Medical News Today: New Year’s resolutions: How to boost success rates

Do we make New Year's resolutions just to ignore them? Are they merely promises doomed to fail? In this feature, we ask whether, statistically speaking, these resolutions work, and what increases the chances of success.

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How can we make a success of this year's resolutions?

New Year's resolutions are an ancient tradition that continues to this day.

The Babylonians started each year with pledges to pay debts and return borrowed items.

The Romans began their year by promising the two faced god, Janus, that they would behave better.

In modern societies, many people still promise to make changes as the new year dawns; this desire, in many cases, is fueled by the excesses of the holiday period.

Most commonly, it would seem, New Year's resolutions revolve around weight loss, quitting smoking, reducing drinking, and exercising more.

Although resolutions are popular, they are not always successful. In this article, we will dissect the evidence and answer the question: Should we bother making New Year's resolutions in 2020?

How effective are annual resolutions?

A study from 1989 tracked 200 people living in Pennsylvania as they attempted to make changes based on New Year's resolutions.

On average, the participants made 1.8 resolutions, most commonly, to stop smoking or lose weight. Less frequently, people pledged to improve relationships, and a surprisingly low 2.5% were hoping to control their drinking habits.

An impressive 77% managed to hold to their pledges for 1 week, but the success rate dropped to 19% over 2 years. Although that is a substantial drop out rate, it means that 1 in 5 of those participants achieved their goal.

Of the 77% successful resolvers, more than half slipped at least once, and, on average, people slipped 14 times across the 2 years.

A study in the Journal of Consulting and Clinical Psychology in 1988 followed the efforts of 153 New Year's resolvers who were determined to quit smoking.

At 1 month, 77% of participants had managed at least one 24-hour period of abstinence. Overall, though, the results seemed a little disappointing with the authors writing:

"Only 13% of the sample was abstinent at 1 year, and 19% reported abstinence at the 2-year follow-up."

Another study, appearing in PLOS ONE, took a more general look at behavior. The research team tracked the food shopping habits of 207 households from July 2010 to March 2011.

Unsurprisingly, the researchers found that, during the holiday period, expenditure increased by 15%. Three-quarters of this increase went on less healthful items.

Also, as expected, when January rolled around, the sale of healthful items shot up by 29.4%.

However, the sale of less healthful items did not drop in tandem with this health drive — people were buying more nutritious items, but still purchasing the same amount of unhealthful food.

Overall, the number of calories they purchased in the New Year was higher than during the holiday period. The authors conclude:

"Despite resolutions to eat more healthfully after New Year's, consumers may adjust to a new 'status quo' of increased less-health[ful] food purchasing during the holidays, and dubiously fulfill their New Year's resolutions by spending more on health[ful] foods."

The authors believe that the key to successful resolutions is to focus on replacing unhealthful items with healthful ones, rather than buying both.

That is sound advice, but not necessarily easy to implement.

Successes and failures of weight loss goals

In 2009, GlaxoSmithKline released Orlistat, which they hailed as "the first clinically proven over-the-counter weight loss aid" in Europe.

As part of their marketing push, the company also conducted an internet survey about weight loss that included questions about New Year's resolutions.

Although the survey was not meant to be a scientific study, it generated a substantial pool of data with 12,410 females from six European countries responding.

A group of researchers took advantage of this dataset and published an analysis in the journal Obesity Facts.

They found that around half of the women had made a weight loss New Year's resolution in the past 2 years.

As for success rates, they observed that women with a body mass index (BMI) of under 25, which health experts define as "normal," were successful 20% of the time.

However, of thos with a BMI of 30 or above — which doctors class as overweight or obese — only 9% reported some success.

In the overweight group, three-quarters of the female respondents said that their primary reason for failing to lose weight was that it took too long to see results. Around one-third of those who were obese or overweight stated that they were not successful due to a lack of confidence.

What increases the chances of succeeding?

In the Pennsylvania study we mention above, the scientists found no link between success rate and participants' sex or age; similarly, the type of resolution did not influence how likely they were to succeed.

The researchers contacted participants by telephone after 1 week, 1 month, 3 months, 6 months, and 2 years.

During these interviews, the researchers also asked participants what techniques they used to help them keep their resolutions, and how often they implemented each one.

They found that the most successful resolvers were applying stimulus control at all five checkpoints.

Stimulus control is the act of keeping things around you that remind you why you chose the resolution.

For instance, someone who is quitting smoking might keep a picture of their young child nearby to remind them why they decided to stop.

At the 6-month and 2-year mark, successful resolvers were using self-liberation (or willpower), and reinforcement management — rewarding themselves for being successful.

Conversely, individuals who did not keep their resolutions most commonly employed self-blame and wishful thinking.

The study we highlighted above that followed the fates of 153 smokers also looked at factors that made quitting more likely. The authors explain:

"The use of multiple strategies for cessation was associated with abstinence at the 2-year follow-up. A strong motivation to quit was found to be important for both initial success and long-term maintenance."

Other studies that have investigated smoking cessation more generally have identified factors that increase the chance of quitting. These factors include staying away from smokey environments, abstaining from alcohol, stress management techniques, and will power.

Another paper took a different approach. Publishing their work in the Journal of Clinical Psychology, the authors set out to understand why some people succeeded where others failed.

To do this, they recruited two sets of participants: 159 New Year's resolvers and 123 people who were interested in solving a problem at a later date. The researchers followed the participants for 6 months and charted their successes and failures.

In agreement with other studies, the most common reasons for New Year's resolutions were losing weight, increasing exercise, and quitting smoking.

The authors found that the most successful resolvers used more willpower, stimulus control, reinforcement management, positive thinking, and avoidance strategies.

Conversely, those who were less successful tended to use more wishful thinking, blame and criticize themselves, and make light of the problem.

Ending on a high

Some of the results above might cast a shadow across ambitions to make a change in 2020, but they shouldn't.

The authors of the study above made some overarching conclusions that should boost the confidence of any New Year's resolver:

"Resolvers reported higher rates of success than nonresolvers; at 6 months, 46% of the resolvers were continuously successful compared to 4% of the nonresolvers."

So, although the cards might be stacked against anyone who plans to make a New Year's resolution, simply by making that resolution, you have boosted your odds of success.

According to this data, forming a New Year's resolution increases your chances of generating change more than 10-fold.

The authors write that, "[C]ontrary to widespread public opinion, a considerable proportion of New Year resolvers do, in fact, succeed, at least in the short run."

In conclusion, New Year's resolutions do not work for everyone. But, as the saying goes, "you've got to be in it to win it."

If you are considering making a resolution for 2020, according to the findings of these studies, the best approach is to keep things around you to remind you why you want to make those changes.

Also, reward yourself for successes, and stay motivated. Throw a healthful dose of willpower into the seasonal mix, and you are likely to succeed. Good luck!

Original Article

Medical News Today: Could MDMA help treat mental health conditions?

Ecstasy — or methylenedioxymethamphetamine (MDMA) — is a recreational drug that is illegal in the United States. However, some researchers believe that it could aid in mental health therapy. A new study in mice puts this idea to the test.

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New research in mice investigates what gives MDMA its positive effects on sociability.

MDMA is a mind-altering drug that can be popular at parties, as it boosts energy and especially empathy, making people feel more connected and safe around others, even if they are strangers.

In the U.S., MDMA is classed as a Schedule I drug, which makes it illegal, as a substance "with no currently accepted medical use and a high potential for abuse."

However, this classification came after some psychiatrists had used the drug for therapeutic purposes, for many years, to help individuals who were struggling with communication feel more at ease and able to talk about their problems.

The fact that the drug can become addictive made it fall from favor, and it acquired its illegal status in 1985. Recently, though, more and more researchers are beginning to ask whether MDMA can ever be used safely in therapy.

Earlier this month, scientists from Stanford University, in California, and the Albert Einstein College of Medicine, in New York, published a paper in the journal Science Translational Medicine, detailing the findings of a study that they had conducted in mice.

In this study, the team aimed to determine how MDMA causes an individual to become more sociable. They also hoped to find out which doses, if any, could provide the positive effects with minimal risk of addiction and other threats to health.

"We've figured out how MDMA promotes social interaction and showed that [this is] distinct from how it generates abuse potential among its users."

Senior author Dr. Robert Malenka

MDMA triggers the release of serotonin

To understand what differentiates MDMA's positive effects from its potential to become addictive, the researchers looked to the brain circuit that underlies addiction: the reward circuit.

"The brain's reward circuitry tells us something is good for our survival and propagation. It evolved to tell us food is good when we're hungry, water is good when we're thirsty, and warmth is good when we're cold. For most of us, hanging out with friends is fun because, over the course of our evolution, it's promoted our survival," explains Dr. Malenka.

But, he adds, the same circuit can end up reinforcing that something unhealthy is highly desirable. When we take an addictive drug, the researcher explains, the substance stimulates brain cells to release the "happy hormone" dopamine.

Dopamine then acts on a brain region that is key to the reward system, the nucleus accumbens, which, in turn, sends out reward signals. These reinforce the sense that the substance is something desirable and that we need to seek it out.

"Drugs of abuse trick our brains by causing an unnatural dopamine surge in the nucleus accumbens. This massive increase is much higher and more rapid than the one you get from eating ice cream or having sex," Dr. Malenka points out.

But which neural mechanisms does MDMA tap into to achieve its prosocial effects?

Dr. Malenka and colleagues explain that the prosocial effects of the drug most likely result from the release of serotonin, a hormone that helps regulate many functions, including mood, sexual desire, and social behavior.

MDMA stimulates neurons to release serotonin into the dorsal raphe nucleus, a part of the brain that communicates with the nucleus accumbens.
By this point in their study, the researchers had yet to discover which doses of MDMA could trigger prosocial behaviors without stimulating addictive responses.

Can dosage aid bonding without addiction?

At a very low dose of 2 milligrams per kilogram (mg/kg), mice that received the substance showed no improvements in sociability. However, when the researchers upped the dose to 7.5 mg/kg — still a low dose — the mice became more sociable.

"You can't ask mice how they're feeling about other mice, but you can infer it from their behavior," Dr. Malenka explains.

After having administered either a low dose of MDMA or a saline solution placebo, the researchers placed each mouse in a space that gave them options — to spend time alone or with another, MDMA-free, mouse.

The investigators found that the mice that had received 7.5 mg/kg of the drug would remain interested in the fellow rodent for at least 30 minutes, while those in the placebo group would invariably get bored after 10 minutes.

And, lead author Dr. Boris Heifets points out, "Giving MDMA to both mice enhanced the effect even further."

"It makes you wonder if maybe [in a human therapy context] the therapist should also be taking MDMA," Dr. Heifets notes.

But how did the investigators know that the 7.5 mg/kg dose did not also trigger addiction? The researchers explain that individuals with addiction — and this goes for humans and rodents — tend to repeatedly seek out the same spaces where they had enjoyed themselves.

The team gave the mice the same dose of MDMA as before and placed them in one room of an environment that had two rooms. The next day, they placed the mice in that environment again, to see whether they would choose to be in the room where they had received the drug.

The rodents, however, showed no preference for either room, suggesting that the neural mechanisms of addiction had not been set in motion. The same was not true for mice who had received a higher dose of the drug: 15 mg/kg.

An MDMA alternative with its own dangers

When researchers blocked a specific type of serotonin receptor present in large numbers in the nucleus accumbens, they saw that this stopped MDMA from having a prosocial effect in mice. This confirmed that serotonin had been responsible for the boost in sociability.

They also found that they could use a drug to trigger the release of serotonin, but — unlike MDMA — not dopamine, to boost sociability in mice without the risk of addiction.

There is, however, a catch. The drug that achieved this effect was d-fenfluramine, which was once popular as a weight loss aid. It fell out of use in the late 1990s, when researchers confirmed that the drug could cause severe, life threatening cardiovascular problems.

Thus, the research team emphasizes that neither MDMA, which has the potential for addiction, nor d-fenfluramine, which can impact vascular health, should ever be used as daily therapeutics.

They do, nevertheless, argue that a one-off dose would likely be a safe way to help an individual open up with their therapist.

Original Article