If nothing changes, nothing changes

A few years ago, I saw a patient I’ll never forget.

She was in her forties, carrying excess weight, running on empty, and holding everything together for everyone else. Her husband relied on her for everything. Her teenagers expected clean clothes and packed lunches. She was the family nurse, advocate, taxi driver, and problem-solver. She came in saying she felt tired all the time.

We worked together for a few months. She made small changes here and there, but nothing really shifted. One day I said something offhand: “If nothing changes, nothing changes.” She smiled politely. I didn’t see her again for six months. I assumed I’d been too blunt.

When she finally came back, I didn’t recognise her. She looked lighter, brighter, and genuinely happy. She told me that one sentence had been a turning point. She realised that her health wasn’t just about food and exercise. It was about the stories she told herself.

She had always believed she had to take care of everyone else first. She thought asking for help was weak. She believed that showing frustration made her a bad mum. Once she challenged those thoughts, everything changed. She set boundaries, left an unhappy marriage, moved closer to the beach, and decided her teenagers could make their own lunch.

Her body followed her mind.

The stories that keep us stuck

We often think of stress as something external. Work deadlines, family responsibilities, traffic, money. But so much of our daily stress actually comes from our thoughts.

Thoughts like:
“I can’t say no.”
“If I don’t do it, it won’t get done.”
“I’ll rest when everything else is finished.”
“I need to eat better, but I’ve already ruined today.”

These thoughts might sound small, but your body doesn’t know the difference between a real threat and a perceived one. Each time you think one of these things, your stress response flicks on. Your heart rate rises, cortisol increases, and your body shifts into survival mode. Over time, that constant low-level stress affects sleep, hormones, digestion, and even blood sugar.

Diet culture, perfectionism, and people-pleasing

So many women I work with are perfectionists in denial. We’ve been conditioned to please others, look a certain way, and do it all with a smile. Diet culture tells us there are “good” foods and “bad” foods. Society tells us we should be endlessly productive and cheerful. It’s exhausting. And it’s not sustainable.You don’t have to earn your rest. You don’t have to fix everyone’s problems before you deserve to sit down. You don’t have to apologise for saying no.

How to start changing your thoughts

Awareness is the first step. Start noticing the thoughts that pop up when you feel stressed or overwhelmed. Write them down. You might be surprised at how harsh your inner voice can be.

Next time you catch one, ask yourself:
Is this thought actually true?
Who told me it had to be this way?
What’s a kinder, more helpful version of this thought?

You don’t have to become relentlessly positive. You just have to become more curious.

If nothing changes…

The truth is, health transformations rarely start with food or fitness. They start with mindset. You can’t create lasting change if you’re still telling yourself the same old stories about who you are and what you owe everyone else. So maybe the question isn’t “What should I change first?”
Maybe it’s “What do I need to stop believing?”

Because if nothing changes, nothing changes.