Till a few years ago, Santanu Chattopadhyay, now 50, weighed 90kg, and suffered from uncontrollable hypertension, abnormal liver function, borderline cholesterol and gout. But by exercising regularly and using a tracking app to monitor his diet, Dr Chattopadhyay, chief operating officer and group medical director of the CK Birla Hospital, Kolkata, and founder of the primary-care chain NationWide, managed to lose 16kg in four months and reverse all his medical problems. Enthused, he introduced the app, which tracks fat, protein and carbohydrate consumption on a daily basis, to patients in his chain of clinics. Unfortunately, it didn’t work for them. “They weren’t motivated to do the work to lose the weight. They didn’t have a strong Internal Health Locus of Control," he says.

Derived from Internal Locus of Control, a concept developed by American psychologist Julian B. Rotter in 1954, Internal Health Locus of Control (IHLC) is the way psychologists describe the belief that we are in control of our health and can do much to improve it. This is the opposite of the belief that fate, or external factors like our doctors and our families, control our health. Research shows that having this belief, or a strong IHLC, is important for overall wellness as it helps us to stay motivated to eat right, exercise and sleep enough and keep stress and anxiety at bay. People with a strong IHLC believe that their behaviour plays a role in how healthy they are, and can be motivated to change their behaviour to improve their health.

Research concurs with Dr Chattopadhay’s experience. Janet D. Latner and Joel W. Hughes’ team of researchers from the department of psychology at the University of Hawaii found that people who have a strong IHLC are more willing to use digital interventions like health apps and online trackers to change their behaviour than people who believe that chance or fate plays a defining role in health outcomes. The study results were published in the Psychology, Health And Medicine journal in April.

According to Atul Biniwale, a consultant cardiologist with a private practice in Pune, IHLC plays a significant role in a patient’s health outcome, particularly when managing obesity and related metabolic health issues like high cholesterol and hypertension. “If an obese patient with high cholesterol comes to me and knows he needs to lose weight, but continually makes excuses for why he can’t exercise or eat right, citing reasons like work or travel, then my prognosis is that he won’t be able to do it with exercise and diet alone, despite all my help. Because the person doesn’t believe he has control over his behaviour," says Dr Biniwale. “However, if an obese person comes to me and says, ‘Doctor, I know I need to lose weight but I am too lazy and like eating sweets too much,’ then I can help him change his eating and exercising habits for the better because he has taken responsibility for his current state of health."

So where does that leave us? The good news is that IHLC is like a muscle that you can build and make stronger. There are certain strategies that psychologists recommend for improving it. The first, and most important, is to change your underlying attitude from one where you aren’t honestly taking responsibility for your health to one where you are. This may sound simple but it is incredibly powerful. Then make a list of the choices available to you in the quest for better health. Even if the choices aren’t appealing, the fact that you can make lifestyle choices that will improve your health is deeply empowering. After that, enlist the support of friends or join a support group on social media to help you stay motivated.

Trust me, it works. I was overweight in my late adolescence and lost 15kg by the time I turned 20. In my 30s I lost 20kg post each of my two pregnancies. Looking back, a strong belief that I was responsible for my health and weight loss was the key to my success; a strong IHLC can change your life too.

Sujata Kelkar Shetty, PhD, is a wellness expert and a certified life coach. She has formerly worked as a clinical scientist at the National Institutes of Health in Bethesda, US.

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