We all have the right to make choices. Every day is a new opportunity to view ourselves and the world in the way we choose, understanding that for each choice we make, there are consequences. No one ever said that we can’t eat ice cream or cookies. There are just repercussions – to our hips, thighs and cholesterol levels. It is what it is.

 We can appreciate the consequences of our communal actions simply by looking at the front pages of the newspapers. Global warming, economic meltdowns, insider trading and oil-ridden waters are all products of what we have become as a culture. We can’t change the whole world, but we can do the best that we can within the confines of our own lives. We recycle, shut off electricity, and become more conscious of environmentally safe products. We tear up our credit cards, pay off loans, and perhaps lower our carbon footprint. We save in a way we never have before. We pause, take notice, and ultimately, many of us choose to do something.

  I often wonder what it is that becomes someone’s “tipping point,” or the point in time when an individual decides to make a change in his or her life. Sometimes the tipping point is when that second cookie becomes less appealing than fitting into the perfect little black dress. For others it may come when we decide to try to get pregnant or to have gastric bypass as a last chance to get our health under control. But for most of us it isn’t that glaringly obvious. What pushes some of us isn’t as forceful as a recession or polluted drinking water, but rather a self-induced nudge which manifests from an honest inventory of who we are, what we do and the subsequent consequences that result from our actions.

When one of my patients recently walked into my office 45 pounds lighter, beaming from ear to ear, on the verge of getting her dream job, telling me about her exercise, her happier attitude and her improved relationship with her husband, I reminded her of when we first met. Her cholesterol was in the 300s and she was depressed, having trouble in her marriage and contemplating quitting her job and going back to school. That was only a year before, soon after her 40th birthday. She was willing to do anything. So we made her accountable. With her weight loss, her cholesterol dropped and she went off all medications but vitamin supplements. She began exercising more and with her newfound vitality, she couldn’t help but smile. With less anxiety, her focus became clearer and she learned that change begins with awareness.

I recommend you stop, assess and take inventory. Get a notebook and write down everything. Everything you eat and everything you drink. When, how much and how often you exercise, relax, relieve stress, and, most of all, smile. Write down each nibble of food and grazing opportunity you seize. Count steps taken and glasses of water consumed.

In taking ownership of your health, you become accountable. That’s usually the tipping point, when our reality becomes glaringly obvious and we can no longer ignore the consequences of our actions. We have an obligation not only to our world at large, but also to our families, friends, neighbors and employers. This obligation starts and ends with becoming accountable to ourselves. With our newfound responsibility to take care of, nurture and nourish ourselves comes the inherent awareness to know that it is easier to shut the refrigerator than it is to clean up an oil spill.