At the beginning of each year, many people set health-related goals with the best of intentions. Yet within a few months, those goals often fall away. While this pattern can feel discouraging, it is not a failure of motivation or discipline. Instead, it reflects how the brain, as well as our environment, form – and resist – behavioral change. Dr. Gareth Dutton is a professor of General Internal Medicine and Population Science at UAB and Research Program faculty co-lead for the UAB Comprehensive Healthy Living Research Center.Gareth Dutton, Ph.D. “What a habit is, fundamentally, is an automatic response triggered by environmental cues you’ve established. It’s a form of associative learning.” In other words, habits are less about conscious effort and more about patterns the brain learns over time. Understanding this process can help people adopt healthier behaviors in ways that are more realistic and sustainable. For individuals with busy schedules or circumstances that make healthy behaviors more difficult, habits may not become fully automatic. In these cases, environmental cues play a critical role. Dr. Dutton recommends designing environments that prompt healthy behaviors, a concept known as choice architecture. “Think about how you can design your environment to maximize your chance of success,” he said. For individuals, visual reminders, phone alarms, placing healthy foods in visible locations, or keeping walking shoes near the door reduce reliance on memory and motivation, making consistency more achievable. The Process of Habit Formation Many people believe that successfully developing habits comes from trying harder or staying motivated. In reality, motivation fluctuates, while habits depend on consistency, context, and repetition. “The goal of habit formation,” Dr. Dutton said, “is to move toward automaticity, where the behavior happens with less effort and less thinking.” Automatic behaviors occur with minimal decision-making and are often triggered by familiar cues such as time of day, location, or an existing routine. The more consistently a behavior is repeated in the same context, the more likely it is to become automatic. Linking New Behaviors to Established Routines One effective strategy for habit formation is pairing new behaviors with routines that are already well established. Dr. Dutton gives an example: “If you’re already doing something consistently like brushing your teeth or making coffee, that’s the perfect place to attach a new habit.” By linking a new behavior to an existing cue, the brain does not have to decide when to act – it simply follows the learned pattern. This approach, often called habit stacking, reduces cognitive effort and increases the likelihood of repetition. This same principle applies directly to nutrition and movement habits. Replacing Habits Rather Than Eliminating Them Breaking unhealthy habits can be particularly challenging if no alternative behavior is in place. “When you’re trying to break a habit,” Dr. Dutton said, “you almost always need a replacement behavior. It’s very hard to just stop without filling that gap.” Rather than attempting to eliminate a habit entirely, replacing it allows the brain to respond to familiar cues in a healthier way. For example, replacing a sugary snack with fruit and yogurt, or substituting a short walk for stress-driven screen time, preserves the habit structure while changing the outcome. This replacement strategy becomes especially important when introducing dietary changes. Building Health Through Gradual Dietary Changes Suzanne Judd, Ph.D.A common barrier to lasting change is starting with goals that are too ambitious. Large-scale lifestyle changes require significant planning and mental energy, making them harder to sustain. Dr. Suzanne Judd, Chair of the UAB Health Behavior Department and assistant director for research at the Healthy Living Center, encourages people to view diet as a gradual progression toward balance rather than focusing on eliminating foods. “There is no such thing as a ‘good food’ or a ‘bad food,’” she said. “Anything that claims there’s a quick fix is going to lead people down another rabbit hole. Food is medicine. Your body is better able to use nutrients when they come from real foods.” Dr. Dutton’s behavioral research reinforces this approach. He noted that the brain is wired to prioritize short-term rewards, even when long-term benefits are clear. “In the moment, a high-calorie or highly palatable food is immediately rewarding,” he explained. “The health benefits we’re working toward are long-term, which makes behavior change challenging.” This is why gradual, repeatable dietary changes are more effective than rigid rules. Over time, as healthier foods become part of routine patterns, the behaviors themselves become reinforcing. Each change can be layered onto existing meals, reinforcing habit loops rather than disrupting them. “When starting to establish change, just get berries in your diet,” said Dr. Judd. This is a practical starting point: berries are widely available, easy to incorporate into meals, and rich in vitamins, minerals, and anti-inflammatory compounds. Just as importantly, this approach emphasizes addition rather than restriction, making it easier to integrate into existing routines. Movement as a Daily (and Social) Practice Physical activity is another foundational habit, yet it is often narrowly defined as structured exercise. “By movement, I don’t mean the gym,” Dr. Judd said. “I mean getting up and taking a 10-minute walk, or even just moving around your house.” Dr. Dutton added that people themselves can function as cues. “Social support and accountability are powerful,” he explained. “If you know someone else is counting on you, you’re more likely to follow through.” Progress Is Rarely Linear Setbacks are a normal part of behavior change and should not be interpreted as failure. “Slips are going to happen,” Dr. Dutton noted. “What matters isn’t the slip itself; it’s how you respond to it. Give yourself patience and compassion and know that you can start again.” Missing one day does not undo progress. Habits are built through repeated return, not perfection. A Sustainable Path Forward Lasting healthy habits are not built through rigid rules or extreme changes. They develop through small, consistent actions that align with how the brain learns. As Dr. Dutton summarized, habits become sustainable when “the behavior happens with less effort and less thinking.” And as Dr. Judd reminds us, meaningful change is rarely dramatic: “It’s just a bunch of little steps.” Together, these strategies offer a practical, evidence-based approach to building good habits: one grounded in patience, consistency, and compassion.

On Friday, November 14, 2025, students from the UAB Heersink School of Medicine gathered to celebrate faculty excellence during the annual Argus Awards Ceremony. Established to recognize outstanding contributions in medical education, the Argus Awards are determined entirely by student nominations and votes, honoring faculty, courses, and course directors who have made a lasting impact throughout the year.

Through hands-on activities, panel discussions, and the inaugural Research Day poster and lightning round competition, UAB Primary Care Week introduced students to the full scope of primary care careers.

UAB Heersink School of Medicine students can enjoy a week-long celebration of Primary Care Week from October 6-10, 2025. This event-packed week aims to educate physicians-in-training and students across the health spectrum on the pivotal role of primary care in the health care system. 

Rebekah Weil, M.D., has been named the associate division director for medical education for the Division of General Internal Medicine and Population Science.

On September 28 and 29, 2023, the University of Alabama at Birmingham (UAB) held the inaugural UAB Global Health Symposium with a mission of “promoting equity in global health partnerships.” One year later, we reflect on the lasting impact of the symposium by recognizing collaborations that have seen continued success because of the event, including an ongoing partnership between UAB and Alexandria University.

Five new scholars have joined the UAB Alzheimer's Disease Research Center's (ADRC) REC Scholars program, which aims to develop research expertise in Alzheimer’s disease and related dementias. As part of the Research Education Component (REC), the program offers mentorship and a specialized curriculum, helping scholars build experience in cross-disciplinary, team-based science.

April Agne, MPH, program director II in the UAB Division of Preventive Medicine and deputy director of the Forge AHEAD Center, has been selected as a recipient of the inaugural Heersink Dean’s Excellence Award for Staff.