Positive resolutions are much easier to keep

Q: I saw on the news that there's a new study about how to make a successful New Year's resolution. My wife and I have the same list of resolutions every year, including to stop eating so much junk food and to quit sugar. And around this time every year, we give up on them. We would love to know why it's hard to follow through.

A: It wouldn't feel like the start of a new year if we weren't hearing from readers about their love-hate relationship with resolutions. On one hand, the calendar hands you a clean slate. It arrives after weeks of festivities during which overindulgence has been a guiding principle. We've eaten and drunk our fill, and we now find ourselves not only ready, but even eager, for a reset. On the other hand, we're still the same people we were before Thanksgiving signaled the start of the annual bingeing season. All of the reasons we didn't lose those 10 pounds last August, or didn't quit our sugar habit in March, still hold true.

Research into the topic of New Year's resolutions finds that many of us fall off the wagon surprisingly soon. An analysis of the online activity of more than 31 million people suggests that by the end of January, many resolutions are already in the rearview mirror. More rigorous studies from the University of Scranton tracked the slow decline of resolve. By the end of one week, researchers found that 23% of the study participants had already abandoned their resolutions. After three months, half had called it quits. When the researchers followed up two years later, about 20% of participants said they had been successful at keeping their resolutions.

In the study you're asking about, published last December in the journal PLOS One, the researchers looked at what separated the people who managed to keep their resolutions from those who didn't. They found that how someone states their goal can make a difference. People whose goals were of the “I will” variety had a higher rate of success than those who approached their resolutions with “I won't.” Specifically, 59% of the 1,066 study participants with proactive goals considered themselves successful, while only 47% of those with avoidance-oriented goals felt they had succeeded.

In terms of your resolution to eat less processed snack food and to cut down on sugar, you might try flipping the focus. Instead of thinking in terms of what you're going to eliminate from your diet, try making a specific decision about something that you will add. For instance, you might start with the resolution to eat one piece of fresh fruit at each meal. You can up the ante by agreeing that, before indulging in any kind of snack food, you first have to eat something good for you, like a fresh carrot. That way, even if you do waver in your resolve and slip into old habits with a bar of chocolate or a bag of chips, you've also kept your resolution. Change is hard, and even small victories can make it easier to stay on track.

Q: Is it true grief can make you get physically sick? My mom passed away just before Thanksgiving, and I've been struggling with my health. I'm having headaches, I've had an eczema flare and I caught the first cold I've had in three years.

A: We have only to look to language to see how closely grief and bereavement are associated with physical pain.

Heartsore, heartsick, heartache, brokenhearted — each word draws a direct line between the emotion of grief and its profound effect on the human body. People who are grieving talk about feeling empty and numb, of being sick with grief. And small wonder. Research shows that, in addition to being an emotional challenge, grief and grieving can indeed take a physical toll on the human body. The sense of loss and longing that are a part of grief often manifest themselves as physical sensations, including a tightness in the throat and chest, a hollow feeling in the solar plexus, physical weakness, aches and pains, lack of energy and changes to appetite and sleep patterns.

Research into the physical effects of grief suggests that the immune system gets involved by mounting an inflammatory response. A study of older adults who were grieving found the effectiveness of certain white blood cells, which fight off infection, to be measurably reduced. A different study, published in the journal Circulation, found that the day after a significant death, a grieving survivor's risk of having a heart attack was 21 times higher than normal. A week later, the risk was 6 times as great. The psychological pain of grief can put your physical health in jeopardy.

Another reason grief can be so difficult to endure is that, in addition to being a state of body and of mind, it also is a process. The famous “five stages of grief” theory, which includes denial, anger, bargaining, depression and acceptance, suggests an orderly and linear progression. However, reality is far more complex. People can find themselves experiencing multiple stages of grief at one time and revisit them repeatedly.

Grief is classified into two distinct types, acute and persistent. Most people experience the former, which lasts about a year and gradually resolves. In persistent grief, the feelings and symptoms last far longer. Although there's no quick way out of the physical and emotional pain of mourning a loss, research suggests specific steps can help make it bearable. First, do your best to maintain a healthy diet and get adequate sleep. Physical exercise, including mind-body practices such as yoga, tai chi and qi gong, is important. It can be hard to get motivated, so consider joining an exercise group or taking regular classes.

Be sure to reach out to your social circle. Grief is an isolating experience, and even one social interaction per day can lift your spirits. And consider a support group. The participants will understand what you're going through. A support group can both show you a way forward and give you a chance to lend someone else a hand when you are able.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.