Urology Pearls: How habits work
MADJAR
When Odysseus, king of Ithaca, sails past the island of the Sirens, he longs to hear their irresistible song. He knows their voices have lured sailors to their death, and that if he listens, he will steer his ship onto the rocks. His solution is clever: he orders his crew to plug their ears with wax and tie him tightly to the mast.
The Odyssey is part of Greek mythology. The Sirens’ story appears in Homer’s epic, composed nearly 2,800 years ago, yet its message still resonates and can be applied to healthy habit formation: when it comes to temptation, willpower alone isn’t enough. Beyond commitment, you need structures, systems, and strategy.
Modern psychology has rediscovered this lesson. Habits work to reduce the daily burden of willpower and blunt the power of temptations. As James Clear describes in Atomic Habits (2018), every behavior follows a loop: cue → craving → response → reward. A cue sparks desire; craving drives the response; the reward reinforces the loop. Repeated often enough, the loop engrains itself into our daily life.
James Clear popularized the idea, but elements of it appear in earlier medical literature, where the emphasis was on habits leading to better health. In 2012, Benjamin Gardner, Phillippa Lally, and Jane Wardle published Making health habitual: the psychology of ‘habit-formation ‘and general practice in the British Journal of General Practice. They argued that rather than telling patients only what to change (lose weight, exercise more), clinicians should also explain how to turn those changes into habits. They offered a practical toolkit: pick a simple behavior, anchor it to a consistent cue, repeat it daily in the same context, and track its automaticity over time.
Here is an example of a simple recommendation for behavioral change: right after washing the dinner dishes in the evening (the cue), prepare a healthy snack for the next day, pack your gym bag, and place it by the door. Then track your caloric intake and daily steps. Weigh yourself each morning and keep a record of your progress.
Seven years later, in 2019, Gardner and colleagues expanded the discussion in an article in Health Psychology Review. They acknowledged how much we still don’t know about habits but also emphasized what we have already learned: start with small, specific habits; build them around consistent cues; design your environment to make healthy cues obvious and unhealthy ones invisible; choose enjoyable, rewarding behaviors; and replace unhealthy habits with better substitutes. Above all, recognize that forming good habits takes time, so be patient.
This latter point is illustrated in a 2009 study by Phillippa Lally and colleagues in the European Journal of Social Psychology. On average, it took about 66 days for a new healthy behavior to feel automatic, with a range of 18 to 254 days. A recent systematic review (2024) confirmed that median times to habit formation hover between 59 and 66 days, though in some cases the process can take almost a year.
My own experience mirrors the science. Good habits grow when I make them easy, attractive, and satisfying. I’ve always enjoyed walking, but when I wanted to walk more, I placed my shoes, sunglasses, and hat by the door the night before–the cue was waiting for me. I chose a route past the lake because the view was rewarding enough to keep me going. When I wanted to add resistance training, I joined a gym five minutes from home–no excuses about travel time–hired a trainer to keep me informed and motivated, and tracked my progress in a simple notebook. Each small success created a craving for the next.
The same principles worked in my diet. On the evenings before workdays, I prepared overnight oats–an easy-to-grab, nutritious meal. I placed a bowl of fruit where I could see it. I made healthy foods attractive by following simple, flavorful recipes, and I paid attention not only to taste and texture but to presentation. The joy of healthy meals has replaced the craving for junk food.
Bad habits, I discovered, thrive when they are easy, attractive, and immediately rewarding. The cookie jar on the counter is a cue; the craving is automatic; the response is a hand reaching out; the reward is a burst of sugar and comfort. To weaken such habits, I had to reverse the loop: make the cue invisible, the craving less tempting, the action inconvenient, and the reward delayed or absent. I stopped storing ice cream in my freezer. The Sirens were silenced, the ice cream no longer screaming, Come get me! If I wanted ice cream, I had to drive to the store–or better yet, walk to a parlor downtown–and most nights laziness saved me from myself.
Taken together, Odysseus’s ropes, Clear’s habit loop, Gardner’s clinical advice, and my own experience all point in the same direction. Willpower is fragile, but structures give us strength. Habits form slowly, unevenly, but reliably when repeated across weeks and months. In dieting, in walking, in resistance training, and in weight maintenance, the challenge is not to muster heroic discipline for a short burst, but to build small loops that repeat until they become part of who we are.




