When I was lecturing in health and wellbeing at Waikato University many years ago, I used to show students the diagram below, which depicts the World Health Organisation’s (WHO) dimensions of health and the known consequences.
Like many women I’ve come across in my own coaching of the MyMT™ programmes, never once did I think it applied to me. I was a regular exerciser, I (supposedly) ate ‘well’, I was pretty motivated and I thought I was a good representative of being ‘healthy’.
But that was before menopause hit.
When I had my health-markers checked with my Doctor to determine what was really going on with how ‘unhealthy’ I was feeling, the results didn’t lie – high cholesterol, liver health changes (I didn’t drink alcohol) and the borderline hypertension was concerning – because I hadn’t had high blood pressure at all throughout my life.
My Doctor had no explanation, other than ‘it’s what I see in menopausal women all the time.’
With insomnia, exhaustion, weight gain, mood swings and joint health concerns distracting me on a daily basis, it was a confusing time.
The blood work was the ‘wake-up’ call that I needed – at the time my liver functions were high, Vitamin D and iron were low, cholesterol was high and goodness knows what my inflammatory marker (C-reactive Protein) was doing, because I didn’t know about that then and nor apparently, did my Doctor.
All I knew was that I couldn’t go on each day feeling the way I felt. Something had to change and the first ‘change’ I had to make, was asking myself, how on earth I had gotten to this point with my ‘health’?
My studies on women’s health and ageing led me out of the confusion, especially the W.H.O. Dimensions of Health.
You see, the women whom I was interviewing at the time, had all positioned their ‘healthy ageing’ in doing lots of vigorous exercise. But when I enquired how this was going for them, not one of them felt ‘healthy’.
They just trusted that their exercise specialists were giving them the correct information about the exercise and nutrition they should be following in their 50s, to move into their older years in the best health possible.
In a couple of weeks, it is World Menopause Day and the theme is heartening to me – it’s Lifestyle Medicine.
It’s a great reminder to get your clients thinking about their health and a great starting point is helping them to understand the Dimensions of Health, which I have also positioned my Practitioners courses on, but specifically for the menopause transition. I talk about the 7 dimensions in all of the MyMT™ Education courses.
Health-Disease models help Practitioners to move people towards 'healthier behaviours'.
Over the past few decades, health-behaviour researchers (mainly Psychologists) have tried to explain the health-disease relationship through various theories. Two main models exist today:
- The Biomedical Model. This is based on the direct cause/effect relationship which explains the occurrence of disease. Appropriate treatments are then able to be presented to patients.
- The Psycho-Behavioural Model. This is part of social-psychology learnings, and incorporates the attitudes and values of individuals and how these influence health-related behaviours.
Both of these theories help Health Practitioners and Health Coaches to move people towards ‘healthier behaviours’. The pandemic was a great example of how governments were using these theories to influence population health.
Understanding the various dimensions of health, enables us to examine ALL aspects of personal health – whether for our own needs, or those of our clients.
The W.H.O. define health as ‘not merely the absence of disease or infirmity, but a state of physical, mental and social wellbeing. The physical dimension also contributes to emotional, intellectual, social and spiritual dimensions.’
Therefore, in order to be considered “healthy,” it is imperative for none of these areas to be neglected.
Optimizing all these determinants of health contribute to a state of balance and harmony both within ourselves and with the world around us.
If we are going to help our midlife clients progress towards improved health, [within any medical or physical limitations they may have], then one of the main cnsiderations is that we assist them to change their daily behaviours and CREATE health promotion skills.
This enables (and hopefully empowers your clients), to keep moving towards, not only the control of their health, but to consider the health promotion behaviours, that they need to take into the environments they are in each day.
But there is more to this discussion too. Health promotion is also about putting your own health needs first, so you can be a respected role model for your clients.
The role of the Health Practitioner/ Coach and role-modelling health behaviour, came through in my Master’s studies. There was a clear perception by the leading Personal Trainers/ Coaches I interviewed, that role modelling health behaviour helped with their credibility, their authenticity and client adherence. Clients are generally more receptive to guidance when they see their coach “walking the talk”.
It’s why I have a focus in my Practitioner and general programmes, not only on ‘what to change’, but also ‘how to change’ based on my 7 Pillars of Women’s Healthy Ageing.
Good health starts from the 'inside-out'.
The rapid growth of Health Coaches globally is a wonderful addition to the support networks for women’s health. In the MyMT™ Introduction to the Science and Psychology of Menopause Certified Course, I reinforce the necessity to consider health-behaviour change within the specific needs of clients and the stage of life they are in.
Just as menopause is primarily viewed as being ‘only’ about hot flushes, or seen in the medical paradigm as requiring ‘only’ pharmaceutical treatments, I often think about the 7 Dimensions of Healthy Ageing and wonder when and how, all of the dimensions of health are being accommodated for clients?
One of the messages in the 12-week Practitioner course, is that good health starts from the inside-out (emotionally, spiritually and physically).
When we take this perspective and explore the various dimensions of health, there is so much more to health-behaviour change than ‘just food’ or ‘just exercise’.
It’s why, one of the strategies that we can help our midlife client’s to focus on, is to get women to reflect on what’s going on in their life and frame this against all of the dimensions of their health.
This is a great way to assist them towards identifying the routines and habits they want to and can, change.
I had to do this too.
3 health-behaviour change strategies to help your clients
Re-imagining aspects of my own health and how to untangle these, began with reflecting on ‘what isn’t working?’
Reflecting on this question is a great starting point to ask clients. You will be surprised at what they might share with you!
As such, I stopped the exhausting high-intensity exercise which had followed me all my working life.
I also stopped listening to dietary advice that took a ‘one-size-fits-all’ approach and was primarily situated in fitness and muscle hypertrophy discourse, which was not evidenced for exhausted women who weren’t sleeping and were putting on weight.
I also began to better manage my stress levels and put my Masters research on health behaviour-change into action, as well as my doctoral studies.
One of my personal reflections, was that I wasn’t following the scientific evidence on health, longevity, lifestyle medicine and women’s ageing.
That’s why, as part of the lead-up to World Menopause Day on October 8th, I want to share some practical things that you can assist your clients with, as they go on their renewed health journey with you as their Coach:
- Start from the inside-out. As I mention in my Masterclass on Menopause, menopause chaos is invisible. Therefore, encourage your clients to talk to their Doctor to get their bloods checked and get some baseline results. The ones I suggest that affect menopause symptoms and weight gain, are: Vitamin D, Iron, Ferritin (stored iron), C-reactive Protein (an inflammatory marker); Liver Function; Cardiac Function and of course, Thyroid Function. I don’t worry too much about hormonal checks, as these only show if clients are in menopause or not. Remember that those women on HRT may also have a false reading about their true menopause status too.
- Help your clients to consider the 7 dimensions of health criteria and discuss which ones they feel they could focus on as a starting point. For some women, they will have higher self-efficacy (confidence) for nutritional changes, compared to movement and exercise changes, or vice versa. For others, it might be that they want to begin with other aspects of their health, such as their joint health or sleep, or their stress management. Encourage them to go to that ‘self-reflection’ place that they may not have thought about for years. Only when we go-deeper into our true selves do we start to (re) discover our true self. Where is she and how has she been hidden over the years?
- Support is crucial to behaviour-change for women. Have your clients got the correct support at home, in the workplace, with their friends/ relatives/ work colleagues etc. I love how workplaces are opening up conversations on menopause. One of the UK ladies, who began with my own programme, but then went on to do Health Coach qualifications and evenutally became a Certified MyMT™ Practitioner, is Nicky (in the banner above). She was brave enough to bring the conversation about menopause into her workplace and at the time, took her on a journey within her company to bring this topic to the attention of others. As she mentioned,
“I reached out to women in our leadership team to begin with and had a great response.
They invited me to join the Inclusion Diversity and Belonging forums they hold to discuss setting up menopause workshops, but also to start to get some open conversations going. I have also been invited to join our “inspiring people ” steering committee where new policies are discussed.”
It was a wonderful initiative from Nicky to achieve this.
And then there is Clare from the UK. I came across Clare during the pandemic. Her role then, was as a Clinical Psychologist with the NHS. She, more than anyone, understands the magnitude of stress in the workplace and the impact of this on menopause symptoms and of course, confidence and wellbeing.
As she led the mental health team for the NHS, I’m so pleased that she joined me at the time and reflected on how and why, she needed some support too.
As you work with your midlife clients, I wonder if you have the support that you need in order to help your knowledge. If not, then I invite you to explore any of the MyMT™ programmes and/or Certified Courses. These are available to learn more about on the website.
Dr Wendy Sweet (PhD)/ MyMT™ Founder and Member: Australasian Society of Lifestyle Medicine.
