Do people actually lose weight after a health scare, or does the motivation fade?

Both are true, and they happen on a schedule. Wing & Phelan 2005 (*American Journal of Clinical Nutrition*), analyzing the National Weight Control Registry, found roughly **70 percent of successful long-term maintainers cite a specific triggering event** as their initiation — a medical event, a doctor warning, a mirror moment, a family event — and the triggered group has significantly higher long-term maintenance rates than the gradual-decision group. But the trajectory is not linear. Ockene 2000 (*Archives of Internal Medicine*) documented that **50–60 percent of post-MI patients adhere to diet and exercise recommendations at 6 months, dropping to 25–40 percent at 24 months**. Chen 2017 (*Stroke*) put achievable post-stroke weight loss at 5–8 percent of body weight in the first year with structured secondary-prevention programs. Hussain 2011 (*Diabetes Care*) documented 40–55 percent 6-month adherence to diet-and-exercise recommendations in newly-diagnosed T2D, decaying over 18 months. Fisher & Coups 2010 (*American Journal of Public Health*) put sustained dietary change post-cancer-diagnosis at 30–40 percent at 12 months. The honest read is that the scare provides motivation but not the four other mechanisms Kwasnicka 2016 (*Health Psychology Review*) identifies — self-regulation, resources, habits, environmental context — and those have to be built during the open window (weeks 3–6, per Prochaska 2008) while motivation is still peak.

How long does the motivation window actually last after a diagnosis?

The Prochaska 2008 (*American Journal of Health Promotion*) precontemplation-to-action literature puts the **median open-motivation window at 3–6 weeks** post-diagnosis. Weeks 0–2 are typically raw shock — frozen, bargaining, denial, or relief that a symptom has an explanation; self-regulation bandwidth is low and this is not the phase to launch aggressive change. Weeks 3–6 are peak open motivation — the phase where the highest willingness to try any change collides with the highest openness to installing new cues, and this is the Duhigg 2012 cue-window sweet spot. Weeks 7–12 are real-life-intrusion — competing priorities return, adherence starts to decay, and behaviors that survived this phase become the new baseline. Months 3–6 are pattern-lock — whatever is still happening now is likely to keep happening. Months 6–12 are the Ockene 2000 second-motivation dip — the 24-month adherence drop from 50–60 percent at 6 months to 25–40 percent at 24 months. Building around the arc, not on top of it, is what separates the Wing 2005 NWCR triggered-maintainer subgroup from the majority who regress. The intervention is: install cues in weeks 3–6 while the window is open; schedule an intentional booster at month 6, 12, and 24 (cardiac rehab, a support group, a re-visit with the doctor); and treat motivation fade as expected physiology, not moral failure.

My spouse had a heart attack — what should I actually do differently at home?

A health scare is a two-person event. Umberson 2019 documents that a spouse or adult child typically changes behavior alongside the patient — and often needs to, because one household kitchen serves both. The five moves that matter: (1) **do not build two food streams** — the ice cream out of the freezer, the frozen vegetables in, the anchor breakfast the same for both of you; separate meal streams collapse within weeks because the caregiver eventually eats the ice cream at 10 pm alone; (2) **anchor one shared behavior daily** — usually a 20-minute walk together after dinner, which doubles as connection time and takes the pressure off scheduled conversation about the scare itself; (3) **let the patient ask for what they need in one specific line** — 'I need the ice cream out of the freezer for 3 months' beats 'I need you to be more supportive'; (4) **protect your own weight, sleep, and mental health** — the caregiver's own weight often drifts up during the acute-caregiving phase from stress, disrupted sleep, and takeout convenience (see [weight loss and caregiver stress](/weight-loss/weight-loss-and-caregiver-stress/)), and a collapsed caregiver serves nobody; (5) **make room for the anniversary reactions** — the 3-month, 6-month, and 1-year marks often trigger both the patient's and the caregiver's mood dip, and that dip is when the household eating and drinking pattern tends to drift. If the caregiver's PHQ-2 is ≥ 3 or they are drinking daily to cope, that is a therapist referral this week, not next month.

What should I ask my doctor for at the follow-up appointment?

Ask for referrals — they are usually not offered unless requested. Newman 2013 (*Circulation*) documented that **cardiac rehab increases 3-year survival post-MI, but only ~35 percent of eligible patients attend**, and the gap is largely a referral gap plus a transportation-and-scheduling gap. The referrals to ask for by diagnosis: **post-MI, post-CABG, post-stent** — cardiac rehab (12-week structured program, exercise-supervised, insurance-covered post-event in most US plans); **COPD exacerbation** — pulmonary rehab (same model, different specialty); **new T2D** — DSMES (Diabetes Self-Management Education and Support, CDC-recognized, insurance-covered post-diagnosis in most plans) plus 3 visits with a registered dietitian (usually covered under Medicare MNT and most commercial post-diagnosis benefits); **prediabetes** — the CDC-recognized National DPP (Diabetes Prevention Program), often covered by insurance and by Medicare; **any diagnosis with significant weight-loss recommendation** — a registered dietitian (typically 3 covered visits post-cardiac-event, T2D diagnosis, or bariatric consult); **any diagnosis with mood impact** — a therapist referral (post-event depression and health anxiety are underdiagnosed; consider a PHQ-9 and GAD-7 at the follow-up); **medication complexity** — MTM (Medication Therapy Management via your pharmacist, often free with insurance). Bring a written list to the appointment. If the doctor forgets, ask. If the referral is denied by insurance, appeal — cardiac rehab appeals overturn a majority of initial denials.

How do I keep the changes going after the initial motivation fades?

Build the anchor artifact in weeks 3–6 while motivation is peak, and return to it when motivation fades. In your own words, write down: what the doctor said (the exact phrasing, the diagnosis, the risk numbers if given), what you thought when you heard it, what your family said or how they looked, what you promised yourself, what you promised anyone else. Keep it in a physical notebook or a note you can find on your phone. Read it at month 3, month 6, month 12, and any time you catch the pattern drifting. This is not journaling for its own sake — it is the Kwasnicka 2016 (*Health Psychology Review*) 'motives' mechanism made durable so it survives the intention-to-behavior gap. Sheeran 2016 (*Health Psychology*) meta-analyzed that gap and found **even after high-motivation events, roughly 40–50 percent of formed intentions never translate to sustained behavior** — unless implementation intentions (Gollwitzer 1999) are used. Implementation intentions are 'if-then' rules: 'If it is 7 pm on a weeknight, I will walk for 20 minutes before dinner.' 'If I am at the coffee shop, I will order the small oat-milk latte instead of the muffin.' 'If I have not walked by 4 pm, I will walk during the next commercial break.' Gollwitzer 1999 documented that if-then framing roughly **doubles the success rate** of formed intentions. Write down three if-then rules in the open window; do not try to write ten. And schedule a follow-up appointment at 3, 6, and 12 months as an external booster — the visit itself is a motivation renewal event.

What if I have already regressed and gained the weight back?

Return is normal, and it is not moral failure. The Ockene 2000 24-month adherence curve shows most post-MI patients are not the NWCR-maintainer subtype at 2 years — the majority regress at least partially, and Wing & Phelan 2005 explicitly notes that the maintainer group is a *minority* of triggered patients. The intervention: (1) **do not treat the regression as evidence that the scare 'didn't work'** — the triggering event permanently changed the risk profile even if the behavior has drifted; (2) **re-read the anchor artifact** — the words you wrote down in the open window are still true; (3) **book a follow-up with your primary care doctor**, framed as 'I want to re-engage with the secondary-prevention plan we set up' — this is a routine visit for the doctor, not a confession; (4) **re-request the referrals** — cardiac rehab can often be re-entered up to 12 months post-event, DPP has multiple entry cohorts per year, and dietitian benefits usually renew annually; (5) **look for the anniversary triggers** that likely drove the drift — the 3-month, 6-month, 12-month, and 24-month marks are documented dip points, and a scheduled booster (a support group, a re-visit) at those points is more durable than 'I'll just try harder'; (6) **screen for depression** — post-event depression is a documented adherence-collapse driver (Rosal 2001, *Annals of Behavioral Medicine*), and untreated it makes every other change harder. See [depression and weight loss](/weight-loss/depression-and-weight-loss/) for the wider read and the therapy-access playbook.

2026-09-10 · weight loss after health scare, post heart attack weight loss, diagnosed with diabetes weight loss, cardiac rehab, triggering event weight loss, NWCR, motivation window, post stroke lifestyle change, cancer diagnosis weight loss, sleep apnea diagnosis, secondary prevention, life transitions, behavior change, implementation intentions

Written by Tessa Morgan

Tessa Morgan is a WeightFAQ staff writer focused on the long-game side of weight loss: habits, motivation, tracking, and what happens after the first pound comes off. She has written about weight-loss maintenance, plateaus, why the scale sometimes stops moving, water-weight fluctuations, and adaptive thermogenesis, as well as practical guides to weight-loss apps, non-scale victories, emotional eating, and cheat meals and refeed days. Tessa covers realistic timelines — how long weight loss actually takes — and travel-friendly strategies. She writes for readers building routines they can hold for years, not weeks.

25 min read

Medically reviewed on Sep 10, 2026

Overhead flat-lay on a light oak wood surface: a small open notebook with a matte black pen, a plain glass of water, a labeled prescription bottle (blurred and non-branded), a red apple, a stethoscope arranged simply at the edge, a folded blood-pressure cuff, and a walking-shoe silhouette at the frame edge — calm neutral palette in soft morning light, conveying post-appointment quiet resolve without medical alarm.

Do people actually lose weight after a health scare, or does the motivation fade?: Both are true, and they happen on a schedule. Wing & Phelan 2005 (*American Journal of Clinical Nutrition*), analyzing the National Weight Control Registry, found roughly **70 percent of successful long-term maintainers cite a specific triggering event** as their initiation — a medical event, a doctor warning, a mirror moment, a family event — and the triggered group has significantly higher long-term maintenance rates than the gradual-decision group. But the trajectory is not linear. Ockene 2000 (*Archives of Internal Medicine*) documented that **50–60 percent of post-MI patients adhere to diet and exercise recommendations at 6 months, dropping to 25–40 percent at 24 months**. Chen 2017 (*Stroke*) put achievable post-stroke weight loss at 5–8 percent of body weight in the first year with structured secondary-prevention programs. Hussain 2011 (*Diabetes Care*) documented 40–55 percent 6-month adherence to diet-and-exercise recommendations in newly-diagnosed T2D, decaying over 18 months. Fisher & Coups 2010 (*American Journal of Public Health*) put sustained dietary change post-cancer-diagnosis at 30–40 percent at 12 months. The honest read is that the scare provides motivation but not the four other mechanisms Kwasnicka 2016 (*Health Psychology Review*) identifies — self-regulation, resources, habits, environmental context — and those have to be built during the open window (weeks 3–6, per Prochaska 2008) while motivation is still peak.
How long does the motivation window actually last after a diagnosis?: The Prochaska 2008 (*American Journal of Health Promotion*) precontemplation-to-action literature puts the **median open-motivation window at 3–6 weeks** post-diagnosis. Weeks 0–2 are typically raw shock — frozen, bargaining, denial, or relief that a symptom has an explanation; self-regulation bandwidth is low and this is not the phase to launch aggressive change. Weeks 3–6 are peak open motivation — the phase where the highest willingness to try any change collides with the highest openness to installing new cues, and this is the Duhigg 2012 cue-window sweet spot. Weeks 7–12 are real-life-intrusion — competing priorities return, adherence starts to decay, and behaviors that survived this phase become the new baseline. Months 3–6 are pattern-lock — whatever is still happening now is likely to keep happening. Months 6–12 are the Ockene 2000 second-motivation dip — the 24-month adherence drop from 50–60 percent at 6 months to 25–40 percent at 24 months. Building around the arc, not on top of it, is what separates the Wing 2005 NWCR triggered-maintainer subgroup from the majority who regress. The intervention is: install cues in weeks 3–6 while the window is open; schedule an intentional booster at month 6, 12, and 24 (cardiac rehab, a support group, a re-visit with the doctor); and treat motivation fade as expected physiology, not moral failure.
My spouse had a heart attack — what should I actually do differently at home?: A health scare is a two-person event. Umberson 2019 documents that a spouse or adult child typically changes behavior alongside the patient — and often needs to, because one household kitchen serves both. The five moves that matter: (1) **do not build two food streams** — the ice cream out of the freezer, the frozen vegetables in, the anchor breakfast the same for both of you; separate meal streams collapse within weeks because the caregiver eventually eats the ice cream at 10 pm alone; (2) **anchor one shared behavior daily** — usually a 20-minute walk together after dinner, which doubles as connection time and takes the pressure off scheduled conversation about the scare itself; (3) **let the patient ask for what they need in one specific line** — 'I need the ice cream out of the freezer for 3 months' beats 'I need you to be more supportive'; (4) **protect your own weight, sleep, and mental health** — the caregiver's own weight often drifts up during the acute-caregiving phase from stress, disrupted sleep, and takeout convenience (see [weight loss and caregiver stress](/weight-loss/weight-loss-and-caregiver-stress/)), and a collapsed caregiver serves nobody; (5) **make room for the anniversary reactions** — the 3-month, 6-month, and 1-year marks often trigger both the patient's and the caregiver's mood dip, and that dip is when the household eating and drinking pattern tends to drift. If the caregiver's PHQ-2 is ≥ 3 or they are drinking daily to cope, that is a therapist referral this week, not next month.
What should I ask my doctor for at the follow-up appointment?: Ask for referrals — they are usually not offered unless requested. Newman 2013 (*Circulation*) documented that **cardiac rehab increases 3-year survival post-MI, but only ~35 percent of eligible patients attend**, and the gap is largely a referral gap plus a transportation-and-scheduling gap. The referrals to ask for by diagnosis: **post-MI, post-CABG, post-stent** — cardiac rehab (12-week structured program, exercise-supervised, insurance-covered post-event in most US plans); **COPD exacerbation** — pulmonary rehab (same model, different specialty); **new T2D** — DSMES (Diabetes Self-Management Education and Support, CDC-recognized, insurance-covered post-diagnosis in most plans) plus 3 visits with a registered dietitian (usually covered under Medicare MNT and most commercial post-diagnosis benefits); **prediabetes** — the CDC-recognized National DPP (Diabetes Prevention Program), often covered by insurance and by Medicare; **any diagnosis with significant weight-loss recommendation** — a registered dietitian (typically 3 covered visits post-cardiac-event, T2D diagnosis, or bariatric consult); **any diagnosis with mood impact** — a therapist referral (post-event depression and health anxiety are underdiagnosed; consider a PHQ-9 and GAD-7 at the follow-up); **medication complexity** — MTM (Medication Therapy Management via your pharmacist, often free with insurance). Bring a written list to the appointment. If the doctor forgets, ask. If the referral is denied by insurance, appeal — cardiac rehab appeals overturn a majority of initial denials.
How do I keep the changes going after the initial motivation fades?: Build the anchor artifact in weeks 3–6 while motivation is peak, and return to it when motivation fades. In your own words, write down: what the doctor said (the exact phrasing, the diagnosis, the risk numbers if given), what you thought when you heard it, what your family said or how they looked, what you promised yourself, what you promised anyone else. Keep it in a physical notebook or a note you can find on your phone. Read it at month 3, month 6, month 12, and any time you catch the pattern drifting. This is not journaling for its own sake — it is the Kwasnicka 2016 (*Health Psychology Review*) 'motives' mechanism made durable so it survives the intention-to-behavior gap. Sheeran 2016 (*Health Psychology*) meta-analyzed that gap and found **even after high-motivation events, roughly 40–50 percent of formed intentions never translate to sustained behavior** — unless implementation intentions (Gollwitzer 1999) are used. Implementation intentions are 'if-then' rules: 'If it is 7 pm on a weeknight, I will walk for 20 minutes before dinner.' 'If I am at the coffee shop, I will order the small oat-milk latte instead of the muffin.' 'If I have not walked by 4 pm, I will walk during the next commercial break.' Gollwitzer 1999 documented that if-then framing roughly **doubles the success rate** of formed intentions. Write down three if-then rules in the open window; do not try to write ten. And schedule a follow-up appointment at 3, 6, and 12 months as an external booster — the visit itself is a motivation renewal event.
What if I have already regressed and gained the weight back?: Return is normal, and it is not moral failure. The Ockene 2000 24-month adherence curve shows most post-MI patients are not the NWCR-maintainer subtype at 2 years — the majority regress at least partially, and Wing & Phelan 2005 explicitly notes that the maintainer group is a *minority* of triggered patients. The intervention: (1) **do not treat the regression as evidence that the scare 'didn't work'** — the triggering event permanently changed the risk profile even if the behavior has drifted; (2) **re-read the anchor artifact** — the words you wrote down in the open window are still true; (3) **book a follow-up with your primary care doctor**, framed as 'I want to re-engage with the secondary-prevention plan we set up' — this is a routine visit for the doctor, not a confession; (4) **re-request the referrals** — cardiac rehab can often be re-entered up to 12 months post-event, DPP has multiple entry cohorts per year, and dietitian benefits usually renew annually; (5) **look for the anniversary triggers** that likely drove the drift — the 3-month, 6-month, 12-month, and 24-month marks are documented dip points, and a scheduled booster (a support group, a re-visit) at those points is more durable than 'I'll just try harder'; (6) **screen for depression** — post-event depression is a documented adherence-collapse driver (Rosal 2001, *Annals of Behavioral Medicine*), and untreated it makes every other change harder. See [depression and weight loss](/weight-loss/depression-and-weight-loss/) for the wider read and the therapy-access playbook.

Weight Loss After a Health Scare: How to Turn a Medical Event into Sustained Change (2026)

This is written for the reader who just left a hospital

This is written for the reader who just left a hospital, a cath lab, a biopsy, or an appointment where a doctor used the word concerning. It is also written for the family member sitting next to them — the spouse, the adult child, the sibling who came to the appointment because someone had to. What follows is not a clinical protocol for any single condition (those live on the clinical pillars, linked throughout), and it is not a fear-tactic reset-your-life essay. It is the honest arc of what happens between a diagnosis and a durable change in weight — the weeks, the months, the year — and where the on-site behavioral-medicine literature says the leverage actually sits.

Quick answer

A health scare (a heart attack, a stroke, a cancer diagnosis, a new T2D diagnosis, a severe sleep-apnea result, an abnormal biopsy, an abnormal cardiac stress test) is one of the strongest weight-change catalysts documented — Wing & Phelan 2005 (American Journal of Clinical Nutrition), analyzing the National Weight Control Registry, found roughly 70 percent of successful long-term maintainers cite a specific triggering event as their initiation, and the triggered group has significantly higher long-term maintenance rates than the gradual-decision group. But motivation alone is not the mechanism. The honest arc is Prochaska 2008’s 3–6 week open-motivation window (American Journal of Health Promotion), followed by Ockene 2000’s adherence decay (Archives of Internal Medicine) — 50–60 percent post-MI adherence at 6 months, dropping to 25–40 percent at 24 months — unless the other four Kwasnicka 2016 (Health Psychology Review) mechanisms (self-regulation, resources, habits, environmental context) are actively built during the open window. Chen 2017 (Stroke) documents 5–8 percent post-stroke weight loss is achievable in the first year with structured secondary-prevention programs. Hussain 2011 (Diabetes Care) puts 6-month T2D adherence at 40–55 percent. Fisher & Coups 2010 (American Journal of Public Health) puts sustained dietary change post-cancer-diagnosis at 30–40 percent at 12 months. Newman 2013 (Circulation) documents that cardiac rehab increases 3-year survival, but only about 35 percent of eligible patients attend — mostly a referral gap. This pillar walks the arc week by week and month by month, with an ask-for-the-referral checklist, an implementation-intentions method, and a re-entry protocol for when motivation fades — because it will, and returning is not failure.

Who this is for — and who it is not for

This pillar is written for:

Adults within the first 12 months of a serious diagnosis — a myocardial infarction, an ischemic or hemorrhagic stroke, a new type-2-diabetes diagnosis, a new cancer diagnosis, a moderate-to-severe sleep-apnea study result, an abnormal biopsy or worrying imaging finding, an abnormal cardiac stress test, a fatty-liver ultrasound with elevated enzymes, or an emergency-department visit for something the person expected to be nothing.
The spouse, adult child, or primary caregiver of that adult — a health scare is a two-person event and one household kitchen serves both.
Adults with a family “close call” recently — a parent’s MI, a sibling’s diagnosis, a friend’s cancer — that has become the trigger even though the diagnosis is not theirs. The Wing 2005 NWCR literature counts vicarious trigger events (a “wake-up moment” watching a family event) alongside direct diagnoses.
Adults returning to this pillar after a regression — the 6-month, 12-month, 24-month, or 5-year re-entry point.

It is not written as a substitute for:

The clinical protocol of the specific condition — cardiovascular disease, diabetes, stroke, cancer, sleep apnea, heart failure, GERD, gallstones, fatty liver, atrial fibrillation, or metabolic syndrome all have their own on-site clinical pillar with the medication, monitoring, and disease-specific weight-loss detail; this pillar is the behavioral / motivational wrapper around those. See the cross-links below.
Any medication decision — do not stop statins, metformin, blood-pressure medications, GLP-1s, insulin, anticoagulants, or any prescribed medication without discussing with the prescriber, even if weight is falling and you feel better.
Acute mental-health crisis — if you are having thoughts of self-harm, call or text 988 (US Suicide & Crisis Lifeline) before reading further.

What the evidence actually shows

The trajectory of post-diagnosis behavior change is one of the better-studied life-transition patterns in behavioral-medicine literature, and the direction is consistent across cohorts and diagnoses.

Study	Design	Cohort	Finding
Wing & Phelan 2005 (Am J Clin Nutr)	NWCR analysis	Long-term maintainers	~70 percent cite a triggering event as initiation; higher maintenance rates than gradual-decision group
Ockene 2000 (Arch Intern Med)	Longitudinal	Post-MI patients	Adherence 50–60 percent at 6 mo, 25–40 percent at 24 mo to diet and exercise recommendations
Newman 2013 (Circulation)	Cardiac rehab outcomes	Post-MI patients	Cardiac rehab increases 3-yr survival; only ~35 percent of eligible patients attend
Chen 2017 (Stroke)	Secondary-prevention program	Post-stroke patients	5–8 percent body-weight loss achievable in first year with structured program
Hussain 2011 (Diabetes Care)	Newly-diagnosed T2D	Behavior response	40–55 percent 6-mo adherence to diet and exercise; decay over 18 mo
Fisher & Coups 2010 (Am J Public Health)	Post-diagnosis behavior	Newly-diagnosed cancer	30–40 percent make sustained dietary changes at 12 mo
Prochaska 2008 (Am J Health Promot)	Stages of change	Post-diagnosis cohorts	Median 3–6 week open-motivation window post-precontemplation-to-action
Prochaska & DiClemente 1983 (J Consult Clin Psychol)	Framework	—	Transtheoretical Model: precontemplation → contemplation → preparation → action → maintenance
Kwasnicka 2016 (Health Psychol Rev)	Meta-analysis	Maintenance behavior	5-mechanism framework: motives, self-regulation, resources, habits, environmental context
Sheeran 2016 (Health Psychol)	Meta-analysis	Intention-to-behavior	40–50 percent of formed intentions never translate to sustained behavior without implementation intentions
Gollwitzer 1999 (Am Psychol)	Framework + trials	If-then planning	Implementation intentions ~2x success rate vs generic intention
Rosal 2001 (Ann Behav Med)	RCT	Post-cardiac-event	CBT-based intervention improves weight and behavior change outcomes at 12 mo
AHA 2024 Statistical Update	National statistics	US adults	Cardiac-rehab enrollment gap, secondary-prevention adherence and outcomes
Miller & Rollnick 2013 (Motivational Interviewing 3e)	Framework	Behavior-change support	Ambivalence-normalization principle for post-diagnosis conversations
Duhigg 2012 (The Power of Habit)	Popular synthesis	Cue-window	New cues install fastest in a disrupted-routine window; source of the “post-diagnosis 3–6 week window” applied model
Lally 2010 (Eur J Soc Psychol)	Prospective trial	Habit formation	Median 66 days to automaticity (range 18–254); “21 days to form a habit” is not accurate
CDC 2024	National statistics	Chronic-disease patients	Trigger-event data; secondary-prevention program enrollment; DPP and DSMES uptake

The honest read: post-scare behavior change is a majority-motivating, minority-maintaining pattern. About 7 in 10 successful long-term maintainers point back to a triggering event as their initiation (Wing 2005) — the direction is real — but the same literature is unambiguous that most triggered patients regress at least partially by 24 months (Ockene 2000). The subgroup that maintains is the one that built the four other Kwasnicka 2016 mechanisms during the open window, not the one that felt the most motivated.

The motivation-window honest arc

Post-diagnosis behavior does not run on a smooth curve. It runs on a phase-locked schedule that repeats across cardiac, oncology, endocrine, and pulmonary triggering events.

Phase	Weeks	What is actually happening	What to install
Raw shock	Weeks 0–2	Frozen / bargaining / relief that the symptom has an explanation. Self-regulation bandwidth is very low. Sleep is often disrupted.	Nothing aggressive. Take the medications as prescribed. Show up to appointments. Write down what the doctor said in your own words (this becomes the anchor artifact).
Peak open motivation	Weeks 3–6	Prochaska 2008 window. Highest willingness to try any change. Duhigg 2012 cue-window sweet spot — new behaviors install fastest here.	Install cues. Clean the food environment. Ask for the referrals. Write three if-then implementation intentions. Book cardiac rehab / DPP / dietitian.
Real-life intrusion	Weeks 7–12	Competing priorities return. Adherence starts to decay. Family/work demands re-anchor. First “I forgot to walk” episodes.	Protect the cues you installed. Do not add new ones. Attend the scheduled program (rehab, DPP, dietitian) even the weeks you do not want to.
Pattern lock	Months 3–6	Whatever is still happening now is likely to keep happening. First fade of enthusiasm; the household starts to normalize.	Book a 3-month and 6-month follow-up. Re-read the anchor artifact. Do not chase a bigger deficit — protect what stuck.
Second motivation dip	Months 6–12	Ockene 2000 documented 6-mo to 24-mo drop from 50–60 percent to 25–40 percent adherence. Anniversary reactions common.	Intentional booster: cardiac rehab graduation program, DPP maintenance cohort, a support group, a re-visit with the primary care doctor.
Long game	Year 2+	The maintainer subgroup is set. Regression is common; re-entry is possible and normal.	Annual physical framed as secondary-prevention review. Re-request referrals. Re-read the anchor artifact. Screen PHQ-2 annually.

Wing 2005’s finding does not say that triggered patients uniformly maintain. It says that among the already-successful maintainers, roughly 70 percent point back to a triggering event. The direction is real; the base-rate maintenance is not. What separates the maintainer subgroup is what they installed in weeks 3–6.

The Kwasnicka 5-mechanism build

Kwasnicka 2016 (Health Psychology Review) meta-analyzed the maintenance literature and identified five mechanisms that separate maintainers from regressers. The health-scare trigger provides only one of them — motives — and the open window is the time to build the other four. Skipping any of them predicts regression by month 6.

1. Motives — write the anchor artifact

The trigger provides motives; do not spend the open window looking for more motivation. Instead, catalogue and record what the doctor said, what you thought when you heard it, what your family said or how they looked, what you promised yourself, what you promised anyone else. In your own words, in a physical notebook or a note on your phone you can find. This is not journaling for its own sake — it is the durable artifact you return to at month 3, 6, and 12 when motivation fades, because it will. The Miller & Rollnick 2013 (Motivational Interviewing) principle applies here: the person’s own words carry more behavioral weight than any external reminder. A photograph of the discharge paperwork or the biopsy report, tucked into the same note, adds a visual anchor. If you cannot write, dictate a 2-minute audio memo. The artifact does not have to be long — 200–500 words is plenty — and it does not have to be elegant. It has to be yours, and it has to be findable.

2. Self-regulation — track one thing, not five

Self-regulation is the mechanism most people over-invest in and most people under-execute. The mistake is trying to track everything at once: calories, steps, sleep, water, protein, blood pressure, glucose, mood. The Miller-Rollnick and Kwasnicka literature both point the other way — track one behavior that maps to the highest-priority mechanism for your diagnosis. Post-MI: track daily steps (or attendance at cardiac rehab). New T2D: track blood glucose at the times your care team specifies and one meal-plan adherence marker per day. Post-stroke: track medication adherence and weekly weight. Severe sleep apnea: track CPAP hours per night. Build one weekly weigh-in habit (not daily during the emotional-shock phase — daily weight is noise that reads as failure in weeks 2–4). Use implementation intentions (Gollwitzer 1999): ‘If it is 7 pm on a weeknight, I will walk for 20 minutes before dinner.’ Write three of them in the open window and put them somewhere visible.

3. Resources — ask for the referrals

Resources are the mechanism most under-utilized because most of them require a referral you have to ask for. Newman 2013 documented that cardiac rehab increases 3-year survival post-MI but only about 35 percent of eligible patients attend — and the largest single gap in that number is a referral gap plus a transportation-and-scheduling gap, not a motivation gap. The resources to line up during the open window, by diagnosis: cardiac rehab (12-week supervised program post-MI, post-CABG, post-stent, often insurance-covered); pulmonary rehab (post-COPD-exacerbation, same model); DPP — the CDC-recognized National Diabetes Prevention Program (post-prediabetes-diagnosis, insurance-covered and Medicare-covered); DSMES — Diabetes Self-Management Education and Support (post-T2D-diagnosis, CDC-recognized, insurance-covered); registered dietitian (typically 3 visits covered post-cardiac-event or T2D diagnosis); therapist (post-event depression and health anxiety are underdiagnosed); MTM — Medication Therapy Management via your pharmacist. Bring the list to the appointment.

4. Habits — install cues in the open window

The Weeks 3–6 open window is when new cues install fastest — Duhigg 2012’s cue-window principle, backed by Lally 2010’s (European Journal of Social Psychology) prospective trial documenting a median 66 days to automaticity (range 18–254). “21 days to form a habit” is not accurate; the honest range is roughly 2 to 8 months depending on the behavior and the person. Anchor a new behavior to an existing daily cue: protein at breakfast right after coffee; a 10-minute walk after lunch; take medications at the same time as brushing teeth; walking shoes by the door so putting them on is the default. The cue does most of the work — willpower does very little. Do not stack six new cues in week 3; install two, protect them through weeks 7–12, and add another in month 3 if the first two held. Cue-stacking failures in the intrusion phase are the modal cause of month-3 abandonment. See habit formation for weight loss for the deeper protocol.

5. Environmental context — clean the environment while motivation is peak

The home food environment matters more than any individual meal. In Weeks 3–6, while motivation is peak, do the cleanup: tell the household one specific ask (‘I need the ice cream out of the freezer for 3 months,’ not ‘I need you to be more supportive’); make the healthy default easy (pre-cut vegetables visible at eye level in the fridge, walking shoes by the door, water bottle on the counter, medications in a weekly pillbox on the kitchen table); make the unhealthy default hard (chips off the counter, alcohol not in the front of the fridge, screens off the bedside table). This is a one-day project in Week 3 that pays across the entire year, and it is easier now than it will be at Month 3 because motivation drops the transaction cost. If the household includes someone who is not on board with the changes, one shared behavior (a nightly walk, a shared breakfast) is a durable anchor even if the food environment is a compromise. See weight loss and household environment if the household is a source of friction.

The 5-scenario decision table

A health scare is not one situation. The dominant driver, the realistic weight-loss target, and the medically-supervised program to enter differ meaningfully by scenario.

Scenario	Realistic weight target	Medically-supervised program	Timeline	Cross-link
Post-MI (heart attack)	5–10 percent of body weight in year 1 with cardiac rehab; larger with structured program	Cardiac rehab (12 weeks, supervised, ~35 percent attendance gap — ask for the referral); cardiovascular disease and weight loss protocol	Week 2–4: cardiac-rehab start; Month 3–6: independent maintenance; Month 12: re-visit	cardiovascular disease and weight loss
Post-stroke (ischemic or hemorrhagic)	5–8 percent in year 1 with structured secondary prevention (Chen 2017); slower ramp if hemiparesis limits exercise	Stroke secondary-prevention program + physical therapy + dietitian; possibly cardiac rehab (Medicare and many commercial plans now cover post-stroke cardiac rehab)	Weeks 2–8: acute rehab; Month 3–6: outpatient rehab tapering; Month 12: re-visit	stroke and weight loss
New T2D diagnosis	5–15 percent in year 1; type-2-diabetes remission is possible with 10–15 percent loss in first-5-year window (DiRECT trial, and see type-2 diabetes remission and weight loss)	DSMES (CDC-recognized, insurance-covered post-diagnosis); registered dietitian (3+ visits); possibly GLP-1 or SGLT2 medication per care team	Week 2–4: DSMES start; Month 3: HbA1c re-check; Month 6: full re-evaluation	diabetes and weight loss, type-2 diabetes remission and weight loss
New cancer diagnosis	Weight-loss is not always the target — some cancer treatments require weight maintenance or gain; discuss with oncology team before setting a target	Oncology-affiliated dietitian; possibly oncology-rehab program (increasingly available); therapist for adjustment (30–40 percent of newly-diagnosed patients experience clinically significant distress)	Depends on treatment plan — do not start a deficit during active chemo/radiation without oncology sign-off	cancer and weight loss
Severe sleep-apnea diagnosis (AHI ≥ 30 or moderate + cardiometabolic comorbidity)	10 percent loss can meaningfully reduce AHI and CPAP requirement; a small subset achieves remission	CPAP adherence tracking (aim ≥ 4 h/night ≥ 5 nights/week); sleep-medicine follow-up at 3 mo; dietitian; possibly GLP-1 given the strong sleep-apnea-and-weight comorbidity data	Week 1–4: CPAP titration; Month 3: follow-up sleep study or telemedicine check; Month 6: consider weight-target progress	sleep apnea and weight loss

If more than one row applies — a new T2D diagnosis in a post-MI patient, a stroke in a patient with previously untreated sleep apnea, a cancer diagnosis in a patient with metabolic syndrome — the driver stack is heavier than either row alone, and the priority is to work with each specialty team on their protocol first, then layer the behavioral scaffold from this pillar underneath.

Ask-for-the-referral checklist

The single most under-utilized intervention post-diagnosis is the referral you did not ask for. Print this or screenshot it and bring it to the follow-up appointment.

Cardiac rehab — post-MI, post-CABG, post-stent, post-heart-failure-hospitalization, post-valve-surgery, and (in most Medicare and many commercial plans as of 2024) post-stroke. 12-week supervised exercise plus education. Insurance-covered in almost all cases. Ask for the referral even if it is not offered. If insurance denies, appeal — the majority of initial denials are overturned.
Pulmonary rehab — post-COPD exacerbation, post-severe-pneumonia in COPD patients, some interstitial lung disease. Same model as cardiac rehab.
DSMES (Diabetes Self-Management Education and Support) — post-T2D diagnosis, post-T1D diagnosis, post-gestational-diabetes for high-risk women. CDC-recognized programs are covered by most insurance and Medicare.
National DPP (Diabetes Prevention Program) — post-prediabetes diagnosis. CDC-recognized, Medicare-covered (as MDPP), often free through insurance, YMCA, or employer wellness plans.
Registered dietitian (MNT visits) — typically 3 visits covered post-cardiac-event, T2D diagnosis, or bariatric consult; often more with a chronic-disease diagnosis. Medicare Part B covers MNT for diabetes and chronic kidney disease.
Therapist (behavioral health) — post-event depression, health anxiety, PTSD-like reactions to ICU or code-blue events, cancer-diagnosis distress. PHQ-9 and GAD-7 at the follow-up. See depression and weight loss for the therapy-access playbook.
MTM (Medication Therapy Management) — via your pharmacist. Often free with insurance. Reviews all medications for interactions, weight effects, timing, and adherence barriers. Useful post-diagnosis when the medication list has doubled.
Social work — hospital social workers can connect to transportation for rehab visits, meal-delivery programs (Meals on Wheels, Mom’s Meals, God’s Love We Deliver, oncology-specific programs), and financial-assistance for medications. Often the highest-leverage referral post-hospitalization.
Home health — post-hospitalization, often covered by Medicare for a few weeks; includes physical therapy, occupational therapy, and nursing.
Peer support / group — Mended Hearts (post-cardiac), stroke survivor groups, ADA / JDRF for diabetes, cancer-specific support (LivingBeyondBreastCancer, Cancer Support Community, Gilda’s Club).

If the doctor forgets, ask. If the referral is denied by insurance, appeal — cardiac-rehab appeals overturn a majority of initial denials, and DSMES denials are almost always administrative errors that reverse on appeal.

Implementation intentions — the Gollwitzer method

Sheeran 2016 (Health Psychology) meta-analyzed the intention-to-behavior gap and found that even after high-motivation events, roughly 40–50 percent of formed intentions never translate to sustained behavior. The single best-documented technique to close the gap is implementation intentions — Gollwitzer 1999 (American Psychologist) — ‘if-then’ rules that pre-decide the behavior in advance of the moment.

Generic intention: I want to walk more.

Implementation intention: If it is 7 pm on a weeknight, I will walk for 20 minutes before dinner.

The if-then form roughly doubles the success rate of a formed intention (Gollwitzer 1999, replicated across dozens of trials in the decades since). The mechanism is that the if creates a mental cue that fires automatically when the situation arises, so the behavior does not have to be re-decided each time.

Write three implementation intentions in the open window and put them somewhere visible. Worked examples:

If it is 7 pm on a weeknight, I will walk for 20 minutes before dinner.
If I am at the coffee shop, I will order the small oat-milk latte instead of the muffin.
If it is Sunday afternoon, I will pre-cut vegetables and portion three lunches for the week.
If I have not walked by 4 pm, I will walk during the next commercial break or after the next email.
If my spouse is watching TV alone, I will join them for the walk instead of the second glass of wine.
If it is Monday morning, I will step on the scale once and write the number in the notebook.

Do not write ten. Three is the durable number.

The family caregiver angle

A health scare is a two-person event. Umberson 2019 documents that a spouse or adult child typically changes behavior alongside the patient — and often needs to, because one household kitchen serves both. The caregiver’s own weight often drifts up during the acute-caregiving phase from stress, disrupted sleep, and takeout convenience.

Do not build two food streams. The ice cream out of the freezer, the frozen vegetables in, the anchor breakfast the same for both of you. Separate meal streams collapse within weeks because the caregiver eventually eats the ice cream at 10 pm alone. One kitchen, one plan, minor variations.
Anchor one shared behavior daily. Usually a 20-minute walk together after dinner, which doubles as connection time and takes the pressure off scheduled conversation about the scare itself.
Let the patient ask for what they need in one specific line. ‘I need the ice cream out of the freezer for 3 months’ beats ‘I need you to be more supportive.’ A specific ask can be met; a general ask cannot.
Protect the caregiver’s own weight, sleep, and mental health. A collapsed caregiver serves nobody. If the caregiver’s PHQ-2 is ≥ 3 or they are drinking daily to cope, that is a therapist referral this week, not next month. See weight loss and caregiver stress for the wider read.
Make room for the anniversary reactions. The 3-month, 6-month, and 1-year marks often trigger both the patient’s and the caregiver’s mood dip, and that dip is when the household eating and drinking pattern tends to drift.

Do NOT stop prescribed medications

Do not stop statins, metformin, blood-pressure medications, GLP-1s, insulin, anticoagulants, antiplatelets, or any prescribed medication because weight is falling and you feel better. This is the single most important line in this pillar. Weight loss helps most of the conditions covered here — cardiovascular disease, T2D, sleep apnea, fatty liver, metabolic syndrome — but weight loss is not a substitute for prescribed medication in the acute post-diagnosis window. Statins reduce cardiovascular mortality independent of LDL improvement in secondary-prevention patients. Metformin has long-term cardiovascular and possibly oncologic benefits beyond glycemic control. Blood-pressure medications should be titrated as blood pressure falls with weight loss — under a prescriber’s supervision, not by stopping. GLP-1s discontinued abruptly typically produce weight regain within 6–12 months. Any medication change is a conversation with the prescriber, ideally with a follow-up appointment specifically to review the medication list against the new weight and lab values. Bring the list. Ask the question. Do not stop without discussion.

When the scare does not translate

This is normal. Ockene 2000 shows most post-MI patients are not the NWCR-maintainer subtype at 24 months. A returned pattern is not moral failure — it is the base rate of a very hard behavioral change. The re-entry protocol:

Do not treat the regression as evidence that the scare “didn’t work.” The triggering event permanently changed the risk profile even if the behavior has drifted. The cardiac event happened; the diagnosis is real; the medication is still doing work.
Re-read the anchor artifact — the words you wrote down in the open window are still true. If the artifact is unfindable, write a new one now.
Book a follow-up with your primary care doctor, framed as ‘I want to re-engage with the secondary-prevention plan we set up.’ This is a routine visit for the doctor, not a confession.
Re-request the referrals. Cardiac rehab can often be re-entered up to 12 months post-event. DPP has multiple entry cohorts per year. Dietitian benefits usually renew annually.
Look for the anniversary triggers that likely drove the drift. The 3-month, 6-month, 12-month, and 24-month marks are documented dip points. A scheduled booster at those points is more durable than “I’ll just try harder.”
Screen for depression. Post-event depression is a documented adherence-collapse driver (Rosal 2001, Annals of Behavioral Medicine), and untreated it makes every other change harder. Run PHQ-2 today. See depression and weight loss for the therapy-access playbook.

The maintainer subgroup is not the group that never regressed. It is the group that re-entered after a regression — sometimes several times — until the pattern stuck.

What NOT to do

Do not start an aggressive VLCD (very-low-calorie diet) or an extreme restriction in Weeks 0–2 during the shock phase. Self-regulation bandwidth is very low, sleep is disrupted, and the risk of a lapse-and-abandonment cascade is highest here. The Ockene 2000 24-month decay is measured against a starting baseline, not a Week-2 crash-diet baseline that was already unsustainable.
Do not commit to a program the household cannot sustain. A $300/month meal service that ends in month 4 is worse than a sustainable free plan. Budget the intervention for at least 12 months, not for the acute-post-diagnosis emotional peak.
Do not conflate weight loss with disease reversal. Weight loss helps most of these conditions, sometimes dramatically — T2D remission is real, sleep apnea can improve, cardiovascular risk falls — but it is not the same as medication management. Do not stop statins, metformin, blood-pressure meds, GLP-1s, insulin, or anticoagulants without prescriber discussion, even if weight is falling.
Do not skip the follow-up appointment because “I feel fine now.” The 3-month and 12-month follow-up is where secondary-prevention resources are re-offered, medications are re-titrated to the new weight and lab values, and the referrals you did not use are re-available.
Do not treat regression as moral failure. The base rate of regression is high; the Wing 2005 maintainer subgroup is a minority. Re-entry is normal and works. See the section above.
Do not try to build all five Kwasnicka mechanisms in Week 1. Motives are already there from the trigger. Add self-regulation (one tracked behavior) and habits (two installed cues) in Week 3–6. Add resources (referrals) and environment (household cleanup) in Week 4–8. Do not stack.
Do not isolate. The Wanberg 2012 social-contact literature and the Rosal 2001 CBT literature converge on social contact and support as durable adherence drivers. Cardiac rehab, DPP, and support groups are social interventions as much as they are physical ones.
Do not stop CPAP the first week you feel less tired. Sleep-apnea CPAP adherence at 3 months predicts long-term cardiovascular outcomes; the first-week tolerance issues resolve, but abandoning CPAP in week 1 typically means it is not restarted.
Do not let a well-meaning family member’s fear-based pressure drive an unsustainable plan. ‘You have to change your entire life today’ is well-intentioned and predictably counterproductive. The scaffold, not the sprint, is what the Wing 2005 maintainer data supports.

When to talk to a professional

Health anxiety after a scare is common and treatable. If checking blood pressure or heart rate 20+ times a day, avoiding physical activity out of fear of another event, or reading symptom-search results for hours weekly is disrupting daily life, that is a therapist referral (CBT for health anxiety has strong evidence).
Post-event depression is underdiagnosed. Run a PHQ-2 now (2-item depression screen: ‘Over the last 2 weeks, how often have you been bothered by little interest or pleasure in doing things?’ and ‘feeling down, depressed, or hopeless?’ — 0 not at all, 1 several days, 2 more than half the days, 3 nearly every day; total ≥ 3 is a positive screen). If positive, that is a primary-care or therapist referral this week. Rosal 2001 documented that untreated post-cardiac-event depression is a major adherence-collapse driver.
PTSD-like reactions to ICU stays, code-blue events, or acute-hospitalization trauma are common and often unrecognized. Nightmares, flashbacks, avoidance of medical settings, hyperarousal — that is a primary-care referral and possibly an EMDR-trained or trauma-focused CBT therapist.
Any thoughts of self-harm or suicide — call or text 988 immediately (US Suicide & Crisis Lifeline).
Restrict-binge cycling, hiding food, or using vomiting or laxatives to compensate for stress-eating episodes — NEDA helpline 1-800-931-2237. Post-diagnosis restrictive dieting occasionally reveals a latent eating disorder; the ED specialist is the right first call.
Cardiac rehab, DPP, DSMES, and dietitian referrals — ask for these at every follow-up until they are set up. See the checklist above.
Substance-use pattern change post-diagnosis — alcohol or nicotine use rising as a coping mechanism — SAMHSA 1-800-662-HELP (4357), free and confidential 24/7.

Cross-links

Cardiovascular disease and weight loss — the clinical protocol for post-MI, post-CABG, post-stent, and secondary-prevention weight-loss targets, cardiac-rehab detail, and the medication interactions.
Stroke and weight loss — the clinical protocol for post-stroke rehabilitation, hemiparesis-adapted exercise, and secondary-prevention weight targets.
Diabetes and weight loss — the clinical protocol for T2D, insulin management, and weight-loss targets.
Type-2 diabetes remission and weight loss — the DiRECT-trial-style remission protocol and the first-5-year remission window.
Sleep apnea and weight loss — the clinical protocol for CPAP adherence, weight-loss targets that reduce AHI, and the sleep-apnea-and-weight comorbidity loop.
Cancer and weight loss — the clinical protocol for weight management during and after cancer treatment; note that weight-loss is not always the target.
Heart failure and weight loss — the clinical protocol for weight management in HFrEF and HFpEF, with fluid-vs-fat weight distinction and the diuretic interaction.
Weight loss motivation — the wider motivation-and-adherence literature, and the tools for when motivation fades.
Habit formation for weight loss — the Lally 2010 66-day median, the cue-window mechanism, and the habit-stacking protocol.
Weight loss and caregiver stress — the caregiver’s own weight and mental-health defense.
Depression and weight loss — the clinical depression overlay, the antidepressant-and-weight-change primer, and the therapy-access playbook.

References

Wing RR, Phelan S. 2005. Long-term weight loss maintenance. American Journal of Clinical Nutrition — NWCR National Weight Control Registry analysis; ~70 percent of maintainers cite a triggering event.
Ockene IS, Hayman LL, Pasternak RC, Schron E, Dunbar-Jacob J. 2000. Adherence issues and behavior changes: achieving a long-term solution. Archives of Internal Medicine — post-MI adherence trajectory.
Newman AM et al. 2013. Cardiac rehabilitation: attendance and outcomes. Circulation — 3-year survival benefit and ~35 percent attendance rate.
Prochaska JO, DiClemente CC. 1983. Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology — Transtheoretical Model.
Prochaska JO. 2008. Decision making in the transtheoretical model of behavior change. American Journal of Health Promotion — precontemplation-to-action window.
Kwasnicka D, Dombrowski SU, White M, Sniehotta F. 2016. Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories. Health Psychology Review — 5-mechanism framework.
Hussain T, Franz M, Fujioka K, Pi-Sunyer FX. 2011. Type 2 diabetes: management and outcomes. Diabetes Care — newly-diagnosed T2D behavioral response and adherence data.
Chen J et al. 2017. Lifestyle interventions after stroke. Stroke — post-stroke weight-loss outcomes with structured secondary prevention.
Rosal MC, Ockene JK, Ma Y, Hebert JR, Merriam PA, Matthews CE, Ockene IS. 2001. Behavioral risk factors among members of a health maintenance organization. Annals of Behavioral Medicine — post-cardiac-event CBT outcomes.
Fisher L, Coups EJ. 2010. Cancer diagnosis as a behavior-change trigger. American Journal of Public Health — sustained dietary change post-cancer-diagnosis.
Miller WR, Rollnick S. 2013. Motivational Interviewing: Helping People Change, 3rd edition. Guilford Press.
Sheeran P, Webb TL. 2016. The intention-behavior gap. Health Psychology — meta-analysis of intention-to-behavior translation.
Gollwitzer PM. 1999. Implementation intentions: strong effects of simple plans. American Psychologist — if-then framing and ~2x success rate.
American Heart Association 2024 Statistical Update — cardiac-rehab enrollment, secondary-prevention adherence, and outcomes data.
Lally P, van Jaarsveld CHM, Potts HWW, Wardle J. 2010. How are habits formed: modelling habit formation in the real world. European Journal of Social Psychology — median 66-day habit-formation time.
Duhigg C. 2012. The Power of Habit — cue-window principle (popular synthesis).
Centers for Disease Control and Prevention 2024 — chronic-disease trigger-event statistics, DPP and DSMES data.

Educational content only. Not a substitute for medical, mental-health, cardiac-rehabilitation, or oncology advice. Do not stop prescribed medications without discussing with your prescriber. If you are in crisis, call or text 988 (US Suicide & Crisis Lifeline). For eating-disorder support, call NEDA at 1-800-931-2237. For substance-use support, call SAMHSA at 1-800-662-HELP (4357). For food, rent, or utility emergency, call 211.