Building Habits That Stick: Lessons From the Consulting Room and The 4 Pillar Plan

As a GP, I spend a significant portion of my week talking to people about change. Not dramatic, overnight transformation—the kind that sells magazines—but the quieter, slower, more meaningful shifts that genuinely improve health. And yet, despite the best intentions, many of my patients struggle to make changes that last. They start strong, feel motivated for a week or two, and then life gets in the way. The habit slips, guilt creeps in, and the cycle repeats.

It’s a pattern I recognise not just professionally, but personally. Which is why I’ve been revisiting The 4 Pillar Plan by Dr Rangan Chatterjee—a book that reframes habit-building in a way that feels refreshingly humane.

🌱 Why Habits Fail (And Why It’s Not About Willpower)

One of the most important messages in Chatterjee’s work is that health isn’t built on heroic acts of discipline. It’s built on small, consistent behaviours that fit into real lives—messy, busy, unpredictable lives. When patients tell me they’ve “failed” because they couldn’t maintain a strict diet or a punishing exercise routine, I often find myself echoing Chatterjee’s core principle: if a habit isn’t sustainable, it isn’t the right habit.

We don’t need more pressure. We need more compassion, more simplicity, and more structure.

🧩 The Four Pillars: A Framework That Actually Works

Chatterjee’s model breaks health down into four pillars:

• Relax

• Eat

• Move

• Sleep

What I love about this framework is its realism. It doesn’t demand perfection in any one area. Instead, it encourages balance—small wins across multiple domains that collectively shift the trajectory of wellbeing.

In clinic, I see how powerful this can be. A patient who feels overwhelmed by the idea of “getting healthy” often finds relief in focusing on just one tiny action within one pillar. A 10‑minute walk. A consistent bedtime. A moment of stillness. These are achievable, repeatable, and confidence‑building.

🔁 The Art of Making Habits Stick

Here are the principles I’ve seen work—both in my patients and in my own life:

1. Start embarrassingly small

If a habit requires motivation, it’s too big. If it feels almost laughably easy, you’re on the right track.

Chatterjee talks about “micro‑changes”—the kind that slip into your day without friction. A single stretch. One extra glass of water. Two minutes of breathing. These tiny actions compound.

2. Anchor habits to existing routines

Habits stick when they have a home. Attach them to something you already do:

• After brushing your teeth, stretch for 30 seconds

• After boiling the kettle, take three slow breaths

• After sitting at your desk, roll your shoulders

Anchoring removes the need for decision-making, which is where most habits fall apart.

3. Focus on identity, not outcomes

Instead of “I want to lose weight,” try: “I’m becoming someone who prioritises movement.”

Instead of “I need to sleep more,” try: “I’m someone who protects my evenings.”

Identity-based habits are more resilient because they’re tied to who you believe yourself to be—not a number on a scale or a target on an app.

4. Build an environment that supports you

People don’t rise to the level of their goals; they fall to the level of their systems.

• Keep fruit visible

• Put your phone in another room at night

• Lay out your walking shoes

• Create a calming corner for relaxation

Small environmental tweaks reduce friction and increase follow-through.

5. Expect setbacks—and plan for them

Life will interrupt your habits. That’s not failure; that’s reality.

The key is to design habits that are flexible enough to survive disruption. A 10‑minute walk instead of a 30‑minute one. A simple meal instead of a perfect one. A shorter bedtime routine instead of abandoning it altogether.

🩺 What I’ve Learned From My Patients

Working in general practice gives me a front-row seat to the complexity of human behaviour. People don’t struggle because they’re lazy or unmotivated. They struggle because change is hard, and modern life is relentless.

But I’ve also seen the transformative power of small, consistent habits. Patients who start with one tiny shift often return months later with a completely different energy—more confident, more grounded, more hopeful.

And that’s the heart of The 4 Pillar Plan: health isn’t a destination; it’s a daily practice.

🌟 A Final Thought

If you’re trying to build habits that stick, start with kindness. Choose one micro‑habit from one pillar. Make it so easy you can’t help but succeed. And remember: sustainable change isn’t built on intensity—it’s built on consistency.

As a GP, as a human being, and as someone continually learning alongside my patients, I’ve come to believe that the smallest habits often create the biggest shifts.