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Your Weight Is As
Important To Us As It Is To You!
Over the past few years it has become clear that
weight is an important health issue. Being overweight is a risk factor for
health problems such as diabetes, high blood pressure, high cholesterol and
triglycerides, arthritis, gall bladder disease, gynecologic problems, some
cancers, and even lung problems. Some people who need to lose weight for their
health don't recognize it, while others who don't need to lose weight, want to
get thinner for cosmetic reasons. We understand that in some ways your weight is
different from, for example, your cholesterol level or your blood pressure,
because you can't see what these are by looking at someone. Many patients have
had health-care providers who approached their weight in a less-than-sensitive
or helpful manner. Some patients may have had health-care encounters in which
they felt blamed, but not helped. Please be assured that when we bring up your
weight, it's because we know that this is an important aspect of your overall
health care. We understand, though, that successful weight management is a
long-term challenge.
By the same token, we may discuss weight goals
that are different from those you select. Weight can affect a person's
self-esteem. Excess weight is highly visible and evokes some powerful reactions,
however unfairly, from other people and from the people who possess the excess
weight. The amount of weight needed to improve your health may be much less than
you wish to lose when you consider how you evaluate your weight. If we suggest
an initial weight goal that seems too heavy for you, please understand that our
major emphasis is on your health and that your health can be greatly improved by
a loss of 5-10 percent of your starting weight. That doesn't mean you have to
stop there, but it does mean that an initial goal of losing 5-10 percent of your
starting weight is both realistic and valuable.
Behaviors That Will Help You
Lose Weight and Maintain It
Set The Right Goals
Setting the right goals is an important first step. Most people trying to lose
weight focus on just that one goal: weight loss. However, the most productive
areas to focus on are the dietary and exercise changes that will lead to that
long-term weight change. Successful weight managers are those who select two or
three goals at a time that they are willing to take on, that meet the following
criteria of useful goals:
Effective goals are 1) specific; 2) attainable;
and 3) forgiving (less than perfect). "Exercise more" is a commendable ideal,
but it's not specific. "Walk five miles everyday" is specific and measurable,
but is it attainable if you 're just starting out?" Walk 30 minutes every day"
is more attainable, but what happens if you're held up at work one day and
there's a thunderstorm during your walking time another day? "Walk 30 minutes,
five days each week" is specific, attainable, and forgiving. In short, a great
goal!
Nothing Succeeds Like Success
Shaping is a behavioral technique in which you
select a series of short-term goals that get closer and closer to the ultimate
goal (e. g., an initial reduction of fat intake from 40% of calories to 35% of
calories, and later to 30%). It is based on the concept that "nothing succeeds
like success." Shaping uses two important behavioral principles: 1) consecutive
goals that move you ahead in small steps are the best way to reach a distant
point; and 2) consecutive rewards keep the overall effort invigorated.
Success (But Not With Food)
Rewards that you control can be used to
encourage attainment of behavioral goals, especially those that have been
difficult to reach. An effective reward is something that is desirable, timely,
and contingent on meeting your goal. The rewards you administer may be tangible
(e. g., a movie or music CD or a payment toward buying a more costly item) or
intangible (e. g., an afternoon off from work or just an hour of quiet time away
from family). Numerous small rewards, delivered for meeting smaller goals, are
more effective than bigger rewards, requiring a long, difficult effort.
Balance Your (Food) Checkbook
Self-monitoring refers to observing and
recording some aspect of your behavior, such as calorie intake, servings of
fruits and vegetables, exercise sessions, medication usage, etc., or an outcome
of these behaviors, such as weight. Self-monitoring of a behavior can be used at
times when you're not sure how you're doing, and at times when you want the
behavior to improve. Self-monitoring of a behavior usually changes the behavior
in the desired direction and can produce " real-time" records for review by you
and your health care provider. For example, keeping a record of your exercise
can let you and your provider know quickly how you're doing, and when the record
shows that your exercise is increasing, you'll be encouraged to keep it up. Some
patients find that specific self-monitoring forms make it easier, while others
prefer to use their own recording system.
While you may or may not wish to weigh yourself
frequently while losing weight, regular monitoring of your weight will be
essential to help you maintain your lower weight. When keeping a record of your
weight, a graph may be more informative than a list of your weights. When
weighing yourself and keeping a weight graph or table, however, remember that
one day's diet and exercise patterns won't have a measurable effect on your fat
weight the next day. Today's weight is not a true measure of how well you
followed your program yesterday, because your body's water weight will change
much more from day to day than will your fat weight, and water changes are often
the result of things that have nothing to do with your weight-management
efforts.
Avoid A Chain Reaction
Stimulus (cue) control involves learning what
social or environmental cues seem to encourage undesired eating, and then
changing those cues. For example, you may learn from reflection or from
self-monitoring records that you're more likely to overeat while watching
television, or whenever treats are on display by the office coffee pot, or when
around a certain friend. You might then try to sever the association of eating
with the cue (don't eat while watching television), avoid or eliminate the cue
(leave coffee room immediately after pouring coffee), or change the
circumstances surrounding the cue (plan to meet with friend in non-food
settings). In general, visible and accessible food items are often cues for
unplanned eating.
Get The (Fullness) Message
Changing the way you go about eating can make it
easier to eat less without feeling deprived. It takes 15 or more minutes for
your brain to get the message you've been fed. Slowing the rate of eating can
allow satiety (fullness) signals to begin to develop by the end of the meal.
Eating lots of vegetables can also make you feel fuller. Another trick is to use
smaller plates so that moderate portions do not appear meager. Changing your
eating schedule, or setting one, can be helpful, especially if you tend to skip,
or delay, meals and overeat later. |
