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Making the Changes You Want to Make: The Six Stages of Change

Have you ever tried to make a major change in your daily routine and found that it is not as easy as you thought?

For example, have you ever tried to change your eating habits? What about eliminating sweets, candy, or desserts from your diet? If you have tried to do this, you may have failed because this is not an easy change to make. So here’s an important question to ask: Do you need to remove these foods from your diet, or can you make them count? Can you make desserts and sweets become part of the important foods you eat?

First, look at your current sweet intake. Is it primarily sodas, candy, and other refined carbohydrates? Then look at the whole foods available to you, and ask yourself if you can make changes where dessert and sweets are concerned, so that you are using whole foods instead of processed foods. The answer is yes, you can. A positive behavioral change process like this will enhance not only the quality of your body but also of your mind, emotions, spirit or soul, and environment.

Changing old habits for new ones poses a significant challenge for most people. However, if you use the right combination of carbohydrates, fats, and proteins from pure, whole foods at each meal, these foods become fun foods and no longer pose a behavioral challenge. For example, if you have a cookie made with poor quality, highly processed ingredients, the cookie will have a negative effect on your body’s cells. However if you make a cookie with high-quality, whole food ingredients, it will have a positive effect. The cookie has now become a positive food for the body. Once we start eating whole foods on a regular basis, our taste adapts. We no longer crave the unhealthy foods we once ate.

Viewing food as a critical ingredient in good health is the first step to making changes in your eating behavior. However, while most people do not connect what they eat with health or disease, making this connection is important. In order to begin changing your behavior, you must first recognize that a change is needed, and then you need to identify how this change will benefit you. Finally, you will have to want to make the change.

Lets look at a method that can support you in this process. It is known as The Six Stages of Change, and since developed by James Prochaska, PhD, and Carlo DiClemente, PhD, in the late 1970s, it has become one of the most important approaches to behavioral change. Here is an outline of each stage, ending with actions you can take to move you toward the next level.

The Six Stages of Change

Stage 1: Pre-contemplation

Characterized by the thought, “I don’t think I have a problem.”

At this level, you are in denial. You see no problem and, therefore, no need to contemplate change. You might say, “There is no problem” or “I don’t have to fix what’s not broken.”

There are no actions you can take at this point since you see no problem or need for change. You may or may not later get a wake-up call and move to the next stage.

Stage 2: Contemplation

Characterized by the thought, “Is change really beneficial?”

You may be saying, “Prove to me that a change is needed.”

At this level, you have some knowledge of your disease-promoting behaviors and may be considering making some beneficial changes. You have not yet made a pledge because you are still considering the advantages and disadvantages of a major behavior change.

Actions you can take: Consider making a plan for initiating change. Keep it simple. For example, you may love to eat at McDonald’s three times a week. You should already know that this kind of food, in excess, is not good for achieving and maintaining optimum health. Slowly it may dawn on you that you can’t keep this up and expect to remain healthy.

Stage 3: Preparation

Characterized by the thought, “I am going to do this! I’m ready to go for it!”

At this stage, you are ready to get started. You’re ready to make a change. You are now developing a concrete plan.

Actions you can take: Develop some clear objectives and precise procedures. Plan short-term and long-term goals that are sensible and achievable, along with a clear idea of how to accomplish them, and in what time frame.

Stage 4: Action

Characterized by the thought, “I’m doing it!”

At this level, you have allocated your time and energy to reaching your goal. Even this is a tremendous step forward. In addition, you may develop a strong belief and have the confidence that what you’re doing is good and worthwhile. These feelings will drive you to achieve success — enjoy them.

Actions you can take: Continue to follow up with those assisting you with this change. Their support can be pivotal in linking you to any additional information and resources you may need to maintain and strengthen your convictions that you can make the desired changes. In-person support is best, but you can get good support by phone or Internet if necessary. For example, you might want to eat fast food only twice a week, then drop down to once a week, and also decide that if you eat fast food, you won’t “super size” it.

Stage 5: Ongoing Maintenance

Characterized by the thought, “It’s difficult to think of how I was before.”

It may be difficult for you to remember what your behaviors were like before you became dedicated to your good health. When you have sustained the new behaviors for six months to a year, you can consider that you have graduated to ongoing maintenance. When you reach this level, you know the benefits of the behavior change because you can feel and experience it firsthand. At this level, there is only one goal left to focus on: prevention of a setback.

Actions you can take: consider defining some long-term behavior maintenance approaches to prevent reverting to old behaviors. For example, develop a support system, review past journals and logs, keep up with body composition tests, be proud of your improved health, and focus on how you feel and look now versus how you previously felt and looked.

Stage 6: Relapse or Termination

Characterized by the thoughts “How can I get back on track?” or “Am I done with this now?”

Relapse is common, and being prepared to start over again is important. If you have relapsed, see if you learned something new about yourself and about the process of changing behavior. For instance, ask yourself, “I did it for six days, so what made that work?” Shift your focus from failure to whatever promotes problem solving. Get the support you need to re-engage in the change process. Set realistic goals to prevent becoming discouraged and take positive steps toward that behavior change.

Alternatively, you have conquered the problem and no longer feel the temptation to return to your old, poor behavior. Congratulations! Typically, confidence in success peaks after a year, but temptation may linger for another year or two. Once you no longer feel any temptation at all, you know you reached your goal and can enjoy your success.

Pamela McDonald is a leading Integrative Medicine Nurse Practitioner, who specializes in the prevention of heart and Alzheimer’s disease, and chronic illness. To learn more about her groundbreaking book, and program – visit APO E Gene Diet. To subscribe to her free APO E Gene Diet Health Notes – send a blank email to

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