, healthy behaviors require far less effort. So, in my opinion, the goal isn't to become more disciplined, because that's hard, that's like you know, uphill battle. I think the goal is to create conditions and an environment where healthy choices feel more natural and just are easier.

And Dr. Julie, if someone listening wants to create one lasting change, what is the best place to begin?

Well, I say this often, but I would encourage you to pause before adding another item to your to-do lists. Um, I think you know, certainly many of the women that I work with, they are just high functioning, high responsibility, high um, well, that they have a high demand life that they need to function in. And so, you know, often adding something else to do is just not the best approach. And so what I encourage people to do is to take a moment to reflect and ask yourself, what matters most right now? What season of life am I in? What is my current capacity? And what is one small thing that would genuinely support me right now Again not what you should do, not what someone on social media is doing, and certainly not what worked for someone else's life. What would support you? Then make it small, small enough that you can do it consistently because lasting change is rarely the result of one dramatic action. It's the result of small choices repeated over time. And I think perhaps it's most important to remember that you don't need to do everything all at once. You only need to take the next step that aligns with the life that you're trying to create. One of the biggest misconceptions about health is that transformation comes from trying harder. In reality, lasting change often comes from creating the right conditions. That's a foundational principle of the well-being ecosystem. Inside the program, we focus on building supportive systems that make healthy choices feel more natural and sustainable over time. Because real health isn't about building perfection. It's built through consistency, compassion, and environments that support who you are becoming. If today's conversation resonated with you, I'd love to hear what healthy habit you're working on right now. Visit my latest Instagram post at Julie. And if you're feeling ready for a reset, you can also find my free reset guide in the show notes. Thank you for joining me for this episode of Medicine with Meaning. Change doesn't happen because we know more. It happens when we create the conditions that allow new behaviors to take root. Small steps practiced consistently can lead to remarkable change over time.