Case Study: Kathy, 54

Overview

In 2017, Kathy was diagnosed with type 2 diabetes, high blood pressure and high cholesterol. She knew many people with complications of these diseases, so when she received the diagnoses, it felt like a death sentence. Although she had difficulty prioritizing herself in the past, she recognized that in order to take care of her kids and family she first had to take care of herself. She started to exercise and thought she was eating right, but her numbers just kept getting worse. She tried a variety of dietary approaches, but didn’t find anything that was practical or sustainable. She was frustrated because she received little guidance, support or resources from her healthcare provider about the lifestyle changes that would help. In addition, she was having very unpleasant side effects from her medications and knew she needed to find another option to improve her health. She enrolled in Better in March, 2019 to learn more about how to manage her conditions. With a better understanding of her condition, she believed she could prioritize herself and make changes to improve her health.

Medications

• Metformin 1000mg, 2x per day (diabetes)

• Losartan 100mg per day (high blood pressure)

Other Health Conditions & Concerns

• High cholesterol

• Fibromyalgia

• History of gallbladder removal (cholecystectomy)

Behavioral Treatment

Challenges & Concerns

• Kathy had heard conflicting information about the best dietary pattern for individuals with diabetes. This left her confused about what to eat.

• She expressed a tendency to worry about things in the future and was concerned that her weekly goals might “get too hard”.

• She is a mother of two teenagers and had difficulty prioritizing herself.

• Kathy grew up on meat and potatoes and she didn’t think she would feel satisfied eating predominantly whole plant foods. She thought preparing plant-based meals would take too much time and she also had budget concerns.

Behavior Changes

• With guidance from Better, Kathy shifted her beliefs about what constitutes a healthy dietary pattern. Despite some initial hesitancy about eating mostly plants, she gradually began to experiment with incorporating more legumes, fruits and non-starchy vegetables. Before she knew it, these foods started to take over her diet.

• Kathy used the Better app to set goals and track her biometric markers and behaviors on a daily basis - including fasting blood sugar, blood pressure, the number of plant-based meals eaten, amount of physical activity, and her weight. She found self-monitoring to be an extremely helpful strategy for reinforcing new behaviors as she was able to connect changes in behavior to the outcomes she achieved.

• She developed clarity about how much she had to gain by making lifestyle changes rather than how much she might be losing. The key for Kathy was making small, incremental changes over time. As a result, she barely felt like she altered her life, however her changes had a major impact on her health.

• With the help of her coach, Kathy adopted a growth mindset that helped her try new things and approach challenges confidently, viewing them as an opportunity to learn. She found creative ways to incorporate more plant foods into meals for her family, such as blending beans into soups, so her kids would eat them. Although she initially was concerned about cost, she found herself saving money because she was buying less meat. Ultimately, she realized it’s a lot more economical to invest the money upfront on choosing healthy foods than paying for the healthcare needed to treat diseases once they’ve progressed.

"I didn’t want to feel like a prisoner within my own life. I want to enjoy life and feel like I have control."

Results

- Kathy no longer takes medication for blood pressure. - She has more energy and is active on a daily basis. - Her LDL is below 100 without medication. - Her generalized aches and pains resolved, she’s sleeping better, and her memory has improved.

“I’m so happy that I found this and I’m proud I stuck it out. I tell people: Try this. It works!”

Takeaways

• Through her experience with Better, Kathy learned that she had choices that could give her control over her condition.

• Her realization that there is no risk in experimenting and trying new things allowed her to approach behavior change as a series of experiments and an opportunity to learn how different choices impacted her health as well as the health of her family.

• Kathy’s journey shows how breaking down larger, long-term goals into smaller, actionable steps can be an effective strategy to create lasting behavior change.

• She continues to make incremental changes toward her larger goals, because she realized that prioritizing herself allows her to be more present for her family and lead a more healthy, active life.

“I feel like I have more control over my life in general, not just my health. That’s something you can’t put a price on.”