Last week’s post was brought to you by Debbie Downer. I confess that I’m really “not feeling it”, the weight loss journey. I’m holding steady a few pounds above what I was earlier, which is a miracle considering how much I’m screwing up my diet regularly. I’m kind of giving myself a pass for the month of January, with a view to going hard again in February. But as part of my coping mechanisms, I’m trying to latch on to brightness wherever I can find it in the journey. And I didn’t really talk about a spark I felt back in December.

I had a good day. Actually, I had a great day. That doesn`t sound like much, does it? Sure, I mean, great days are good, but so what? Because it had been so long since I had a day like that, I think that I’d forgotten they exist. It was like my “new normal” over the last ten years defined good days within a narrower and narrower set of parameters.

For context, the “great day” was a normal everyday day, nothing special. I woke up, had a shower, ate some breakfast, did some basic things, and went to take something out to the garage. As I stepped out of the house, and into the garage, I suddenly became acutely aware of my body. It was like my brain was trying to tell me something, and suddenly I decided to listen. My brain was saying, “Yo’ dude, have you noticed how you’re feeling right NOW?”.

I was energized. I had been listening to music, I was bopping along, I felt pumped. I felt, well, healthy. And most of the day, I kept thinking, “What is THIS? And how do I get this feeling EVERY day?”. 

It felt new.

As I thought about it, I harkened back to an earlier post about various indicators — on-scale and off-scale ones. Lots of people had ideas of what else to suggest, and most of them fell into psycho/socio measures that tend to be very subjective. One friend in particular noted that she has indicators that lead themselves, in the most simplistic version, to whether you`re having good days or bad, what pain thresholds look like, etc. But they didn’t seem to “fit” with my journey, or my experiences in the past. I set them aside in favour of some future work (i.e., this post) about well-being. I wasn’t sure I would find anything that fit well with me, personally, but I wanted to check it out further. 

I confess that I had looked at well-being indicators once before, and was underwhelmed. Perhaps it’s my analytical side, perhaps it’s the performance measurement work I’ve done in my career, or perhaps it’s the approach I take to goal-setting in general, but I found that most of the indicators were either population level (i.e. not suited to the individual), too subjective (how do you feel today? are you satisfied with your life?), or too specific to unique populations (i.e., for chronic pain sufferers, what is your pain level today? Can you walk 10m? 20m?). Most of them didn’t seem to apply to me.

For example, I wasn’t in physical discomfort, pain, etc. I had no injury, I was just fat. Mental health is always an open question for me, sometimes jokingly and sometimes literally, but I wasn’t in any distress. In fact, that was one of the weird elements up until I hit 300 pounds — sometimes it was hard to see the direct impact on me. I coped pretty well.

Which when I write it out — “coping” — it seems obvious that there is impact. Likely measureable impact. Yet the dampening down of my energies and general feelings of health have been so long and gradual that I have equated much of it with simply growing older. No “good days” vs. “bad days”, just “what was”. Minor ripples and variations within a narrower range. Never too high, never too low. The “new normal” became simply my “normal”.

But like I said, then I had a good day. And I experienced again what that can feel like. My energy was up, I felt physically fitter within my current body frame, and my mood was positive. Oh, sure, it was gone the next day. Yet a couple of weeks later, I had a half day where I felt the same initial energy and mood bump, without the physical health sensation, and I thought, “Hmm, maybe I *should* be tracking this.”

More research on well-being

So I went back to some of my old bookmarks, did some additional searching and found some basic stuff online, even some more pop psych articles. Most were crap. Even ones where there was any rigour to them, they often were only for population level indicators rather than for individuals. Or just ones that didn’t apply to me. Until I found the Personal Wellbeing Index for Adults (PWI-A) from the “International Wellbeing Group” run out of (I think) Australia. As I read the file linked above, I found myself nodding YES! in a few places.

For example, they noted that one of the challenges with Quality of Life measurements is that you have to first define QoL — and if you change the definition, the measurements are either relevant or not. There’s no consensus on the definition, and thus little consensus on measurement, with one estimate being over 1200 indices around the world all with different elements. Yes, been there, seen that.

It then noted that even where there was a bit of consensus, it often was extremely narrowly focused, such as on a specific age demographic, medical condition or disability. In other words, if you defined the group as those with a muscular disease with motor control impairment, a bunch of your indicators are going to be about how they experience their day from that lens (or at least in part from that lens). Like the chronic pain example I used above.

In part, this was the same reaction I had to my friend’s initial advice — absence of pain wasn’t really relevant to me. I didn’t see how I could simply call it “absence of fattiness” instead.

What I wasn’t expecting in the article was that they faced head on the issue of objective and subjective measures of personal well-being. And the rigour with which they approached the question of “which domains to measure?”. They wanted no overlap between categories to prevent the possibility of something being influenced by the other indicators OR merely being a contributor, not a stand-alone area.

In fact, it was one of the areas that led them away from single-item/dimension constructs…if you defined QoL from a single lens/theme, and then decided it was made up of elements A, B and C, those elements are both contributory and definitional — you can only understand A within the control of the QoL definition, as opposed to understanding A as a standalone area on its own.

For me, it was some of the limitations I saw with some of the 1200+ constructs…circular definitions and inconsistent rigour in the elements, meaning that if one piece fell, the whole construct failed. I generally prefer models that can be seen as complementary and potentially capable of compensation rather than hardcore integration.

The scale chose seven domains that includes opportunities for both objective and subjective outcomes:

1. Standard of living
2. Personal health
3. Achieving in life
4. Personal relationships
5. Personal safety
6. Community-connectedness
7. Future security

It also includes a general question about overall satisfaction with one’s life, but that isn’t included in the scale (not a unique domain). The ninth question is one on which the group couldn’t achieve consensus — whether or not to include a spiritual or religion domain.

Each of the questions is measured on a 10-point scale where 0 is not satisfied at all and 10 is tickled pink (okay, actually it is completely satisfied). So I did the test (Taking a Personal Wellbeing Index (PWI) test) and it was interesting, but it didn’t really get me to the point of having some good indicators. I am going to ignore the Standard of Living, Current Achievements, Personal Relationships, Safety, Community, Future Security, Spirituality / Religion, and Overall Life questions, but I am going to incorporate one of them in two forms:

• How satisfied am I with my health?
• How satisfied am I with my current options and approach?

Embracing my inner researcher

Okay, I liked that first one, and it was encouraging enough that I went a little research-crazy. Which means, for the first time ever, I have a blog post with an Appendix! I’m sharing my notes and links at the bottom to what I found.

So having read all those links, I find myself at a bit of a cross-roads. I know which parts are directly relevant to my weight journey (marked in yellow in the appendix):

• Global:
  • current life satisfaction, overall sense of WB
• Physical:
  • breathing, dexterity, discomfort, elimination, energy levels, fatigue, fitness, general health, illness, mobility, nutritional balance, pain, physical activity, sleep, stress, usual activities, self-reported health status
• Mental:
  • anxiety, acceptance, mood, emotional reactions, inner balance, intellectual wellness/mental alertness, motivation, optimism, relaxation, self-esteem, self-care, self-control, positive affect, optimism, prevalence of dementia
• Activities / functioning
  • ability or time to do interests/hobbies, recreation, sex, work/life balance, outdoor environment
• Social WB
  • family, friendships, home life, lonely dissatisfaction, parenting, partner relations, social supports, volunteering, arts & culture

But the cross-roads is related to the fact that I really hate doing the same work twice. And if I like these WB indicators enough to incorporate for my health journey, perhaps I should consider them more broadly. Like a Personal Well Being Index that I review likely annually that also takes into account all those other factors that don’t really apply to my physical health journey, more the broader holistic “me 2.0”. It’s the same challenge that the first article had — ensuring that the domains are discrete, and I see a bunch of the ones above as being “part” of a larger discrete category, it’s just those other parts aren’t as relevant.

I don’t know who I’m fooling, my decision is already made. I need to make a quick and dirty PolyWogg Well-being Index that goes beyond the basics. Maybe I can tie it to my favorite Blue / Red / Yellow / Green model.

All because of that one little spark.

APPENDIX: Notes on well-being indicators

• https://www.theguardian.com/news/datablog/2011/jul/25/wellbeing-happiness-office-national-statistics: Subjective ones like life satisfaction, happy, anxiety, feelings of worth vs. objective ones around children’s happiness, economy and inequality, inequalities in health, and work/life balance (although more about # of hours in sport per week);
• https://bmjopen.bmj.com/content/6/7/e010641: Strong theoretical analysis (including distinguishing between “priority” areas in various disciplines), and 99 self-report measures based on frequency, intensity, and strength of agreement with various statements. The research separated out “affective” component (emotions) and “cognitive” component (evaluation). Strong links identified in the literature between “positive health” and “well-being”. Of the 99 indicators, the ones most likely to be of interest to my health journey are physical WB (breathing, dexterity, discomfort, elimination, energy levels, fatigue, fitness, general health, illness, mobility, nutritional balance, pain, physical activity, sleep, stress, and usual activities), global WB (current life satisfaction, overall sense of WB), mental WB (acceptance, mood, emotional reactions, inner balance, intellectual wellness/mental alertness, motivation, optimism, relaxation, self-esteem, self-care, and self-control), activities / functioning (ability to do interests/hobbies, recreation, and sex), and social WB (family, friendships, home life, lonely dissatisfaction, parenting, partner relations, social supports).
• https://b.3cdn.net/nefoundation/7a378df45fafe612cc_a3m6i6g49.pdf: Well-being = how people feel (emotions) and how they function (sense of competence or connectedness), including feeling optimistic / useful / relaxed / dealing with problems well / thinking clearly / feeling close to people / make up my mind about things; feeling satisfied with life today / happy yesterday /  anxious yesterday / doing worthwhile things;  
• https://www.hsph.harvard.edu/health-happiness/research-new/positive-health/measurement-of-well-being/: Differences between objective WB(population) and subjective WB (individual), as well as WB vs. resilience. Questions if some WB indicators are more determinant of health behaviours, chronic disease or mortality, with links for multidimensional, positive affect, purpose / meaning in life, life satisfaction, mastery, happiness, optimism, etc.
• https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/measuringnationalwellbeing/apr2017: National statistics;
• www.geog.uvic.ca/wellness/wellness2011/Chapter2.pdf: Physical wellness, psychological/emotional wellness, social wellness, intellectual wellness, spiritual wellness, occupational wellness, environmental wellness, economic wellness, cultural wellness, climate wellness, governance / social justice wellness are all covered in brief. In addition, the social determinants of health (macro issues that are foundational for micro considerations).
• https://www.mentalhealth.org.uk/blog/what-wellbeing-how-can-we-measure-it-and-how-can-we-support-people-improve-it: Mental health supports;
•  https://www.governanceinstitute.edu.au/magma/media/upload/ckeditor/files/Wellbeing%20Indicators%20across%20the%20life%20cycle_FINAL.pdf: Economic factors (including number of working hours), home factors, health factors (including life expectancy, self-reported health status, disability, smoking, mental health + overall life satisfaction, time devoted to leisure or personal care or sports), education and skills factors (including cognitive skills), social and community factors (including standard ones plus volunteering, outdoor environment, and arts & culture), empowerment factors, and safety factors. Good list of indicators useful for “older adults”, including caring duties, access to transportation, connectivity (access to internet), home tenure, rent assistance, assistance with core activities, use of aged-care services, home and community care, number of hours of care, community-packaged care, prevalence of dementia, and underemployment.
• https://www.researchgate.net/publication/251380964_Subjective_Indicators_of_Personal_Well-Being_among_Adolescents_Performance_and_Results_for_Different_Scales_in_Latin-Language_Speaking_Countries_A_Contribution_to_the_International_Debate: International applicability of indicators/frameworks, along with focus on youth;
• http://theconversation.com/how-do-we-measure-well-being-70967: Disconnecting happiness (positive and negative fluctuations in emotion) and satisfaction (cognitive evaluation, perspective), focus instead on capability model (since physical condition/neglect can become “normal” and valuation neglect reduces person to single number rather than multidimensional i.e., the UNDP HDR effect) and the need to also understand well-being in context of opportunities/capabilities;
• http://libres.uncg.edu/ir/uncg/f/H_Helms_Marital_2007.pdf: Generally, the idea that “conflict” has strong effect on PWB, while “love” is weaker on increasing it;