Doctors get a lot of flak in the media for not knowing enough about nutrition or not giving enough nutritional guidance. I can see why. We often tell a patient simply to “diet and exercise,” but how much harder would it be to provide a bit more structure, such as “to eat a Mediterranean diet” or to “try the DASH diet,” and provide some basic information about what those diets entail?

Instead, many times, the conversation is more obscure, with a focus on simply emphasizing the importance of a heart-healthy life. The problem with that is the look of confusion or overwhelm on the faces of our patients. In the face of a lack of true explanation and understanding, there is also an almost certain non-compliance that will follow.

Then there are those patients who jump in with both feet. You can tell that even before they walk out of the office, they will start researching any advice and checking out the rules and food lists for any suggested diet online.

Both of those patients have valid reactions and the reason is because they are each in completely different places. Some people are ready for advice like, “Follow a Mediterranean diet.” Some people just aren’t there yet.

So, if your doctor hasn’t given you specific advice but you are motivated to change your life and your health, let me step in and give you some guidance. My most important advice for you right now is: “Start where you are.”

When making any change, or listening to any advice, the greatest chance for success and good outcomes you have is to know exactly where you are. Start from there. If you tell someone who is overweight to lose 50 pounds or even if you just tell them to “diet and exercise,” it is overwhelming. They may not know where to start. But if you tell them, “Start by losing 5 pounds. Eat more vegetables every chance you get,” then that is specific, and small, and is much more likely to feel totally doable. Someone else may already be well down the path of a healthy diet but not exercising. They may do better with different advice, such as, “Start walking every day.” That may be all it takes for them—they may go all-out with a walking plan that turns into a running plan.

Honestly, though, if you know where you are and you know where you want to be, you really don’t need a doctor to tell you how to get there. You can look frankly at where you are right now, and if you really think about it, you will probably realize that you know what you are doing right and you know what you are doing wrong. Are you eating too much sugar, or too much fat, or too much junk food, or just too much in general? Are you living a sedentary life and not exercising or moving enough during the day? Are you stressed out most of the time? You know where your problem areas are. You know where you are, so start there. Eat a little less of those things you know you shouldn’t eat. Move a little more. Work on some stress reduction. “You do you,” but do it a little bit better today than you did yesterday. That’s how you start.

I’ve been thinking about how we all achieve success in different ways. The one commonality is that changing your life requires changing your thoughts. If you have the preconceived notion that you “can’t do it,” then chances are that any significant changes won’t stick. If you strive for a vision that is too much, too big, too great, or with an end so far out of sight from where you are right now that you can’t even imagine it, success can seem unreachable, and probably will be. So pull your goal back into sight. Five pounds at a time, five minutes of exercise at a time, five minutes of deep breathing or meditation at a time. And then you grow from there. The further down the path you get, the easier it is to make bigger and loftier goals.

I know, I know. You are impatient. You want big changes now. We all are, as we are inundated with these beautiful “before” and “after” pictures on Instagram and Facebook. All over social media, we see the dramatic results of people who change for the better, but what we don’t see are the baby steps it took to get there. The 280-pound women who lost 150 pounds and now looks fantastic at 130 pounds did not go from being obese to posing in a bikini overnight. She began slowly, deliberately, and with conviction. Her journey started on day one, just like yours can. I assure you, it wasn’t always easy for her, and it won’t always be easy for you, no matter what your goals are. But that woman wouldn’t have gotten where she is now if she hadn’t taken that first small step from the place she was then.   

A patient of mine, Dan Pearson, who has been very vocal on social media, tracked his story from the day he weighed in at 250 pounds, with a blood pressure of 180/100, LDL (“bad” cholesterol) of 180, an elevated Lp(a) (a type of LDL) and a hemoglobin A1C (a measure of blood glucose) of 6.4. After we talked about the reality of his risk factors for heart disease, he decided he was going to change his life. We started with a simple diet plan and one additional goal of walking 10,000 steps daily. He recorded his progress on Instagram (@theycallmedannyboy), beginning exactly where he was. With each day, he got a little bit stronger and a little bit wiser, and now he offers advice to help others with smart inspiration like “Fill your cup first” and “Change comes from within.” Today his morning walk/jog is now closer to 30,000 steps and he is 55 pounds lighter—and counting. His blood pressure is now a healthy 112/82, and he has been able to decrease all of his medications. 

To me, he is the perfect reminder that the path to success is simply to begin, exactly where you are. If you are sedentary, you walk. If you walk, you run. If you run, you go further and faster and harder. You won’t achieve a goal if you don’t start, and then all you have to do is move slowly and steadily towards where you want to go. Anybody can do that.

I remember when I was writing my book, I was sitting at the computer with an empty screen and a blank mind, wondering exactly how to begin. My then-five-year-old son picked up my recorder and said into it, “I want Suzanne to take care of every people’s heart.” 

I remember smiling, a welcome break from my writer’s block. I asked, “Why do you say that?”

He said, “Because people need to take care of their own bodies and they have to eat good food and they will grow to be strong, healthy, and they exercise, by Suzanne Steinbaum.”

This was an important moment for me because my wise little boy reminded me of two things: 1) I could help guide people in the right direction, and 2) The way to guide them is to show them how to guide themselves…one step at a time. Since then, I’ve been on a mission to make lifestyle changes easier, more accessible, more understandable, and more possible for anyone who is ready to make a change.

So are you ready to change your life? Are you ready to support your healthy heart? Are you ready to fill your cup first, and to let change come from within you? Then start by looking in the mirror and asking yourself, “Where am I right now?” That is the way to begin.